Electrical Stimulation During Gait Promotes Increase of Muscle Cross-sectional Area in Quadriplegics: A Preliminary Study

  • Daniela Cristina Carvalho de AbreuEmail author
  • Alberto CliquetJr.
  • Jane Maryan Rondina
  • Fernando Cendes
Original Article


Increases in muscular cross-sectional area (CSA) occur in quadriplegics after training, but the effects of neuromuscular electrical stimulation (NMES) along with training are unknown. Thus, we addressed two questions: (1) Does NMES during treadmill gait training increase the quadriceps CSA in complete quadriplegics?; and (2) Is treadmill gait training alone enough to observe an increase in CSA? Fifteen quadriplegics were divided into gait (n = 8) and control (n = 7) groups. The gait group performed training with NMES for 6 months twice a week for 20 minutes each time. After 6 months of traditional therapy, the control group received the same gait training protocol but without NMES for an additional 6 months. Axial images of the thigh were acquired at the beginning of the study, at 6 months (for both groups), and at 12 months for the control group to determine the average quadriceps CSA. After 6 months, there was an increase of CSA in the gait group (from 49.8 ± 9.4 cm2 to 57.3 ± 10.3 cm2), but not in the control group (from 43.6 ± 7.6 cm2 to 41.8 ± 8.4 cm2). After another 6 months of gait without NMES in the control group, the CSA did not change (from 41.8 ± 8.4 cm2 to 41.7 ± 7.9 cm2). The increase in quadriceps CSA after gait training in patients with chronic complete quadriplegia appears associated with NMES.


Spinal Cord Injury Functional Electrical Stimulation Gait Training Quadriplegia Body Weight Support 
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We thank the students and the subjects for their participation in the project and the FAPESP.


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Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  • Daniela Cristina Carvalho de Abreu
    • 1
    Email author
  • Alberto CliquetJr.
    • 2
  • Jane Maryan Rondina
    • 3
  • Fernando Cendes
    • 3
  1. 1.Biomechanics, Medicine and Rehabilitation of Locomotor System Department, Faculty of Medicine of Ribeirão PretoUniversity of São PauloRibeirão PretoBrazil
  2. 2.Orthopaedics Department, Faculty of Medical SciencesState University of CampinasCampinasBrazil
  3. 3.Neuroimage Laboratory, Faculty of Medical SciencesState University of CampinasCampinasBrazil

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