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Step Ergometer Training Augmented With Functional Electrical Stimulation in Individuals With Chronic Spinal Cord Injury: A Feasibility Study.

Artificial organs
November 1, 2017
Candy Tefertiller et al. (2 authors)
Clinical TrialJournal ArticleHuman StudyClinical
Study Details

Study Goal

The researchers aimed to evaluate the feasibility and potential impact of the STEP (stimulation and ergometer training protocol) on walking function in individuals with chronic spinal cord injury (SCI).

Results Summary

The study found that participants who completed the 12-week STEP intervention showed improvements in walking speed, endurance, and mobility outcomes, with 50% improving on the Walking Index for Spinal Cord Injury II and 60% increasing lower extremity motor scores. However, 29% of participants withdrew due to lower extremity pain and exertional demands.

Population

Individuals with chronic motor incomplete SCI (>1-year post-injury).

Effective Dosage

12-week walking training program delivered three times per week (20-45 min sessions) with 10 channels of FES on a step ergometer, followed by 30 min over-ground walking training.

Duration

12 weeks

Interactions

None mentioned

Extracted Claims (8)
InterventionDirectionEndpointPopulationDosageImpactClaim #
12-week walking training program delivered three times per week from 20 up to 45 min in combination with 10 channels of FES on a step ergometer, followed by 30 min over ground walking training
increase
walking speed
participants with a chronic motor incomplete SCI (>1-year post injury) who completed the trial
0.13 m/s (0.08)
increased
#1
12-week walking training program delivered three times per week from 20 up to 45 min in combination with 10 channels of FES on a step ergometer, followed by 30 min over ground walking training
increase
walking endurance
participants with a chronic motor incomplete SCI (>1-year post injury) who completed the trial
117 ft (84 ft)
increased
#2
12-week walking training program delivered three times per week from 20 up to 45 min in combination with 10 channels of FES on a step ergometer, followed by 30 min over ground walking training
increase
Walking Index for Spinal Cord Injury II level
50% of participants who completed the trial
by at least one level
demonstrated increases
#3
12-week walking training program delivered three times per week from 20 up to 45 min in combination with 10 channels of FES on a step ergometer, followed by 30 min over ground walking training
increase
lower extremity motor scores
60% of participants who completed the trial
-
demonstrated an increase
#4
12-week walking training program delivered three times per week from 20 up to 45 min in combination with 10 channels of FES on a step ergometer, followed by 30 min over ground walking training
decrease
time to complete the Timed Up and Go Test
all participants who completed the trial and completed the Timed Up and Go Test at baseline
-
demonstrated a reduction
#5
stimulation and ergometer training protocol (STEP)
increase
mobility outcomes
participants with chronic SCI
-
generated improvements
#6
stimulation and ergometer training protocol (STEP)
no change
-
participants who were >1 year and less than 10 years post SCI
-
was well-tolerated
#7
stimulation and ergometer training protocol (STEP)
increase
commonly used SCI walking outcome measures
those completing the protocol
-
exhibited improvements
#8
Abstract

Spinal cord injury (SCI) often results in loss of upright mobility and independence subsequently challenging rehabilitation practitioners for meaningful intervention strategies. The objective of this study was to evaluate the feasibility and potential impact on walking function of the stimulation and ergometer training protocol (STEP) in chronic SCI. Fourteen individuals with a chronic motor incomplete SCI (>1-year post injury) were enrolled in the study. The intervention consisted of a 12-week walking training program delivered three times per week from 20 up to 45 min in combination with 10 channels of FES on a step ergometer. Subsequent to this training, 30 min over ground walking training was performed. Ten out of the 14 participants completed the trial (71%). All participants who completed the intervention increased their walking speed by an average of 0.13 m/s (0.08) and walking endurance by an average of 117 ft (84 ft). For those who completed the trial, 50% demonstrated increases on the Walking Index for Spinal Cord Injury II by at least one level while 60% demonstrated an increase in lower extremity motor scores; all completing the Timed Up and Go Test at baseline demonstrated a reduction in time to complete during post-test evaluation. Recruitment objectives were attained. Overall retention was lower than anticipated with 29% withdrawing secondary to issues with lower extremity pain and exertional demands; however, no other adverse events occurred. Improvements in mobility outcomes generated by the STEP show promise in the context of feasibility and warrant further investigation to evaluate efficacy in comparison to other walking recovery interventions. The STEP was well-tolerated by participants who were >1 year and less than 10 years post SCI. Those completing the protocol exhibited improvements in commonly used SCI walking outcome measures.

Medical Subject Headings (MeSH)
AdultAgedElectric Stimulation TherapyEquipment DesignErgometryExercise TestExercise ToleranceFeasibility StudiesFemaleGaitHumansLower ExtremityMaleMiddle AgedMotor ActivityRecovery of FunctionSpinal Cord InjuriesTime FactorsTreatment OutcomeWalkingYoung Adult
Study Links
Quality Scores
Safety80
Efficacy75/10
Quality70/10
Citation Metrics
Total Citations5
Citations/Year0.6
Relative Citation Ratio0.48
NIH Percentile26.2%
Research Impact Scores
APT Score0.25
Weight Score1.66
Normalized Score0.76
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