Incomplete spinal cord damage: Spastic paretic paralysis

In spastic paretic patients the "rules of spinal locomotion", derived from animal experiments and found useful in human (Wernig & Müller, 1992; Wernig et al., 1995) need to be applied. These include: Full extension of knee and hip joint with full loading of this limb during stance phase, physiological hyperextension of the hip joint at the end of stance phase, deloading of this limb and shifting of body weight onto the contralateral limb. Additional afferent stimulation, like skin irritation by pinching or pressing or electrical stimulation may be effective in inducing or facilitating flexion and extension movements. The optimal positions need to be found by trying; often for pinching/pressing the foot or digit I, the lower thigh or the back of the knee joint, for the stimulating electrode a site above the knee is effective. At this stage special shoes with thin leather soles are used for the same purpose often with considerable success.