Exclusion Criteria: Functional electrical stimulation for walking (Parastep I System) is spectifically contraindicated and has no proven value for members with SCI with any of the following: Note: Aetna considers the FES exercise devices such as the FES Power Trainer, ERGYS, REGYS, Neuro EDUCATOR, STim Master Galaxy, RT200 Elliptical, RT300 FES Cycle Ergometer (also referred to as a FES bicycle), RT600 Step and Stand Rehabilitation Therapy System, and Spectra STIM to be exercise equipment.
Functional electrical stimulation has had some success in improving ventilatory function in adult patients with SCI (Glenn et al, 1984; Carter et al, 1987; Glenn et al, 1988).
Neuromuscular electrical stimulation (NMES) can be grouped into 2 categories: (i) stimulation of muscles to treat muscle atrophy, and (ii) enhancement of functional activity in neurologically impaired individuals.
These devices use electrical impulses to activate paralyzed or weak muscles in precise sequence and have been utilized to provide SCI patients with the ability to walk (e.g., The Parastep I System).
The microcomputer shapes, controls, and distributes trains of stimulation signals that trigger action potentials in selected peripheral nerves. The patient can don the system in less than 10 minutes. Klose et al (1997) described performance parameters and effects on anthropometric measures in SCI patients (13 men and 3 women) training with the Parastep I system.
Subjects with thoracic (T4 to T11) motor-complete SCI, mean age of 28.8 years, and mean duration post-injury of 3.8 years underwent 32 functional neuromuscular stimulation ambulation training sessions using the Parastep I System.