Abstract
Introduction: Muscle atrophy, spasticity, and deformity are among long term complication of spinal cord injury (SCI) veterans. There are numerous studies evaluating effect of functional electrical stimulation on muscle properties of SCI people, but less research has focused on the benefits of passive cycling in the management of spasticity and improving ROM of lower limbs in individuals with SCI. Aims: To evaluate the effect of electrical passive cycling on passive range of movement spasticity and electrodiagnostic parameters in SCI veterans. Methods: Sixty-four SCI veterans referred to two clinical and research center in Tehran were recruited in this prospective clinical trial. The subjects were divided into two groups according to electrical passive cycling usage: (1) patients who did not use pedal exercise (control group), (2) patients used Electrical passive cycling up to optimal level (intervention group). Main outcome measures included hip, knee, and ankle range of motion, spasticity scale, and electrodiagnostic parameters including F-Wave Consistency, F-Wave Amplitude, H/M Ratio, F/M Ratio, H-Reflex Onset Latency, and H-Reflex Amplitude. Data were recorded at the time of receiving and 1 year after pedal exercise usage. Results: Sixty-four SCI patients including 95.3% male, 4.7% female with mean age 43 years old were included in this study. All patients except one suffered from complete SCI. The involved spinal levels were cervical (17.2%), upper thoracic (34.4%), lower thoracic (45.3%), and lumbar (3.1%). Spasticity scale decreased significantly after passive cycling in group 2. Also hip, knee, and ankle ROM in group 2 were significantly improved after pedal exercise. There was a significant difference in H max/M max (RT<) and F/M ratio after versus before electric passive cycling system in group 2. Conclusion: These findings suggest that passive rhythmic leg exercise can lead to decrease in spasticity, increase in passive ROM of lower limbs and improvement in electrodiagnostic parameters of spasticity in patients with SCI.
Highlights
Muscle atrophy, spasticity, and deformity are among long term complication of spinal cord injury (SCI) veterans
According to the study method, all the SCI Veterans living in Tehran were invited to receive the Electric Passive Cycling equipment and to undergo clinical and electrodiagnostic tests by the assigned PM and R MDs of Shohada Hospital and JMERC (Janbazan Medical Engineering Research Center) which is affiliated to The Health deputy of the Foundation of Martyrs and Veterans Affair
ELECTRODIAGNOSTIC DATA In both intervention and control group, there was no significant difference in H-Reflex amplitude either before or after launching the Electrical passive pedaling systems (EPPS)
Summary
Spasticity, and deformity are among long term complication of spinal cord injury (SCI) veterans. There are numerous studies evaluating effect of functional electrical stimulation on muscle properties of SCI people, but less research has focused on the benefits of passive cycling in the management of spasticity and improving ROM of lower limbs in individuals with SCI. Aims:To evaluate the effect of electrical passive cycling on passive range of movement spasticity and electrodiagnostic parameters in SCI veterans. Conclusion:These findings suggest that passive rhythmic leg exercise can lead to decrease in spasticity, increase in passive ROM of lower limbs and improvement in electrodiagnostic parameters of spasticity in patients with SCI. As a consequence of relative sedentary or complete inactivity life style, these patients encounter muscle atrophy, joints stiffness, spasticity and deformity, cardiopulmonary sequelae, and other systemic complications. The level of a SCI, the paralyzed muscles become atrophied It is considered that physical exercises on a continuous and precise basis maintains muscle tone both in trunks and the limbs, leading to prevention of joint contracture, maintenance of flexibility in joints and muscles and enhancement of the internal organs functions (Braddom, 2007; Devillard et al, 2007)
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