Sains Malaysiana 48(3)(2019): 607–612

http://dx.doi.org/10.17576/jsm-2019-4803-13

Muscle Size and Strength Benefits of Functional Electrical Stimulation-Evoked Cycling Dosage in Spinal Cord Injury: A Narrative Review

(Faedah Dos Rangsangan-Elektrik Berfungsi Berbasikal terhadap Saiz dan Kekuatan Otot pada Kecederaan Saraf Tunjang: Suatu Kajian Naratif)

NURHAIDA ROSLEY¹, NUR AZAH HAMZAID², NAZIRAH HASNAN³, GLEN M DAVIS⁴ & HAIDZIR MANAF*¹

¹Centre of Physiotherapy, Faculty of Health Sciences Universiti Teknologi MARA (Puncak Alam Campus), 42300 Puncak Alam, Selangor Darul Ehsan, Malaysia

²Department of Biomdical Engineering, Faculty of Engineering, University Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia

³Department of Rehabilitation Medicine, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia

⁴Department of Clinical Exercise and Rehabilitation Unit, Faculty of Health Science, University of Sydney, Camperdown NSW 2006, Australia

Received: 19 July 2017/Accepted: 9 January 2019

ABSTRACT

Loss of sensory motor function is one of the main causes of physical and activity limitations among individual with spinal cord injury (SCI). SCI may lead to muscle paralysis, weakness and disused muscle atrophy. Evidences have shown electrical stimulation and strengthening exercise might improve lower limb muscle strength and size among individual with SCI. Functional electrical stimulation (FES) evoked cycling is one of the methods that can elicit leg muscle contractions in order to produce a cycling motion and promote the integrity of the involved muscles. Therefore, this review is to synthesize the scientific literature regarding the effects of multiple dosages of FES-evoked lower limb cycling on muscle properties. A systematic literature search from 1946 to 2016 was performed. From over 1,139 articles retrieved from the database, about 31 potentially relevant articles were retained for possible inclusion. However, only 10 articles out of 31 articles fulfilled the inclusion criteria. Although the available evidence is compelling, there is insufficient quantity and quality evidence to draw conclusions regarding the specific parameter of FES-CE that may optimally increase muscle strength, mass, and circumference. However, it can be safely concluded that an effective training session would spend for 45-60 min, 3 times a week for at least 4 weeks to see changes in muscle size and strength.

Keywords: Cycling exercise; functional electrical stimulation; muscle strength; spinal cord injury

ABSTRAK

Kehilangan fungsi deria motor adalah salah satu punca kepada pembatasan fizikal dan aktiviti dalam kalangan individu yang mengalami kecederaan saraf tunjang. Kecederaan saraf tujang boleh mengakibatkan kelumpuhan otot, kelemahan dan ketidakgunaan otot atau atrofi. Bukti menunjukkan stimulasi elektrik dan senaman kekuatan otot boleh memperbaiki saiz dan kekuatan otot bahagian kaki dalam kalangan individu yang mengalami kecederaan saraf tunjang. Sistem berbasikal rangsangan FES adalah salah satu metod yang boleh merangsang kontraksi otot kaki untuk menghasilkan pergerakan berbasikal dan meningkatkan integriti otot yang terlibat. Oleh itu, kajian ini adalah bertujuan untuk mensintesis kepustakaan saintifik untuk mengkaji kesan pelbagai dos rangsangan FES untuk anggota bawah berbasikal pada sifat otot. Satu carian kepustakaan secara sistematik telah dijalankan dari 1946 hingga 2016. Daripada 1,139 artikel yang didapati daripada pangkalan data, 31 artikel yang berpotensi telah dikekalkan mengikut kebarangkalian inklusi. Walau bagaimanapun, hanya 10 artikel daripada 31 artikel memenuhi kriteria rangkuman. Walaupun bukti yang didapati sangat menarik perhatian, namun kuantiti dan kualitinya tidak mencukupi untuk dijadikan kesimpulan berkaitan dengan parameter khusus FES-CE yang mampu meningkatkan kekuatan, jisim dan ukur lilit otot secara optimum. Namun, ia selamat untuk disimpulkan bahawa keberkesanan suatu sesi latihan mengambil masa 45-60 minit, 3 kali seminggu untuk sekurang-kurangnya 4 minggu untuk melihat perubahan saiz dan kekuatan otot.

Kata kunci: Kecederaan saraf tunjang; kekuatan otot; rangsangan elektrik berfungsi; senaman berbasikal

REFERENCES

American College of Sports Medicine (ACSM). 2010. ACSM’s Resources for Clinical Exercise Physiology: Musculoskeletal, Neuromuscular, Neoplastic, Immunologic and Hematologic Conditions (ACSMs Resources for the Clinical Exercise Physiology). 2nd edition. Philadelphia: Lippincott, Williams and Wilkins.

Baldi, J.C., Jackson, R.D., Moraille, R. & Mysiw, W.J. 1998. Muscle atrophy is prevented in patients with acute spinal cord injury using functional electrical stimulation. Spinal Cord 36: 463-469.

Demchak, T.J., Linderman, J.K., Mysiw, W.J., Jackson, R., Suun, J. & Devor, S.T. 2005. Effects of functional electric stimulation cycle ergometry training on lower limb musculature in acute SCI individuals. Journal of Sports Science and Medicine 4(3): 263-271.

