Improved Motor Function in Tetraplegics Following Neuromuscular Stimulation-Assisted Arm Ergometry

Needham-Shropshire, Belinda M.; Broton, James G.; Cameron, Tracy; Klose, K J

doi:10.1080/10790268.1997.11719455

Cited by 36 publications

(44 citation statements)

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“…[11][12][13] Therefore, the primary purpose of this trial was to determine the clinical effectiveness of ES superimposed on PRT for increasing voluntary strength in the paretic quadriceps muscles of people with SCI.…”

Section: Introductionmentioning

confidence: 99%

Electrical stimulation plus progressive resistance training for leg strength in spinal cord injury: A randomized controlled trial

et al. 2010

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Study design: A randomized controlled trial. Objectives: To determine the effectiveness of electrical stimulation (ES)-evoked muscle contractions superimposed on progressive resistance training (PRT) for increasing voluntary strength in the quadriceps muscles of people with spinal cord injuries (SCI). Setting: Sydney, Australia. Methods: A total of 20 people with established SCI and neurologically induced weakness of the quadriceps muscles participated in the trial. Participants were randomized between experimental and control groups. Volunteers in the experimental group received ES superimposed on PRT to the quadriceps muscles of one leg thrice weekly for 8 weeks. Participants in the control group received no intervention. Assessments occurred at the beginning and at the end of the 8-week period. The four primary outcomes were voluntary strength (Nm) and endurance (fatigue ratio) as well as the performance and satisfaction items of the Canadian Occupational Performance Measure (COPM; points). Results: The between-group mean differences (95% confidence interval (CI)) for voluntary strength and endurance were 14 Nm (1-27; P ¼ 0.034) and 0.1 (À0.1 to 0.3; P ¼ 0.221), respectively. The between-group median differences (95% CI) for the performance and satisfaction items of the COPM were 1.7 points (À0.2 to 3.2; P ¼ 0.103) and 1.4 points (À0.1 to 4.6; P ¼ 0.058), respectively. Conclusion: ES superimposed on PRT improves voluntary strength, although there is uncertainty about whether the size of the treatment effect is clinically important. The relative effectiveness of ES and PRT is yet to be determined.

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Section: Introductionmentioning

confidence: 99%

Electrical stimulation plus progressive resistance training for leg strength in spinal cord injury: A randomized controlled trial

et al. 2010

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“…Several studies have indicated that for tetraplegic persons with inco mplete SCI, massed practice is mo re effective when co mbined with sensory stimulat ions (e.g. functional electrical stimulat ion) than when delivered alone [7,47]. These studies also suggest a minimu m training dose of 15 sessions for effective training results.…”

Section: Discussionmentioning

confidence: 74%

RiceWrist Robotic Device for Upper Limb Training: Feasibility Study and Case Report of Two Tetraplegic Persons with Spinal Cord Injury

Kadivar¹,

Sullivan²,

Eng³

et al. 2012

IJBE

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Regaining upper extremity function is the primary concern of persons with tetraplegia caused by spinal cord injury (SCI). Robotic rehabilitation has been inadequately tested and underutilized in rehabilitation of the upper extremity in the SCI population. Given the acceptance of robotic train ing in stroke rehabilitation and SCI gait training, coupled with recent evidence that the spinal cord, like the brain, demonstrates plasticity that can be enhanced by repetitive movement training such as that available with robotic devices, it is probable that robotic upper ext remity train ing of persons with SCI could be clin ically beneficial. The primary goal of th is pilot study was to test the feasibility of using a novel robotic device -the RiceWrist Exoskeleton-for rehabilitation of the upper limbs (UL) of t wo tetraplegic persons with inco mplete SCI. Two pilot experiments were conducted. Experiment 1was the first novel attempt to admin ister treatment with the RiceWrist. The left UL of a tetraplegic subject was treated during seven therapy sessions. The subject's feedback and the investigator's observations were used to enhance the robotic device and the corresponding graphical-interface. In Experiment 2, a second tetraplegic subject underwent 10 three-hour train ing sessions admin istered by a physical therapist. Smoothness factor (F S ) -a new measure developed in Experiment 1-was used as the primary outcome to test the subject's performance before and after the training. The RiceWrist was modified accord ing to the feedback obtained in Experiment 1. Thereafter, the device was successfully administered for upper limb training of the tetraplegic individual. Noticeable improvements in F S were observed for the stronger arm of the subject who co mpleted 10 sessions of train ing. Improvements were also observed in the subject's hand according to the Jebsen-Taylor Hand Function Test. Results fro m this study suggest a potential application of the RiceWrist for rehabilitation of SCI individuals and offer valuable in formation regard ing development of UL robotic devices for this population.

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“…17,19,22,25,26,38 Six more trials reported between-group statistical differences but either the results were inconclusive 9,31 or the size of the between-group differences could not be determined. 18,21,20,28 The majority of trials either did not report or did not find between-group statistical differences and were inconclusive 7,8,10,23,24,27,29,30,34,36,37,[39][40][41][42] or demonstrated treatment ineffectiveness. 32,33,35,43 The interpretation of this systematic review is partly dependent on the definition of minimally important between-group differences.…”

Section: Discussionmentioning

confidence: 99%

“…[17][18][19][20][21][22] However, only three trials had clearly important between-group differences. The key findings from these three trials were that ES-driven exercise (versus no intervention) of the paralyzed lower limbs increased lower limb lean body mass; 17 strength and fitness training (versus education and relaxation) decreased pain; 19 and arm-cranking exercise (versus no intervention) increased the proportion of slow twitch muscle fibres in the triceps muscles.…”

Section: La Harvey Et Almentioning

confidence: 99%

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The effectiveness of physical interventions for people with spinal cord injuries: a systematic review

et al. 2008

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Study design: Systematic review. Objectives: To provide a quantitative analysis of all randomized controlled trials designed to determine the effectiveness of physical interventions for people with spinal cord injury (SCI). Setting: Sydney, Australia. Methods: A search was conducted for randomized controlled trials involving physical interventions for people with SCI. Two reviewers independently rated methodological quality using the PEDro scale and extracted key findings from the trials. Results: Four thousand five hundred and forty three abstracts were identified of which 31 trials met the inclusion criteria. Trials examined the effectiveness of fitness and strength training (n ¼ 7), gait training (n ¼ 5), hand therapy (n ¼ 3), stretch (n ¼ 4), acupuncture (n ¼ 3), hand splinting (n ¼ 2) and other related therapies (n ¼ 7). Six trials reported a between-group mean difference with a clearly important treatment effect on at least one outcome measure. These trials supported the use of fitness, strength and gait training as well as acupuncture. Conclusion: There is initial evidence supporting the effectiveness of some physical interventions for people with SCI. However, there is a pressing need for high-quality trials to determine the effectiveness of all physical interventions commonly administered in clinical practice.

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Improved Motor Function in Tetraplegics Following Neuromuscular Stimulation-Assisted Arm Ergometry

Cited by 36 publications

References 0 publications

Electrical stimulation plus progressive resistance training for leg strength in spinal cord injury: A randomized controlled trial

Electrical stimulation plus progressive resistance training for leg strength in spinal cord injury: A randomized controlled trial

RiceWrist Robotic Device for Upper Limb Training: Feasibility Study and Case Report of Two Tetraplegic Persons with Spinal Cord Injury

The effectiveness of physical interventions for people with spinal cord injuries: a systematic review

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