Functional electric stimulation–assisted rowing: Increasing cardiovascular fitness through functional electric stimulation rowing training in persons with spinal cord injury

Wheeler, Garry D.; Andrews, B.J.; Lederer, Robert; Davoodi, Rahman; Natho, Karen Erika.; Weiss, Christina Barbara; Jeon, Justin Y.; Bhambhani, Yagesh; Steadward, Robert D.

doi:10.1053/apmr.2002.33656

Cited by 95 publications

(63 citation statements)

References 16 publications

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“…FES is a practical therapy in this population as it minimizes excess strain on the upper extremities while activating the paralyzed musculature to stimulate hypertrophy, improve circulation, and enhance aerobic fitness. 7,8 Mean VO 2 during FES widely varies across individuals, ranging from 0.57 l/ minute in persons with injury at C4-T10 to 2.12 l/ minute in males with thoracic injury. 9,10 Another popular modality is resistance training, as it augments muscular strength in this population.…”

Section: Introductionmentioning

confidence: 99%

Acute energy cost of multi-modal activity-based therapy in persons with spinal cord injury

Harness

Astorino

2011

The Journal of Spinal Cord Medicine

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Objective: To examine acute energy costs of multi-modal activity-based therapy (ABT) in men and women with spinal cord injury (SCI). Study design: Descriptive case series. Setting: An outpatient center in California. Participants: Seven men and women (age = 28.3 ± 11.6 years; duration of injury = 4.3 ± 2.5 years) with injury levels ranging from C5 to T8. Intervention: Activity-based therapy. Outcome measures: Oxygen uptake (VO 2 ), energy expenditure (kcal/minute), SCI Metabolic Equivalent of Task (MET) (1 MET = 2.7 ml/kg/minute). Results: Oxygen uptake (VO 2 ) during ABT ranged from 5.10 to 8.62 ml/kg/minute, with VO 2 consistently higher during modalities involving load bearing versus non-load bearing (P = 0.08). SCI MET values ranged from 1.89 to 3.24 and were significantly higher in subjects with mid-thoracic injury versus low-cervical injury (P = 0.01). Conclusion: Data reveal that multi-modal ABT increases VO 2 in persons with SCI, but energy expenditure is relatively low. Strategies must be identified to optimize energy expenditure in the SCI to reduce health risks. Modalities involving load bearing seem to be superior to non-load-bearing activities. VO 2 was greater in response to load-bearing modalities than non-load-bearing modalities. It remains to be determined whether chronic ABT enhances cardiovascular fitness and reduces disease risks in this population.

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Section: Introductionmentioning

confidence: 99%

Acute energy cost of multi-modal activity-based therapy in persons with spinal cord injury

Harness

Astorino

2011

The Journal of Spinal Cord Medicine

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“…13,[18][19][20][21] In paraplegia, this prototype uses four channels of electrical stimulation and an external control switch with stimulation parameters set at a frequency of 50 Hz, a pulse width of 450 μs, and an output current manually adjusted by the participant between 0-115 mA. A momentary-acting pushbutton switch is used to change over the electrical stimulation between quadriceps and hamstrings to produce the rowing action.…”

Section: Equipment Modificationsmentioning

confidence: 99%

FES-rowing in tetraplegia: a preliminary report

et al. 2014

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Study design: A training intervention study using functional electrical stimulation-rowing (FES-R) in a group of eight individuals with tetraplegia. Objectives: To assess the feasibility of a structured progressive FES-R training programme in people with tetraplegia, and to explore the number and type of FES-training sessions required to enable continuous FES-R for 30 min. Setting: A fully integrated sports centre, elite rowing training centre and university sport science department. Methods: Eight participants with chronic complete and incomplete tetraplegia (C4 to C7, American Spinal Injury Association Impairment Scale A, B and C) who had not previously used any form of FES-assisted exercise, participated in the study. Participants completed a progressive FES-assisted training programme building to three continuous 30-min FES-R sessions per week at 60-80% of their predetermined peak power output. Thereafter, rowing performance was monitored for 12 months. Main outcome measures: number and type of FES-training sessions required before achieving 30-min continuous FES-R, and FES-R average power output (PO av ) pre and post 12 months training. Participant feedback of perceived benefits was also documented. Results: All participants were able to continuously FES-row for 30 min after completing 13 ± 7 FES-R training sessions. Each individual PO av during 30 min FES-R increased over 12 months FES-training. FES-R was found safe and well tolerated in this group of individuals with tetraplegia. Conclusion: Individuals with tetraplegia are able to engage in a progressive programme of FES-R training. Future research examining FES-R training as an adjunctive therapy in people with tetraplegia is warranted.

