The effect of Functional Electrical Stimulation-assisted posture-shifting in bone mineral density: case series-pilot study

Spinal Cord Series and Cases, 2022 · DOI: https://doi.org/10.1038/s41394-022-00523-9 · Published: May 6, 2022

Spinal Cord Injury Neurology Musculoskeletal Medicine

Simple Explanation

This study investigates how using Functional Electrical Stimulation (FES) to help people with spinal cord injuries shift their weight while standing affects their bone density. The study found that FES-assisted exercises could improve bone density in the tibia (shin bone) of individuals with acute or subacute spinal cord injuries. These exercises involved anti-gravity load-bearing, meaning the participants were working against gravity while FES helped them move.

Study Duration

29 ± 5 weeks

Participants

Twelve participants with ASIA A SCI were recruited for this study. Three participants completed both phases.

Evidence Level

Case series-pilot study

Key Findings

1
Participants with acute and subacute SCI showed an absolute increase of trabecular vBMD (vBMDTRAB) in the proximal (mean of 26.9%) and distal tibia (mean of 22.35%).
2
Loss of vBMDTRAB in the distal femur was observed.
3
Improvements in vBMDTRAB in the distal tibia were found in acute and subacute SCI participants, and in the proximal tibia of acute participants, when subjected to anti-gravity FES-assisted load-bearing exercises for 29 ± 5 weeks.

Research Summary

The study investigated the impact of FES-assisted dynamic load-shifting exercises on bone mineral density (BMD) in individuals with complete spinal cord injury (SCI). The results indicated improvements in trabecular volumetric BMD (vBMDTRAB) in the distal tibia of acute and subacute SCI participants and in the proximal tibia of acute participants after 29 ± 5 weeks of anti-gravity FES-assisted load-bearing exercises. The study suggests that combining high-intensity and lower-intensity exercises may improve vBMD and provides more flexibility in exercise routines for individuals with SCI.

Practical Implications

Rehabilitation Strategies

FES-assisted dynamic load-shifting exercises can be incorporated into rehabilitation programs to improve bone mineral density in individuals with SCI.

Exercise Flexibility

Combining high-intensity and low-intensity exercises may offer more adaptable exercise routines for vBMD improvements.

Thermic Regulation and Muscle Hypertrophy

FES use can lead to improvements in thermic regulation and muscle hypertrophy, potentially enhancing overall physiological well-being.

Study Limitations

1
Small sample size (three participants completed the study).
2
High participant withdrawal rate.
3
Lack of significant differences in cortical volumetric bone mineral density (vBMDCORT) or improvement in distal femur (DF).

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