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Long-term exercise training in persons with spinal cord injury:

Written by Derek Jones

Study design: Randomized controlled trial of exercise training in persons with spinal cord injury.

Objective: The purpose of this study was to examine the effects of 9 months of twice-weekly exercise training on strength, arm ergometry performance, and indices of psychological well-being and quality of life.

Setting: Centre for Health Promotion and Rehabilitation, McMaster University, Hamilton, Ontario, Canada.

Methods: Thirty-four men and women (aged 19–65 years) with traumatic spinal cord injury (C4–L1; ASIA A–D) of 1–24 years duration volunteered to participate, and were randomized into exercise (EX; n=21) and control (CON; n=13) groups. Twenty-three subjects (11 EX; 12 CON) successfully completed the 9-month study. Subjects were assessed for one repetition maximum (1RM) strength, arm ergometry performance, and several indices of quality of life and psychological well-being at baseline, 3, 6, and 9 months.

Results: At baseline, there were no significant differences between groups in age, submaximal arm ergometry performance, muscle strength, or psychological well-being. Following training, the EX group had significant increases in submaximal arm ergometry power output (81%; P<0.05), and significant increases in upper body muscle strength (19–34%; P<0.05); no significant changes occurred in CON. Participants in EX reported significantly less pain, stress and depression after training, and scored higher than CON in indices of satisfaction with physical function, level of perceived health and overall quality of life (P<0.05). Exercise adherence (per cent of prescribed sessions attended) in those subjects who completed the 9 months of training was 82.5%.

Conclusions: These results demonstrate that long-term twice-weekly exercise training in this population is feasible, and results in significant gains in both physical and psychological well-being.

Spinal Cord (2003) 41, 34–43. doi:10.1038/sj.sc.3101389

Long-term exercise training in persons with spinal cord injury: effects on strength, arm ergometry performance and psychological well-being

A L Hicks¹, K A Martin¹, D S Ditor¹, A E Latimer¹, C Craven², J Bugaresti² and N McCartney¹

Health implications of physical activity in individuals with spinal cord injury: a literature review

Written by Derek Jones

Physical activity has demonstrated beneficial effects on health and longevity in the general population, and physically active individuals are at lower risk for many chronic diseases compared to their sedentary peers.

Individuals with disabilities in general are less active than individuals without disabilities, but it is still unknown if physical activity confers the same level of risk reduction in populations with as without disabilities. Individuals with spinal cord injury (SCI) have among the lowest levels of physical activity participation compared to other populations. They also demonstrate early onset of cardiovascular disease and other chronic diseases.

This literature review discusses evidence for the potential benefits of physical activity in persons with SCI and provides a summary of pertinent studies to date.

Although being physically active and physically fit appears to be associated with several health benefits in persons with SCI, most studies are small and little longitudinal evidence exists. Future studies will be needed to address this need.

See Fernhall B, Heffernan K, Jae SY, Hedrick B. in

Health implications of physical activity in individuals with spinal cord injury: a literature review.

J Health Hum Serv Adm. 2008 Spring;30(4):468-502. Links

FES Cycling reduces spasticity in MS patient

Written by Derek Jones

An article by Phillip Krause, Johann Szecsi and Andreas Straube from the University of Munich reported benefits in reducing spastic muscle tone in a patient with MS. Stimulation by means of surface electrodes applied to the thigh muscles induced cycling leg movements.
Spastic muscle tone was measured clinically using the modified Ashworth scale and semiautomatically by pendulum testing of spasticity. This was done before and directly after stimulation.

The patient was able to endure the stimulation for 30 minutes; there was a significant reduction of spasticity after each stimulation session. The authors conclude, that this type of stimulation could be another potential treatment modality for multiple sclerosis patients, especially those with a high score in the expanded disability Status scale.

Orthopods recognise value of FES Cycling

Written by Derek Jones

Review articles are always excellent ways of keeping abrest of medical techniques and their FES Cycling electrodes apparent effectiveness.

A new article in the Journal of Bone & Joint Surgery entitled "What’s New in Orthopaedic Rehabilitation" by Harish Hosalkar, MD, MBMS(Orth), FCPS(Orth), DNB(Orth), Jason Hsu, MD, Nirav K. Pandya, MD, and Mary Ann Keenan, MD - see J Bone Joint Surg Am. 2008;90:2301-11.

includes a section on management of spinal cord injury. The authors report on the work of Griffin et al. who investigated functional electrical stimulation cycling and its effect on the metabolic, body composition, and neurologic profile of patients with paralysis resulting from spinal cord injury.

High-volume FES-cycling partially reverses bone loss in people with chronic spinal cord injury.

Written by Derek Jones

Spinal cord injury (SCI) leads to severe bone loss in the paralysed limbs and to increased fracture Balancing effect risk.Since long bone fractures can lead to comorbidities and a reduction in quality of life, it is important to improve bone strength in people with chronic SCI.

In this prospective longitudinal cohort study, the authors investigated whether functional electrical stimulation (FES) induced high-volume cycle training can partially reverse the loss of bone substance in the legs after chronic complete SCI.

The authors conclude that high-volume FES-induced cycle training has clinical relevance as it can partially reverse bone loss and thus may reduce fracture risk at this fracture prone site.