Sanjeev Agarwal

Publications (2)3.89 Total impact

• Article: Functional electrical stimulation for walking in paraplegia: 17-year follow-up of 2 cases.

  Sanjeev Agarwal, Rudi Kobetic, Sanjay Nandurkar, E B Marsolais
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  ABSTRACT: To assess the safety and effectiveness of long-term use of functional electrical stimulation (FES) for exercise, standing, and walking in individuals with paraplegia, using percutaneous intramuscular wire electrodes. Case study with more than 17 years of follow-up. Institutional rehabilitation practice. Two long-term (17 years) volunteer participants with paraplegia who were able to stand and walk using FES. Chronically indwelling percutaneous intramuscular wire electrodes connected to a portable microprocessor-controlled stimulator were used to exercise muscles while controlling trunk, hips, knees, and ankles and develop activation patterns to produce standing and walking. Clinical complications, electrode performance and survival probability, and functional performance. The most noted clinical complications included localized inflammation at the electrode site and superficial infection that responded well to topical and oral antibiotic treatment. The change from coil-wire electrodes, with a survival of 35% after 1 year, to double-helix electrodes improved electrode survival to 80% at 1 year and 48% at 5 years. Maintenance of the multichannel percutaneous FES walking system required replacement of an average of 2 electrodes every 6 months. Participants were able to use their system for independent exercise and standing and for walking with standby assistance. Although the FES system was devised as a temporary means of achieving functional activation until permanent means could be achieved, it was found to be effective and relatively safe for more than 17 years. Two long-time users of the system had no adverse effects to their skeletal system. The most common problems were daily care of electrodes at exit sites, frequent irritation of the skin around electrodes, and replacement of failed electrodes. The percutaneous system has the potential for short-term rehabilitation in individuals with incomplete paraplegia or stroke.
  The journal of spinal cord medicine 02/2003; 26(1):86-91. · 2.11 Impact Factor
• Source

  Available from: Rudi Kobetic

  Article: Long-term user perceptions of an implanted neuroprosthesis for exercise, standing, and transfers after spinal cord injury.

  Sanjeev Agarwal, Ronald J Triolo, Rudi Kobetic, Michael Miller, Carol Bieri, Sahana Kukke, Lori Rohde, John A Davis
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  ABSTRACT: This study was completed to understand the usage patterns, system performance, degree of satisfaction, complications, and health benefits as perceived by recipients of a surgically implanted neuroprosthesis for exercise, standing, and transfers in individuals with low-cervical or thoracic spinal cord injury (SCI). A standardized telephone survey was administered to 11 recipients of the Case Western Reserve University/Veterans Affairs (CWRU/VA) implanted standing neuroprosthesis with more than 12 months of experience with the functional electrical stimulation (FES) system. Nine implant recipients were using the neuroprosthesis regularly for standing and/or exercising at the time of the survey. All 11 implant recipients noted improved health and a reduced incidence of pressure sores, leg spasms, and urinary tract infections (UTIs). No incidents of deep-vein thrombosis, infection, cellulitis, or electrical burns because of the neuroprosthesis were noted. System recipients uniformly felt that the neuroprosthesis resulted in better overall health and general well-being. Subjects were moderately to very satisfied with the performance of the neuroprosthesis and unanimously expressed a willingness to repeat the surgery and rehabilitation to obtain the same clinical outcome. All implant recipients reported the system to be safe, reliable, and easy to use. The implanted standing neuroprosthesis appears to be a clinically acceptable and effective means of providing the ability to exercise, stand, and transfer to selected individuals with paraplegia or low tetraplegia.
  The Journal of Rehabilitation Research and Development 40(3):241-52. · 1.78 Impact Factor