Dionyssiotis, Y., Stathopoulos, K., Trovas, G., Papaioannou, N., Skarantavos, G. & Papagelopoulos, P. 2015. Impact on bone and muscle area after spinal cord injury. BoneKEy Reports 4(1): 1-8.

Duffell, L.D., Donaldson, N.D.N., Perkins, T.I.M.A. & Ms, C. 2008. Long-term intensive electrically stimulated cycling by spinal cord-injured people: Effect on muscle properties and their relation to power output. Muscle Nerve 38(4): 1304-1311.

Estigoni, E.H., Fornusek, C., Smith, R.M. & Davis, G.M. 2011. Evoked EMG and muscle fatigue during isokinetic FES-cycling in individuals with SCI. Neuromodulation: Journal of the International Neuromodulation Society 14(4): 349-355.

Fornusek, C. & Davis, G. 2004. Maximizing muscle force via low-cadence functional electrical stimulation cycling. Journal of Rehabilitation Medicine 36(5): 232-237.

Fornusek, C., Davis, G.M. & Russold, M.F. 2013. Pilot study of the effect of low-cadence functional electrical stimulation cycling after spinal cord injury on thigh girth and strength. Archives of Physical Medicine and Rehabilitation 94(5): 990-993.

Giangregorio, L.M., Hicks, A.L., Webber, C.E., Phillips, S.M., Craven, B.C., Bugaresti, J.M. & McCartney, N. 2005. Body weight supported treadmill training in acute spinal cord injury: Impact on muscle and bone. Spinal Cord: The Official Journal of the International Medical Society of Paraplegia 43(11): 649-657.

Hamzaid, N.A. & Davis, G.M. 2009. Health and fitness benefits of functional electrical stimulation-evoked leg exercise for spinal cord-injured individuals. Topics in Spinal Cord Injury Rehabilitation 14(4): 88-121.

Hasnan, N., Ektas, N., Tanhoffer, A.I.P., Tanhoffer, R., Fornusek, C., Middleton, J.W., Husain, R. & Davis, G.M. 2013. Exercise responses during functional electrical stimulation cycling in individuals with spinal cord injury. Medicine and Science in Sports and Exercise 45(6): 1131-1138.

Hicks, A.L., Ginis, K.A.M., Pelletier, C.A., Ditor, D.S., Foulon, B. & Wolfe, D.L. 2011. The effects of exercise training on physical capacity, strength, body composition and functional performance among adults with spinal cord injury: A systematic review. Spinal Cord. 49(11): 1103-1127.

Johnston, T.E., Schmidt-Read, M., Marino, R., Oleson, C., Leiby, B. & Modlesky, C. 2015. Musculoskeletal effects of two functional electrical stimulation cycling paradigms for people with spinal cord injury. Archives of Physical Medicine and Rehabilitation 97(9): 1413-1422.

Kuhn, D., Leichtfried, V. & Schobersberger, W. 2014. Four weeks of functional electrical stimulated cycling after spinal cord injury: A clinical cohort study. International Journal of Rehabilitation Research 37(3): 243-250.

Liu, C., Chen, S., Chen, C., Chen, T. & Chen, J.J. 2007. Effects of functional electrical stimulation on peak torque and body composition in patient with spinal cord injury. The Kaohsiung Journal of Medical Sciences 23(5): 232-240.

LiVecchi, M.A. 2011. Spinal cord injury. Continuum: Lifelong Learning Neurology 17(3): 568-583.

Lynch, C.L., Popovic, M.R. & Rushton, D. 2008. Functional electrical stimulation. IEEE Control Systems Magazine 28(2): 40-50.

National Spinal Cord Injury Database. 2015. www.nscisc.uab. edu/nscisc-database.aspx.

Peckham, P.H. & Knutson, J.S. 2005. Functional electrical stimulation for neuromuscular applications. Annual Review of Biomedical Engineering 7(1): 327-360.

Ragnarsson, K.T. 2008. Functional electrical stimulation after spinal cord injury: Current use, therapeutic effects and future directions. Spinal Cord 46(4): 255-274.

Sadowsky, C.L., Hammond, E.R., Strohl, A.B., Commean, K., Eby, S.A., Damiano, D.L., Wingert, J.R., Bae, K.T. & McDonald, J.W. 2013. Lower extremity functional electrical stimulation cycling promotes physical and functional recovery in chronic spinal cord injury. J. Spinal Cord. Med. 36(6): 623-631.

Sköld, C., Lönn, L., Harms-Ringdahl, K., Hultling, C., Levi, R., Nash, M. & Seiger, Å. 2002. Effects of functional electrical stimulation training for six months on body composition and spasticity in motor complete tetraplegic spinal cord-injured individuals. Journal of Rehabilitation Medicine 34(1): 25-32.

Thrasher, T.A., Ward, J.S. & Fisher, S. 2013. Strength and endurance adaptations to functional electrical stimulation leg cycle ergometry in spinal cord injury. NeuroRehabilitation 33(1): 133-138.

Thrasher, T.A., Flett, H.M. & Popovic, M.R. 2006. Gait training regimen for incomplete spinal cord injury using functional electrical stimulation. Spinal Cord 44(6): 357-361.

Westcott, W.L. & Rosa, S.A. 2010. Spinal cord injury. Strength and Conditioning Journal 32(6): 16-18.

*Corresponding author; email: haidzir5894@uitm.edu.my