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“…24 Previous investigations into the effectiveness of FESassisted rowing have shown a significant improvement in upper extremity muscle strength, body composition and aerobic fitness. [25][26][27] Most FES-assisted rowing machines require the participant to have enough electrically-stimulated lower extremity muscle strength and endurance to perform multiple resisted knee extensions prior to the initiation of FES-row training, i.e. sufficient force produced to move the weight of the rower seat plus the participant's body weight.…”

Section: Introductionmentioning

confidence: 99%

“…Participants without sufficient force production must perform remedial FES-assisted strength training until they have enough strength to move the seat, their body mass, and overcome the resistance of the flywheel to perform FES-assisted rowing on current models, and the intensity may still be limited by their lower extremity strength and endurance. 26,27 Additionally, the rowing stroke produced by current FES-assisted rowing machine models is not typical of the able-bodied rowing stroke, the participants do not achieve and maintain full knee extension throughout the arm pulling action because the legs collapse under the force of the arm pull. The FES-assisted rowing machine developed by our laboratory and utilized in this study is a promising mode of exercise for adults with SCI who have shoulder pain.…”

Section: Introductionmentioning

confidence: 99%

Effects of functional electrical stimulation assisted rowing on aerobic fitness and shoulder pain in manual wheelchair users with spinal cord injury

Wilbanks

Rogers

Pool

et al. 2016

The Journal of Spinal Cord Medicine

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Objective: Test the effectiveness of a 6-week functional electrical stimulation (FES)-assisted rowing intervention to increase aerobic fitness and decrease shoulder pain in manual wheelchair users with spinal cord injury (SCI) Methods: Ten adults with SCI (47 ± 12 years, 86 ± 19.7 kg, 175.5 ± 13.2 cm) 18 ± 14 years since injury, AIS classification A-C who had pain in one or both shoulders for >6 months took part in a pre-test, post-test experiment in our human performance laboratory. Participants took part in 30 minutes of FES-assisted rowing, 3 days/week × 6 weeks. Participants were evaluated for VO 2 peak (FES-row and arm bike), distance rowed, arm power output, Wheelchair User Shoulder Pain Index (WUSPI), upper extremity isokinetic strength, scapular stabilization, participation (LIFE-H), quality of life (QOL-SCI), qualitative exit interview. Results: Participants increased distance rowed by 257 ± 266 m and increased arm power output by 6.7 ± 7.9 W. An 8% increase in VO 2 peak and 10.5 ± 4.4 point decrease in shoulder pain were observed (all P < 0.05). There were no changes in upper extremity strength, scapular stabilization, or survey-based measures of participation or quality of life. Qualitative interviewing indicated overall enjoyment of the intervention and improvement in perceived quality of life. Conclusions: FES-assisted rowing is effective to increase aerobic fitness and decrease shoulder pain in manual wheelchair users with SCI. Further research is necessary to determine if rowing without FES can provide similar benefits, and to determine mechanisms driving improvements in shoulder pain, as no changes in measures of upper extremity strength or scapular stabilization were observed.

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Functional electric stimulation–assisted rowing: Increasing cardiovascular fitness through functional electric stimulation rowing training in persons with spinal cord injury

Cited by 95 publications

References 16 publications

Acute energy cost of multi-modal activity-based therapy in persons with spinal cord injury

Acute energy cost of multi-modal activity-based therapy in persons with spinal cord injury

FES-rowing in tetraplegia: a preliminary report

Effects of functional electrical stimulation assisted rowing on aerobic fitness and shoulder pain in manual wheelchair users with spinal cord injury

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