Abstract
Background: Functional electrically stimulated (FES)-arm ergometry has been shown to increase peak power output and aerobic capacity in individuals with cervical SCI. However, the functional benefits remain unknown. Objective: To determine the effects of FES-arm ergometry on exercise performance, upper limb function and resting cardiovascular function in individuals with tetraplegia. Methods: Five individuals (43.8 ± 15.4 years old) with SCI (C3-C5, AIS C-D, 14.0 ± 11.1 years post-injury) completed 12 weeks FES-arm ergometry. Exercise performance (time and distance to fatigue), perceived upper limb function [Capabilities of Upper Extremity Questionnaire (CUE), short form-Quadriplegia Index of Function Questionnaire (sf-QIF) and Spinal Cord Injury Spasticity Evaluation Tool (SCI-SET)] and resting mean arterial pressure (MAP) and heart rate (HR) were measured pre and post. Results: Following training, MAP significantly decreased (91.1 ± 14.0 to 87.7 ± 14.7 mmHg; p = 0.04), and there was a trend for an increased time to fatigue (804.6 ± 359.4 to 1483.8 ± 1110.2 sec; p = 0.08), distance to fatigue (3508.4 ± 3524.5 to 7412.6 ± 7773.1 m, p = 0.08) and the CUE scores pertaining to hand function (31.6 ± 12.8 to 38.0 ± 17.7; p = 0.07). Conclusion: Twelve-week FES-arm ergometry was associated with decreased resting MAP in individuals with tetraplegia, and may show promise as a means to increase exercise performance and hand function. Further research is required to verify these preliminary findings.
Highlights
For individuals with cervical SCI, reductions in hand and upper limb function can be debilitating
Following the 12-week exercise program, there were no significant changes in exercise performance, there were trends towards improvement in both time to fatigue (804.6 ± 359.4 to 1483.8 ± 1110.2 sec; p = 0.08; Effect size (ES) = 1.14) and distance to fatigue (3508.4 ± 3524.5 to 7412.6 ± 7773.1 m, p = 0.08; ES = 1.24) during the exercise performance test (Table 2)
There was a trend towards an increase in the Capabilities of Upper Extremity Questionnaire (CUE) subscale pertaining to hand function following the 12-week exercise program (Table 3)
Summary
For individuals with cervical SCI, reductions in hand and upper limb function can be debilitating. Anderson found that 96.5% of individuals with a SCI considered exercise to be important for functional recovery, only 56.9% had access to exercise, and only 12.2% had access to a trained therapist These findings demonstrate a need for therapies which are targeted at upper limb and hand musculature, and have the potential to improve function and independence. A recent study found that 12 weeks of thrice-weekly progressive FES-arm ergometry resulted in increased peak power output and peak aerobic capacity in individuals with cervical SCI [3]. These results are very encouraging, the functional benefits of OPEN ACCESS.
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