1 Theory and Background.- 1 The Theory and Background of Functional Electrical Rehabilitation.- and the Basic Animal Studies.- The Early Human Studies.- The Later Human Studies.- 2 Control of Extremity Motor Prostheses: The Motor Feedback Applications.- and Overview.- The Biological System.- Mathematical Modeling and the Closed-Loop Control of Skeletal Muscle.- Human Studies on Muscle Control.- 3 Control of Extremity Motor Prostheses: The Sensory Feedback Applications.- and Overview.- Upper Extremity Applications.- Lower Extremity Applications.- Effective Sensory Feedback Control.- 2 Stationary Exercise Rehabilitation.- 4 Stationary Exercise Rehabilitation: Introduction and Overview.- to Stationary Exercise Rehabilitation.- Cardiovascular Responses and Thermoregulation.- Cardiovascular Circulatory Dynamics with Quadriplegia.- 5 Acute Effects with the Leg Exerciser System: The Physiological Process.- to the Leg Exercise System.- Functional Electrical Exercise with the Leg Exercise System.- Blood Pressure and Heart Rate Responses with Leg Trainer Exercise.- 6 Acute Effects with the Exercise Bicycle System: The Physiological Process.- to the Exercise Bicycle System.- The Cardiorespiratory Stress Effects During Dynamic Exercise.- Functional Electrical Exercise with the Exercise Bicycle System.- 7 Chronic Exercise Effects: The Therapeutic Outcome.- Muscular Response with the Leg Exercise System.- Cardiovascular Circulatory Dynamics with the Exercise Bicycle System.- Muscular, Respiratory, and Cardiovascular Responses with the Exercise Bicycle System.- 3 Ambulatory Exercise Rehabilitation.- 8 Ambulatory Exercise Rehabilitation: Introduction and Overview.- Synopsis of Ambulatory Exercise Systems, Procedures, and Effects.- Overview of Ambulatory Exercise Rehabilitation.- 9 Ambulatory Exercise Systems.- Paraplegic Walking System.- Quadriplegic Walking System.- A Systems Approach to Physician-Prescribed FES Ambulation.- 10 Ambulatory Exercise Procedures and Effects.- Cardiopulmonary Effects During Quadriplegic Ambulation Exercise.- Psychological Effects with Quadriplegic Ambulation Exercise.- Training Effects with the Sensory Feedback System.- 4 Prescription of Functional Electrical Rehabilitation.- 11 The Medical Criteria: Physician Guidelines for Patient Participation.- Active Physical Therapy.- The Medical Criteria for Functional Electrical Rehabilitation.- A Computer Program for the Prescription of Functional Electrical Rehabilitation.- 12 The Functional Electrical Rehabilitation Patient Evaluation and Prescription Program.- Getting Started with the Functional Electrical Rehabilitation Program.- The Patient File Option.- The Evaluation File Option.- The Prescription File Menu.- Epilogue.
On one of my returns to California, I attended the "Disabilities Expo 88" at the Los Angeles Convention Center. Among the various marvels oftech nology for the wheelchair disabled were stair-climbing wheelchairs, self raising and lowering kitchen cabinetry, and even a completely accessible "dude ranch" experience. At the same time, as a guest of the Southern California Chapter of the National Spinal Cord Injury Association, I was part of a small booth (among the more than two hundred exhibitors) in which we had spinal cord injured people up and walking with a lower extremity bracing system (the reciprocating gait orthosis) used at the PEERS Spinal Injury Program in Los Angeles. I had a young man, a C6/7 level quadriplegic, walking with electrical muscle stimulation and lower extremity bracing. The system is reviewed in Chapter 8 of this book. As these "disabled" persons walked erect and upright among their wheel chair bound colleagues and took long, confident strides past exhibits extol ling the latest technological virtues of yet another "new" wheelchair (Fig. 1), I reflected on the paradox of it all. What a majority of these paralyzed people W0re really looking for was an alteration oftheir disability so that they could more normally function (in an unaltered environment). What the great majority of the exhibitors were offering was an alteration of the environment so that they could more normally function (with an unaltered disability).
The rehabilitation treatment discussed here is based on the electrical stimulation of paralyzed muscle to cause movement. Though relatively new and limited, it offers paralysis victims the hope of being able to function more normally than other treatment programs allow.