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Randomized Controlled Trial
. 2014 Sep;37(5):511-24.
doi: 10.1179/2045772314Y.0000000263.

A randomized trial of functional electrical stimulation for walking in incomplete spinal cord injury: Effects on walking competency

Naaz Kapadia, Kei Masani, B Catharine Craven, Lora M Giangregorio, Sander L Hitzig, Kieva Richards, Milos R Popovic
Randomized Controlled Trial

A randomized trial of functional electrical stimulation for walking in incomplete spinal cord injury: Effects on walking competency

Naaz Kapadia et al. J Spinal Cord Med. 2014 Sep.

Abstract

Background: Multi-channel surface functional electrical stimulation (FES) for walking has been used to improve voluntary walking and balance in individuals with spinal cord injury (SCI).

Objective: To investigate short- and long-term benefits of 16 weeks of thrice-weekly FES-assisted walking program, while ambulating on a body weight support treadmill and harness system, versus a non-FES exercise program, on improvements in gait and balance in individuals with chronic incomplete traumatic SCI, in a randomized controlled trial design.

Methods: Individuals with traumatic and chronic (≥18 months) motor incomplete SCI (level C2 to T12, American Spinal Cord Injury Association Impairment Scale C or D) were recruited from an outpatient SCI rehabilitation hospital, and randomized to FES-assisted walking therapy (intervention group) or aerobic and resistance training program (control group). Outcomes were assessed at baseline, and after 4, 6, and 12 months. Gait, balance, spasticity, and functional measures were collected.

Results: Spinal cord independence measure (SCIM) mobility sub-score improved over time in the intervention group compared with the control group (baseline/12 months: 17.27/21.33 vs. 19.09/17.36, respectively). On all other outcome measures the intervention and control groups had similar improvements. Irrespective of group allocation walking speed, endurance, and balance during ambulation all improved upon completion of therapy, and majority of participants retained these gains at long-term follow-ups.

Conclusions: Task-oriented training improves walking ability in individuals with incomplete SCI, even in the chronic stage. Further randomized controlled trials, involving a large number of participants are needed, to verify if FES-assisted treadmill training is superior to aerobic and strength training.

Trial registration: ClinicalTrials.gov NCT00201968.

Keywords: Balance; Chronic; Functional electrical stimulation; Incomplete; Physiotherapy; Spinal cord injury; Therapy; Walking.

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Figures

Figure 1
Figure 1
Consort diagram.
Figure 2
Figure 2
Individual subject results on the SCIM Mobility Sub-score assessment: a) Control Group results and b) Intervention Group results.
Figure 3
Figure 3
Individual subjects results during 2-min Walk Tests: a) Control Group results and b) Intervention Group results. “Unable to walk” suggests that the participant was unable to perform the tests on all four assessment occasions.
Figure 4
Figure 4
Individual subjects results during 10m Walk Tests: a) Control Group results and b) Intervention Group results. ”Unable to walk” suggests that the participant was unable to perform the tests on all four assessment occasions.
See this image and copyright information in PMC

References

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