Abstract
Twelve patients were involved in a 3 month stimulation induced cycling programme at the Royal Perth Rehabilitation Hospital. A number of the patients were less than 1 year post injury, all except one had an incomplete injury, and most were receiving physiotherapy. All patients who completed the programme increased their time of cycling and, in all but one case, the exercise load, indicative of a local training effect. Significant improvements were found in voluntary isometric strength, stimulated isometric strength and stimulated isometric endurance of the quadriceps, muscle grading of the quadriceps and biceps femoris and the cross-sectional areas of the quadriceps and total thigh muscle. No change was found in voluntary isokinetic strength of the quadriceps. All patients with incomplete injuries reported improvements in the activities of daily living (ADL) after the programme. Bone mineral density (BMD) was examined in two patients, one less than 1 year post injury, and one greater than 4 years post injury. The programme of cycling did not restore BMD in the latter patient. However, while the former patient still displayed a reduced BMD after the programme, it is unknown whether this loss of bone was retarded. This needs further investigation. This study demonstrates the effectiveness of a combined physiotherapy/cycling programme in the rehabilitation of people with spinal injuries. To be successful this type of programme has to be incorporated into the rehabilitation process, as has been done at the Sir George Bedbrook Spinal Unit.
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Pollack S F, Axen K, Spielholz N et al (1989) Aerobic training effects of electrically induced lower extremity exercises in spinal cord injured people. Arch Phys Med Rehabil 70: 214–219.
Bremner L A, Sloan K E, Day R E, Scull E R (1992) A clinical exercise system for paraplegics using functional electrical stimulation. Paraplegia 30: 647–655.
Siegel S (1956) Nonparametric Statistics for the Behavioural Sciences. McGraw-hill Kogakusha, Ltd, Tokyo: 68–75.
Haddaway M J, Davie M W, McCall I W (1992) Bone mineral density in healthy women and reproducibility of measurements in spine and hip using dual energy X-ray absorptiometry. Br J Radiol 65: 213–217.
Petrofsky J S, Phillips C A (1984) The use of functional electrical stimulation for rehabilitation of spinal cord injured patients. Cent Nerv Syst Trauma 1: 57–73.
Ragnarsson K T, Pollack S, O'Daniel, W et al (1988) Clinical evaluation of computerised functional electrical stimulation after spinal cord injury: A multicentre pilot study. Arch Phys Med Rehabil 69: 672–677.
Hooker S P, Figoni S F, Rodgers M M et al (1992) Physiologic effects of electrical stimulation leg cycle exercise training in spinal cord injured persons. Arch Phys Med Rehabil 73: 470–476.
Freyschuss U, Knutsson E (1969) Cardiovascular control in man with transverse cervical cord lesions. Life Sci 8: 421–424.
Phillips C A, Petrofsky J S, Hendershot D M, Stafford D (1984) Functional electrical exercise: A comprehensive approach for physical conditioning of the spinal injured patient. Orthopaedics 7: 1112–1123.
Gruner J A, Glaser R M, Feinbeg S D et al (1983) A system for evaluation and exercise conditioning of paralysed leg muscles. J Rehab; Res Dev 20: 21–30.
Petrofsky J S, Phillips C A, Petrofsky S H (1985) Electronic physicians’ prescription system for functional electrical stimulation patients. J Neurol Orthop Med Surg 6: 239–246.
Block J E, Steinbach L S, Friedlander A L et al (1989) Electrically stimulated muscle hypertrophy in paraplegia: Assessment by quantitative CT. J Comput Assist Tomogr 13: 852–854.
Pacy P J, Halliday D A, Katz D et al (1988) Muscle and bone in paraplegic patients, and the effect of functional electrical stimulation. Clin Sci 75: 481–487.
Phillips C A, Danopulos D, Kezdi P, Hendershot D (1989) Muscular, respiratory and cardiovascular responses of quadriplegic persons to an FES bicycle ergometer conditioning program. Int J Rehabil Res 12: 147–157.
Ericson M (1986) On the biomechanics of cycling: A study of joint and muscle load during exercise on the bicycle ergometer. Scand J Rehabil Med Suppl 16: 1–43.
Leeds E M, Klose J, Ganz W et al (1990) Bone mineral density after bicycle ergometry training. Arch Phys Med Rehabil 71: 207–209.
Chantraine A, Nusgens B, Lapiere C h M (1986) Bone remodelling during the development of osteoporosis in paraplegia. Calcif Tissue Int 38: 323–327.
Garland D E, Stewart C A, Adkins R H et al (1992) Osteoporosis after spinal cord injury. J Orthop Res 10: 371–378.
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Sloan, K., Bremner, L., Byrne, J. et al. Musculoskeletal effects of an electrical stimulation induced cycling programme in the spinal injured. Spinal Cord 32, 407–415 (1994). https://doi.org/10.1038/sc.1994.67
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DOI: https://doi.org/10.1038/sc.1994.67
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