A randomized trial of functional electrical stimulation for walking in incomplete spinal cord injury: Effects on walking competency

The Journal of Spinal Cord Medicine, 2014 · DOI: 10.1179/2045772314Y.0000000263 · Published: September 1, 2014

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

This study aimed to determine if using functional electrical stimulation (FES) during walking could improve gait and balance in people with incomplete spinal cord injuries, compared to a non-FES exercise program. Participants with chronic incomplete SCI were randomly assigned to either a FES-assisted walking group or a control group that performed aerobic and resistance exercises. The study found that both groups improved their walking ability, but the FES group showed a greater improvement in spinal cord independence measure (SCIM) mobility sub-score.

Study Duration

4, 6, and 12 months

Participants

34 individuals with traumatic and chronic (≥18 months) motor incomplete SCI

Evidence Level

Level 1, Randomized Controlled Trial

Key Findings

1
The spinal cord independence measure (SCIM) mobility sub-score improved over time in the intervention group compared with the control group.
2
Walking speed, endurance, and balance during ambulation all improved upon completion of therapy, and majority of participants retained these gains at long-term follow-ups.
3
On all other outcome measures the intervention and control groups had similar improvements.

Research Summary

This study investigated the benefits of FES-assisted walking compared to a non-FES exercise program for individuals with chronic incomplete SCI. While both groups showed improvements in walking ability, the FES group demonstrated a greater increase in SCIM mobility sub-score. The findings suggest that task-oriented training, including both FES-assisted walking and conventional exercise, can improve walking ability in this population, even in the chronic stage.

Practical Implications

Rehabilitation Potential

Individuals with chronic incomplete SCI can still improve their walking ability through targeted therapies.

Therapeutic Approach

Both FES-assisted walking and conventional exercise programs can be effective for improving walking function in this population.

SCIM as Indicator

The Spinal Cord Independence Measure (SCIM) mobility sub-score may be a useful tool for assessing the effectiveness of interventions for improving walking ability.

Study Limitations

1
The study may not have been adequately powered to detect small but clinically meaningful differences.
2
Many participants could not complete all measures at all time points, resulting in missing data.
3
Our sample had a very wide range of functional abilities ranging from participants being wheelchair bound to participants who were community ambulators.

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