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Objective: In a large, single-center study of subjects with acute traumatic spinal cord injury (SCI), we describe the sample population with respect to gender, age, cause of injury, and severity of injury, to see whether these properties are similar to those of other large-scale studies of acute SCI conducted in the past., Methods: As part of a study to examine the natural pattern of recovery after acute SCI (presented elsewhere), descriptive information was gathered in relation to subject population and injury properties., Results: A total of 229 subjects were recruited. The study population had a higher percentage of women and a higher mean age of men and women than those of most other published studies of acute SCI. A greater percentage of incomplete subjects was also encountered. The incidence of gunshot injury as a cause of SCI was considerably lower in this study than had been the case 10 years previously in Dade County, Florida., Conclusions: The demography of acute SCI within a major urban center of South Florida suggests a trend toward less severe injury than in years past. These findings support the development of animal models for testing SCI treatment that include cohorts having mild to moderate injury severity, in order to achieve greater clinical relevance.

Objective: The purpose of this study was to compare the electromyography (EMG) score during contraction of a given muscle to the independently measured manual muscle test (MMT) score for that same muscle (or muscle group), to determine whether EMG measures could serve as a reasonable approximation of muscle contraction force in persons with acute spinal cord injury (SCI)., Methods: We examined the strength of relationship between surface-recorded EMG and estimated muscle strength using the MMT in a population of 45 subjects with acute (<1 week) traumatic SCI. Eight different muscle groups were compared in each individual; measures were repeated on these subjects approximately 2 months later. A 6-point numeric index was used for assignment of EMG scores, all of which were done in a blinded fashion by 1 investigator from tape-recorded evaluations., Results: Nearly all of the individual muscle comparisons led to positive and significant (P < .01) correlations between EMG and MMT scores, at both the acute and subacute time points following injury., Conclusions: These findings support the use of EMG scoring as an indicator of recovery of volitional strength following SCI in a given subject. However, caution must be used when attempting to extrapolate EMG scores to absolute forces or when comparing EMG scores among different subjects.

A device is described which combines arm crank ergometry and neuromuscular electrical stimulation (NMS) delivered at different phases of the crank cycle. Details of the device including circuit schematics are shown. The device was evaluated by non-paralyzed subjects for its operational safety and by tetraplegic subjects for its effectiveness as a muscle-strengthening tool. All subjects showed improvement in one or more of their manual muscle scores. The most dramatic increased motor score occurred in the triceps muscle group. There was an average increase in the manual muscle score of 1.1 +/- 0.2 for the left triceps and 0.7 +/- 0.1 for the right triceps after eight weeks of NMS assisted exercise. No adverse effects were experienced and it appears to meet safety considerations necessary for this group of individuals. Preliminary observations indicate that an eight-week exercise protocol that utilizes this device can be beneficial for this population.

The effectiveness of neuromuscular stimulation (NMS)-assisted arm ergometry for strengthening triceps brachii was evaluated in 34 cervical spinal cord injured persons. Group I (n = 12) received eight weeks of NMS-assisted ergometry. Group II (n = 11) received four weeks of NMS-assisted ergometry followed by four weeks of arm ergometry alone. Group III (N = 11) received only arm ergometry (control group). Seventeen of 24 muscles in Group I subjects had improved manual muscle test scores after eight weeks, compared with 10 of 22 Group II muscles and five of 22 Group III muscles. Including only muscles with initial scores < or = 3, Group I demonstrated significant improvements versus Group III after four weeks (p < .003) and after eight weeks (p < .0005) of exercise. A difference was also found between Groups II and III (p < .03) after eight weeks. These results suggest that NMS-assisted ergometry is effective for strengthening voluntary triceps muscle contractions in tetraplegics.