Effects of Neuromuscular Electrical Stimulation in People with Spinal Cord Injury

Bochkezanian, Vanesa; Newton, Robert U.; Trajano, Gabriel S.; Blazevich, Anthony J.

doi:10.1249/mss.0000000000001637

Cited by 23 publications

(18 citation statements)

References 40 publications

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“…Neuromuscular electrical stimulation (NMES) has been used as an effective training or rehabilitation tool (Bochkezanian et al., 2018; Bremner et al., 2017; Maffiuletti, 2010; Nussbaum et al., 2017). Various parameters are related to NMES, such as the stimulus intensity, stimulus frequency, pulse width, duty cycle, duration, electrode location, and electrode size (Glaviano & Saliba, 2016).…”

Section: Introductionmentioning

confidence: 99%

Novel perspective on contractile properties and intensity‐dependent verification of force–frequency relationship during neuromuscular electrical stimulation

Tomita

Kawade²,

Moritani

et al. 2020

Physiol Rep

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Section: Introductionmentioning

confidence: 99%

Novel perspective on contractile properties and intensity‐dependent verification of force–frequency relationship during neuromuscular electrical stimulation

Tomita

Kawade²,

Moritani

et al. 2020

Physiol Rep

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“…Bochkezanian et al used a different approach to the use of NMES investigating the effects of high-intensity strength training performed under isometric conditions using a lower frequency (30 Hz) and a higher pulse width (1000 µs) for 12 weeks on five adults with chronic SCI [42]. The participants were seated with the hip and knee joint angles at 85 and 90 degrees, respectively.…”

Section: Optimizing Electrical Stimulation Training Parametersmentioning

confidence: 99%

Invasive and Non-Invasive Approaches of Electrical Stimulation to Improve Physical Functioning after Spinal Cord Injury

Dolbow

Gorgey

Sutor

et al. 2021

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This review of literature provides the latest evidence involving invasive and non-invasive uses of electrical stimulation therapies that assist in restoring functional abilities and the enhancement of quality of life in those with spinal cord injuries. The review includes neuromuscular electrical stimulation and functional electrical stimulation activities that promote improved body composition changes and increased muscular strength, which have been shown to improve abilities in activities of daily living. Recommendations for optimizing electrical stimulation parameters are also reported. Electrical stimulation is also used to enhance the skills of reaching, grasping, standing, and walking, among other activities of daily living. Additionally, we report on the use of invasive and non-invasive neuromodulation techniques targeting improved mobility, including standing, postural control, and assisted walking. We attempt to summarize the effects of epidural stimulation on cardiovascular performance and provide a mechanistic explanation to the current research findings. Future trends such as the combination of epidural stimulation and exoskeletal-assisted walking are also discussed.

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“…The review from Naro et al (2017) reported that FES 30 min two times a day, 5 days a week for 4 weeks can decrease spasticity in patients with SCI and stroke. FES itself has been applied to reduce spasticity not only in SCI (Bochkezanian et al, 2018) but also in stroke or cerebral palsy (Ho et al, 2014;Naro et al, 2017). A previous study also reported high-intensity knee extension NMES training two times a week for 12 weeks decreased spasticity in the patients with chronic SCI (Bochkezanian et al, 2018).…”

Section: Decreasing Spasticity After Functional Electrical Stimulation-cycling Trainingmentioning

confidence: 99%

“…FES itself has been applied to reduce spasticity not only in SCI (Bochkezanian et al, 2018) but also in stroke or cerebral palsy (Ho et al, 2014;Naro et al, 2017). A previous study also reported high-intensity knee extension NMES training two times a week for 12 weeks decreased spasticity in the patients with chronic SCI (Bochkezanian et al, 2018). However, a previous meta-analysis from Thomaz et al (2019) reported that electrical stimulation did not improve spasticity in people with SCI.…”

Section: Decreasing Spasticity After Functional Electrical Stimulation-cycling Trainingmentioning

confidence: 99%

The Effect and Dose-Response of Functional Electrical Stimulation Cycling Training on Spasticity in Individuals With Spinal Cord Injury: A Systematic Review With Meta-Analysis

et al. 2021

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Background: To investigate the effect and dose-response of functional electrical stimulation cycling (FES-cycling) training on spasticity in the individuals with spinal cord injury (SCI).Method: Five electronic databases [PubMed, Scopus, Medline (Proquest), Embase, and Cochrane Central Register of Controlled Trials (CENTRAL)] were searched before September 2021. The human trials and studies of English language were only included. Two authors independently reviewed and extracted the searched studies. The primary outcome measure was spasticity assessed by Modified Ashworth Scale or Ashworth Scale for lower limbs. The secondary outcome measures were walking abilities, such as 6 Min Walk Test (6MWT), Timed Up and Go (TUG), and lower limbs muscle strength (LEMS). A subgroup analysis was performed to investigate the efficacious threshold number of training sessions. A meta-regression analysis was used to examine the linear relationship between the training sessions and the effect on spasticity.Results: A total of 764 studies were identified. After screening, 12 selected studies were used for the qualitative synthesis, in which eight of them were quantitatively analyzed. Eight studies included ninety-nine subjects in total with SCI (male: female = 83:16). The time since injury was from less than 4 weeks to 17 years. The age ranged from 20 to 67 years. American Spinal Injury Association (ASIA) impairment level of the number of participants was 59 for ASIA A, 11 for ASIA B, 18 for ASIA C, and 11 for ASIA D. There were 43 subjects with tetraplegia and 56 subjects with paraplegia. Spasticity decreased significantly (95% CI = − 1.538 to − 0.182, p = 0.013) in favor of FES-cycling training. The walking ability and LEMS also improved significantly in favor of FES-cycling training. The subgroup analysis showed that spasticity decreased significantly only in more than 20 training sessions (95% CI = − 1.749 to − 0.149, p = 0.020). The meta-regression analysis showed training sessions and spasticity were not significantly associated (coefficient = − 0.0025, SE = 0.0129, p = 0.849, R2 analog = 0.37).Conclusion: Functional electrical stimulation-cycling training can improve spasticity, walking ability, and the strength of the lower limbs in the individuals with SCI. The number of training sessions is not linearly related to the decrease of spasticity. Twenty sessions of FES-cycling training are required to obtain the efficacy to decrease spasticity.

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Effects of Neuromuscular Electrical Stimulation in People with Spinal Cord Injury

Abstract: High-intensity NMES strength training in people with SCI may improve muscle strength, mass, physical health, and QoL. However, replication of these results is necessary before clinical implementation.

Cited by 23 publications

References 40 publications

Novel perspective on contractile properties and intensity‐dependent verification of force–frequency relationship during neuromuscular electrical stimulation

Novel perspective on contractile properties and intensity‐dependent verification of force–frequency relationship during neuromuscular electrical stimulation

Invasive and Non-Invasive Approaches of Electrical Stimulation to Improve Physical Functioning after Spinal Cord Injury

The Effect and Dose-Response of Functional Electrical Stimulation Cycling Training on Spasticity in Individuals With Spinal Cord Injury: A Systematic Review With Meta-Analysis

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