Letter: Help for those with spinal cord injuries

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Sir: Following Julie Newing's article 'Doctor, let me shake your hand' (24 August), there are several points we would like to clarify and expand upon. As she states, there is a difference between using the technique of neuromuscular stimulation with stroke patients and those with complete spinal cord injuries (SCI). However, the use of the word 'unsatisfactory' in describing the use of the technique with people with SCI is rather misleading.

It is certainly far more difficult, and hence a longer-term project, to achieve independent walking for those with SCI than for certain stroke patients. Therefore, most of our work with those with SCI to date has been to develop systems to enable people to stand up from their wheelchair (eg, to reach objects on shelves), rather than to proceed directly to the more emotive aim of achieving walking.

We are also investigating the effect of neuromuscular stimulation on muscle, blood flow, skin condition and spasticity. Some of these results, although less glamorous than walking, could make a considerable difference to those with a spinal cord injury.

Although the equipment is not ideal - using electrodes on the surface of the skin rather than being internally implanted - there are still 12 subjects who have taken the 'standing system' home. This work is funded by the Department of Health and we have applied to it for additional support. It is hoped that the joint project with University College and Stanmore, funded by the Medical Research Council, will overcome some of these problems, making the system more clinically acceptable and easy to use.

Yours faithfully,


District Medical Physicist



Duke of Cornwall Spinal

Treatment Centre

Odstock Hospital

Salisbury, Wiltshire

27 August