A randomized trial of functional electrical stimulation for walking in incomplete spinal cord injury: Effects on walking competency.
Study Goal
To compare the short- and long-term benefits of FES-assisted walking therapy versus a non-FES exercise program on gait and balance improvements in individuals with chronic incomplete traumatic SCI.
Results Summary
The intervention group showed improvement in the SCIM mobility sub-score compared to the control group, but other outcome measures showed similar improvements in both groups. Walking speed, endurance, and balance improved in both groups post-therapy, with most participants retaining gains at follow-ups.
Population
Individuals with traumatic and chronic (≥18 months) motor incomplete SCI (level C2 to T12, ASIA Impairment Scale C or D).
Effective Dosage
Thrice-weekly FES-assisted walking program.
Duration
16 weeks.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
FES-assisted walking therapy | increase | Spinal cord independence measure (SCIM) mobility sub-score | individuals with chronic incomplete traumatic SCI | baseline/12 months: 17.27/21.33 vs. 19.09/17.36 | improved over time compared with the control group | #1 |
FES-assisted walking therapy | no change | all other outcome measures | individuals with chronic incomplete traumatic SCI | - | had similar improvements | #2 |
aerobic and resistance training program | no change | all other outcome measures | individuals with chronic incomplete traumatic SCI | - | had similar improvements | #3 |
therapy | increase | walking speed, endurance, and balance during ambulation | participants | - | improved upon completion | #4 |
therapy | no change | walking speed, endurance, and balance during ambulation | majority of participants | - | retained these gains at long-term follow-ups | #5 |
Task-oriented training | increase | walking ability | individuals with incomplete SCI | - | improves | #6 |
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.