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

Harvey, L A; Lin, Chung‐Wei Christine; Glinsky, Joanne; Wolf, Annelies De

doi:10.1038/sc.2008.100

Cited by 75 publications

(66 citation statements)

References 43 publications

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“…4 The results indicate a statistically significant increase in voluntary strength, although there is uncertainty as to whether the size of the treatment effect is clinically important (the 95% CI spanned the sufficiently important difference of 8 Nm). The effects of ES superimposed on PRT on stimulated strength, stimulated endurance and voluntary endurance were equivocal.…”

Section: Discussionmentioning

confidence: 99%

“…there is no direct evidence from clinical trials to suggest that voluntary strength is increased by superimposing ES on PRT 4,9,10 or by superimposing ES on any type of voluntary exercise in people with muscle paresis. [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%

“…1,2 However, its clinical efficacy for paretic muscles after SCI is less clear 4 and it has only been investigated in two randomized controlled trials, 1,5 neither of which have provided conclusive evidence of benefits. It is commonly believed that the effectiveness of PRT may be enhanced through superimposed electrical stimulation (ES)-evoked muscle contractions.…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

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“…It is also beneficial for psychological well-being, participation in the community, and quality of life. 4,5 Previous studies have shown that preserved muscle strength, as assessed using the International Standards for Neurological Classification of Spinal Cord Injuries (ISNCSCI) neurological assessment, is highly correlated with ambulation ability. 6,7 Ambulatory capacity is defined as the degree of independence in walking, both at home and outdoors in the community.…”

Section: Introductionmentioning

confidence: 99%

Ten Meters Walking Speed in Spinal Cord–Injured Patients: Does Speed Predict Who Walks and Who Rolls?

Silfhout

Hosman

Bartels

et al. 2017

Neurorehabil Neural Repair

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Background. Walking speed is assumed to be a key factor in regaining ambulation after spinal cord injury (SCI). However, from the literature it remains unclear which walking speed usually results in independent community ambulation. Objective. The primary aim of this study was to determine at which walking speed SCI patients tend to walk in the community instead of using a wheelchair. The secondary aim was to investigate clinical conditions that favor independent ambulation in the community. Methods. Data from SCI patients were collected retrospectively from the European Multicenter Study about Spinal Cord Injury database. We determined a cutoff walking speed at which the patients tend to walk in the community by plotting a receiver operating characteristics curve, using the Spinal Cord Independence Measure for outdoor mobility. Univariate analyses investigated which factors influence independent community ambulation. Results. A walking speed of 0.59 m/s is the cutoff between patients who do and do not ambulate independently in the community, with a sensitivity of 91.6% and a specificity of 80.3%. Age, injury severity, and lower limb muscle strength have a significant influence on independent community ambulation. Conclusions. Patients with an SCI who regain a walking speed of 0.59 m/s tend to achieve a level of walking effectiveness that allows for independent community walking. Although such patients tend to be younger and less severely injured, this walking speed can be a target for locomotor training in rehabilitation and clinical trials that lead to a meaningful outcome level of community walking.

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“…This may be a result of the increased number of people living with incomplete SCIs [1]. Consequently, rehabilitation therapies have altered, to address activity limitations that patients may experience, to increase participation in the community and to improve patients' overall quality of life [2]. One of the primary goals of thebeing [5].…”

Section: Introductionmentioning

confidence: 99%

The Ability to Walk After a Spinal Cord Injury with Emphasis on Exoskeletons: A Review

L¹,

Edwards²,

Hosman³

et al. 2017

J Spine

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Background: In recent years, an increasing number of patients with a spinal cord injury (SCI) have been reintegrating into community life and have been getting back to a more active and independent lifestyle. Consequently, rehabilitation therapies have altered, to address activity limitations that patients may experience, to increase participation in the community and to improve patients' overall quality of life. An innovative, supportive approach to locomotor training is through use of an exoskeleton, which could be used in those patients who are unable to ambulate by themselves.

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

Cited by 75 publications

References 43 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

Ten Meters Walking Speed in Spinal Cord–Injured Patients: Does Speed Predict Who Walks and Who Rolls?

The Ability to Walk After a Spinal Cord Injury with Emphasis on Exoskeletons: A Review

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