TY - JOUR
T1 - Lower extremity functional electrical stimulation cycling promotes physical and functional recovery in chronic spinal cord injury
AU - Sadowsky, Cristina L.
AU - Hammond, Edward R.
AU - Strohl, Adam B.
AU - Commean, Paul K.
AU - Eby, Sarah A.
AU - Damiano, Diane L.
AU - Wingert, Jason R.
AU - Bae, Kyongtae T.
AU - McDonald, John W.
PY - 2013/11
Y1 - 2013/11
N2 - Objective: To examine the effect of long-termlower extremity functional electrical stimulation (FES) cycling on the physical integrity and functional recovery in people with chronic spinal cord injury (SCI). Design: Retrospective cohort, mean follow-up 29.1 months, and cross-sectional evaluation. Setting: Washington University Spinal Cord Injury Neurorehabilitation Center, referral center. Participants: Twenty-five people with chronic SCI who received FES during cycling were matched by age, gender, injury level, and severity, and duration of injury to 20 people with SCI who received range of motion and stretching. Intervention: Lower extremity FES during cycling as part of an activity-based restorative treatment regimen. Main outcome measure: Change in neurological function: motor, sensory, and combined motor-sensory scores (CMSS) assessed by the American Spinal Injury Association Impairment scale. Response was defined as ≥1 point improvement. Results: FES was associated with an 80% CMSS responder rate compared to 40% in controls. An average 9.6 CMSS point loss among controls was offset by an average 20-point gain among FES subjects. Quadriceps muscle mass was on average 36% higher and intra/inter-muscular fat 44% lower, in the FES group. Hamstring and quadriceps muscle strength was 30 and 35% greater, respectively, in the FES group. Quality of life and daily function measures were significantly higher in FES group. Conclusion: FES during cycling in chronic SCI may provide substantial physical integrity benefits, including enhanced neurological and functional performance, increased muscle size and force-generation potential, reduced spasticity, and improved quality of life.
AB - Objective: To examine the effect of long-termlower extremity functional electrical stimulation (FES) cycling on the physical integrity and functional recovery in people with chronic spinal cord injury (SCI). Design: Retrospective cohort, mean follow-up 29.1 months, and cross-sectional evaluation. Setting: Washington University Spinal Cord Injury Neurorehabilitation Center, referral center. Participants: Twenty-five people with chronic SCI who received FES during cycling were matched by age, gender, injury level, and severity, and duration of injury to 20 people with SCI who received range of motion and stretching. Intervention: Lower extremity FES during cycling as part of an activity-based restorative treatment regimen. Main outcome measure: Change in neurological function: motor, sensory, and combined motor-sensory scores (CMSS) assessed by the American Spinal Injury Association Impairment scale. Response was defined as ≥1 point improvement. Results: FES was associated with an 80% CMSS responder rate compared to 40% in controls. An average 9.6 CMSS point loss among controls was offset by an average 20-point gain among FES subjects. Quadriceps muscle mass was on average 36% higher and intra/inter-muscular fat 44% lower, in the FES group. Hamstring and quadriceps muscle strength was 30 and 35% greater, respectively, in the FES group. Quality of life and daily function measures were significantly higher in FES group. Conclusion: FES during cycling in chronic SCI may provide substantial physical integrity benefits, including enhanced neurological and functional performance, increased muscle size and force-generation potential, reduced spasticity, and improved quality of life.
KW - Activity-based restorative therapy
KW - Assistive technology
KW - Cycle ergometry
KW - Functional electrical stimulation
KW - Paraplegia
KW - Physical muscle strength
KW - Quality of life
KW - Rehabilitation
KW - Spasticity
KW - Spinal cord injury
KW - Tetraplegia
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U2 - 10.1179/2045772313Y.0000000101
DO - 10.1179/2045772313Y.0000000101
M3 - Article
C2 - 24094120
AN - SCOPUS:84890483472
SN - 1079-0268
VL - 36
SP - 623
EP - 631
JO - Journal of Spinal Cord Medicine
JF - Journal of Spinal Cord Medicine
IS - 6
ER -