Effect of FES Cycling Training on Spasticity in Spinal Cord Injured Subjects

Training with Functional Electrical Stimulation (FES) has both physiological and psychological benefits for spinal cord injured subjects. Commonly used methods for quantification of spasticity have shown controversial reliability. In this study we propose a method for quick determination of spasticity in spinal cord injured subjects on a cycling and measurement system. 23 patients did training sessions on an instrumented mobile FES cycle three times a week over two months as part of their clinical rehabilitation program. Spasticity (MAS) and the legs resistance to the pedaling motion were assessed before and after the FES training and measurements were done on the subjects ability to pedal with our without motor assistance. Measurements with test persons with incomplete spastic paraplegia have shown that spasticity is decreased after a 30 min cycling training with functional electrical stimulation (FES).




References:
[1] Janssen T.W.J., Glaser R.M., and Shuster D.B.: "Clinical efficacy of
electrical stimulation exercise training: effects on health, fitness, and
function." Top Spinal Cord. Inj. Rehabil., (1998), 3, 33-49.
[2] Figoni S.F., Rodgers M.M., Glaser R.M., Hooker S.P., Faghri P.D.,
Ezenwa B.N., Mathews T., Suryaprasad A.G. and Gupta S.C.:
"Physiologic responses of paraplegics and quadriplegics to passive and
active leg cycle ergometry." J.Am.Paraplegia Soc., (1990) 7, 33-39.
[3] Heesterbeek P.J.C., Berkelmans H.W.A, Thijssen D.H.J., Kuppevelt van
H.J.M., Hopman M.T.E. and Duysens J., "Increased physical fitness
after 4-week training on a new hybrid FES-cycle in persons with spinal
cord injuries"; Technology and Disability, 17 (2005),103-110.
[4] Frotzler A., Coupaud S., Kakebeeke T.H., Hunt K.J., Allan D.B.,
Donaldson N., and Eser P., "Effects of high volume FES-cycling
training on bone parameters of subjects with chronic spinal cord injury,"
in Proc. 45th ISCoS Annual Scientific Meeting, (Boston, USA), June
2006.
[5] Hunt K.J., McLean A.N., and Fraser M.H., "The health benefits of
cycling exercise in paraplegia using functional electrical stimulation",
Proc. 42nd Ann. Sci. Mtg. Int. Spinal Cord Soc., (Beijing, China), 2003.
[6] J. W. Lance, Symposium synopsis, in Spasticity: Disordered Motor
Control, R. G. Feldman, R. R. Young, and W. P. Koella, Eds. Miami:
Symposia Specialist, (1980), 485-495.
[7] A. D. Pandyan, G. R. Johnson, C. I. M. Price, R. H. Curless, M. P.
Barnes, and H. Rodgers, "A review of the properties and limitations of
the Ashworth and modified Ashworth Scales as measures of spasticity,"
Clinical Rehabilitation, 13 (1999), 373-383.
[8] P Krause, J Szecsi, A Straube,Changes in spastic muscle tone increase in
patients with spinal cord injury using functional electrical stimulation
and passive leg movements Clin Rehabil. 22 (2008), 627-34.
[9] W.Reichenfelser, H.Hackl, S.Mina, S.Hanke, P.Lugner, M.Gföhler,
Trainings- and Measurement- System for FES- Cycling, Proc. IFESS
2008.
[10] Reichenfelser W, Hackl H, Hufgard J, Kastner J, Gstaltner K, Gföhler
M. Monitoring of spasticity and functional ability in individuals with
incomplete spinal cord injury with a functional electrical stimulation
cycling system. J Rebahil Med 2012; 44: 444-449.