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Functional electrical stimulation cycling exercise after spinal cord injury: a systematic review of health and fitness-related outcomes
journal contribution
posted on 2021-06-14, 15:53 authored by Jan van der Scheer, Vicky Goosey-TolfreyVicky Goosey-Tolfrey, Sydney Valentino, Glen Davis, Chester HoObjectives: The objective of this review was to summarize and appraise evidence on functional electrical stimulation (FES) cycling exercise after spinal cord injury (SCI), in order to inform the development of evidence-based clinical practice guidelines.
Methods: PubMed, the Cochrane Central Register of Controlled Trials, EMBASE, SPORTDiscus, and CINAHL were searched up to April 2021 to identify FES cycling exercise intervention studies including adults with SCI. In order to capture the widest array of evidence available, any outcome measure employed in such studies was considered eligible. Two independent reviewers conducted study eligibility screening, data extraction, and quality appraisal using Cochranes’ Risk of Bias or Downs and Black tools. Each study was designated as a Level 1, 2, 3 or 4 study, dependent on study design and quality appraisal scores. The certainty of the evidence for each outcome was assessed using GRADE ratings (‘High’, ‘Moderate’, ‘Low’, or ‘Very low’).
Results: Ninety-two studies met the eligibility criteria, comprising 999 adults with SCI representing all age, sex, time since injury, lesion level and lesion completeness strata. For muscle health (e.g., muscle mass, fiber type composition), significant improvements were found in 3 out of 4 Level 1-2 studies, and 27 out of 32 Level 3-4 studies (GRADE rating: ‘High’). Although lacking Level 1-2 studies, significant improvements were also found in nearly all of the 35 Level 3-4 studies on power output and aerobic fitness (e.g., peak power and oxygen uptake during an FES cycling test) (GRADE ratings: ‘Low’).
Conclusion: Current evidence indicates that FES cycling exercise improves lower-body muscle health of adults with SCI, and may increase power output and aerobic fitness. The evidence summarized and appraised in this review can inform the development of the first international, evidence-based clinical practice guidelines for the use of FES cycling exercise in clinical and community settings of adults with SCI.
Funding
University of Alberta Spinal Cord Injury Research Chair Endowment Funds
History
School
- Sport, Exercise and Health Sciences
Published in
Journal of NeuroEngineering and RehabilitationVolume
18Publisher
BioMed CentralVersion
- VoR (Version of Record)
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© The AuthorsPublisher statement
This is an Open Access Article. It is published by BioMed Central under the Creative Commons Attribution 4.0 International Licence (CC BY 4.0). Full details of this licence are available at: https://creativecommons.org/licenses/by/4.0/Acceptance date
2021-05-19Publication date
2021-06-12Copyright date
2021ISSN
1743-0003eISSN
1743-0003Publisher version
Language
- en
Depositor
Prof Vicky Tolfrey. Deposit date: 18 May 2021Article number
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