Feasibility of home-based functional electrical stimulation cycling: case report

Abstract

Study design: Single-subject (male, 64 years of age) case. Objectives: To determine the feasibility of a home-based FES-LEC (functional electrical stimulation lower extremities cycling) program and effects on body composition, quality of life (QOL) and seat pressure mapping in an older individual with spinal cord injured (SCI). Setting: Home-based FES-LEC with internet connection. Southeastern United States. Methods: FES-LEC three sessions per week for 9 weeks in the participant's home and monitored by the research staff via internet connection. Pre-and post-exercise program testing of seat pressure mapping, QOL and body composition including percent body fat (%BF), fat mass (FM), lean mass (LM) and bone mineral density (BMD). Results: The participant completed 25 of 27 recommended exercise sessions over 9 weeks for a 93% compliance rate. Cycling distance increased from 3.98 to 9.00 km (126%). Total body LM increased from 48.94 to 53.02 kg (8.3%). The %BF decreased from 29.6 to 28.4(À1.2%). Total body weight, FM and BMD remained unchanged. Average static seat pressure decreased from 55.5 to 52.59 mm Hg (5%), whereas maximum seat pressure decreased from 120.76 to 91.5 mm Hg (24%). The psychological domain (perception of body image, appearance and self-esteem) of the QOL questionnaire improved from 12.67 to 14. INTRODUCTIONOnly 31% of able-bodied (AB) older adults report participating in 20 min of moderate physical activity three or more times per week whereas the activity level of the spinal cord injured (SCI) population is o40% of the sedentary AB population. 1 Add in the factor of a markedly increased life span (currently nearing that of people without SCI) 2 and it is no wonder that the primary causes of death are no longer complications related to SCI but rather conditions associated with age and inactivity. Cardiovascular disease is now the foremost cause of death of persons with SCI over 60 years of age 3 and obesity, metabolic syndrome and osteoporosis are considered epidemic in the SCI population. 4 It is clear that the challenge of promoting an active lifestyle for those with SCI is imperative for healthy aging. The goal of this study was to determine the feasibility of a home-based FES-LEC (functional electrical stimulation lower extremities cycling) program and effects on body composition and quality of life (QOL) in an older individual with SCI.

Body composition changes after 12 months of FES cycling: case report of a 60-year-old female with paraplegia

“…6,7 These results also enhance the theory that regular long-term FES-LEC may decrease the risk factors associated with cardiovascular and metabolic diseases. The fact that BMD increased supports the findings of Frotzler et al 3 and provides hope that this activity may also help enhance bone health.…”

Exercise Adherence During Home-Based Functional Electrical Stimulation Cycling by Individuals with Spinal Cord Injury

“…Previous reports have shown that FES significantly impacts several health variables after SCI, such as lean mass, percentage body fat, and metabolic profiles. 8,9 Gorgey et al 10 found that 12 wks of electrical stimulation to evoke leg extension resistance training resulted in muscle hypertrophy, reduction in visceral adipose tissue, and improvement in metabolic profile in people with SCI. However, applications of FES cycling had been limited largely to clinics and research laboratories, which limited its effectiveness as a rehabilitation intervention to promote physical activity and continuity of care after SCI.…”

Differences in current amplitude evoking leg extension in individuals with spinal cord injury

“…Considering the current findings, bioengineers and manufactures should consider expanding the existing stimulation parameters in therapeutic stimulators. Because reliance on portable units to conduct home-exercise program may be a costeffective compared to expensive FES bikes [34]. The smaller muscle size after SCI compared to able-bodied individuals can result in full muscle activation accompanied with increasing the evoked torque that may result in significant muscle damage or fracture of osteoporotic bones.…”