The Effect of Surface Electric Stimulation of the Gluteal Muscles on the Interface Pressure in Seated People With Spinal Cord Injury Andrea van Londen,

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The Effect of Surface Electric Stimulation of the Gluteal Muscles on the Interface Pressure in Seated People With Spinal Cord Injury Andrea van Londen, MSc, Mariska Herwegh, MSc, Carlijn H. van der Zee, MSc, Andreas Daffertshofer, PhD, Christof A. Smit, MD, Annelieke Niezen, PT, MSc, Thomas W. Janssen, PhD Archives of Physical Medicine and Rehabilitation Volume 89, Issue 9, Pages 1724-1732 (September 2008) DOI: 10.1016/j.apmr.2008.02.028 Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 1 FSA profiles for 1 participant. The left panels show a 2-dimensional map of interface pressure (ie, a top view); the right panels show a 3-dimensional pressure profile. Images are oriented with the thighs pointing downward. (A) Pressure profile during a rest period of the simultaneous stimulation protocol. The blue and green square indicate the left and right tuber area. The red square denotes the sensors used in computing the pressure gradient. (B) Pressure profile during a stimulation period of the simultaneous stimulation protocol. Archives of Physical Medicine and Rehabilitation 2008 89, 1724-1732DOI: (10.1016/j.apmr.2008.02.028) Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 2 (A) Interface pressure profiles and (B) the corresponding fit for 1 participant. Images are oriented with the thighs pointing upward to the left. Archives of Physical Medicine and Rehabilitation 2008 89, 1724-1732DOI: (10.1016/j.apmr.2008.02.028) Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 3 Gauss curve with (A) a small and (B) a large SD. A narrow Gauss curve corresponds to a low value for the pressure spread (left). The tissue in this area might be at risk for developing pressure ulcers, because the greater part of the interface pressure is supported by a relatively small area and because a rapid decline in pressure over a small distance is associated with a large shear force within the buttocks. Archives of Physical Medicine and Rehabilitation 2008 89, 1724-1732DOI: (10.1016/j.apmr.2008.02.028) Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 4 Time series of the interface pressure during the (A) alternating and (B) simultaneous stimulation protocol for 1 participant. Archives of Physical Medicine and Rehabilitation 2008 89, 1724-1732DOI: (10.1016/j.apmr.2008.02.028) Copyright © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions