The article that I chose for my last critique focused on the use of electrical stimulation for treating spinal cord injuries to help reduce the normal muscle atrophy associated with such an injury. The successful use of electrical stimulation in preventing muscle atrophy has created the concept of Functional Electrical Stimulation (FES) which is defined as the “electrical stimulation of a muscle deprived of nervous control with view of providing a muscular contraction and producing a functionally useful movement”. Along with causing these functional contractions, functional electrical stimulation can also aide in pain reduction, improved blood flow, and bone growth among many other uses.
There were 26 subjects in this experiment, 14-15 weeks post-traumatic spinal cord injury. Lean body mass of the lower limbs were measured as well as the girth of the gluteal muscle region using dual energy X-ray absorptiometry. Control groups that did not receive the electrical stimulation lost 26.8% over the six months of the experiment while the groups that did receive electrical stimulation had much lower amounts of muscular atrophy. The study concludes that the treatment of electrical stimulation on patients with spinal cord injuries is beneficial in reducing the amount of atrophy and helping to reduce the catabolic process.
I agree with the study and its basic procedure, it does make sense for the treatment of a spinal injury with electrical stimulation to excite otherwise dormant muscle fibers. A spinal cord injury could be seen in athletics from a hard hit in the contact sport but I think it would be seen more often inn the general public from car accidents, falls, etc. The treatment involved in returning these two different populations to their daily activities will be very different. Athletes would usually be younger, more motivated, and can be pushed harder with various other treatments and exercise along with electrical stimulation. Athletes with a spinal cord injury could not afford several months of any amount of atrophy and would need to engage in significant therapeutic exercise throughout the treatment and recovery process as long as it is safe to do so. An older or less active patient could take a slower and less aggressive approach to rehabilitation with more passive treatments to reducing atrophy in the form of this functional electrical stimulation. Along with electrical stimulation, ultrasound or short wave diathermy could be used as well to help relieve pain, promote blood flow, and retain ROM. I am also a believer in acupressure, acupuncture, and massage to help the recovery process and the retarding of muscle atrophy. For every patient with spinal cord injury I would also recommend safe amounts of any type of exercise possible including cardiovascular (upper body with UBE or lower body, whichever possible), isometric exercises, and light isotonic exercises wherever possible. With these treatments, the patient can recover as quickly and effectively as possible and get back to their activities of daily living or sport.