Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 4 , Pages 564-570, April 2009

A Comparison of Functional Electrical and Magnetic Stimulation for Propelled Cycling of Paretic Patients

  • Johann Szecsi, MD

      Affiliations

    • Center for Sensorimotor Research, Department of Neurology, Ludwig-Maximillians University, Munich, Germany
    • Corresponding Author InformationCorrespondence to Johann Szecsi, MD, Center for Sensorimotor Research, Dept of Neurology, Ludwig-Maximillians University, Marchioninistrasse 23, 81377 Munich, Germany
    • ,
  • Martin Schiller, MD

      Affiliations

    • Center for Sensorimotor Research, Department of Neurology, Ludwig-Maximillians University, Munich, Germany
    • ,
  • Andreas Straube, MD

      Affiliations

    • Center for Sensorimotor Research, Department of Neurology, Ludwig-Maximillians University, Munich, Germany
    • ,
  • Dieter Gerling, PhD

      Affiliations

    • Department of Electrical Drives, University of Federal Defense, Munich, Germany

Abstract 

Szecsi J, Schiller M, Straube A, Gerling D. A comparison of functional electrical and magnetic stimulation for propelled cycling of paretic patients.

Objective

To compare isometric torque and cycling power, smoothness and symmetry using repetitive functional magnetic stimulation (FMS) and functional electrical stimulation (FES) in patients with paretic legs with preserved sensibility and in patients without sensibility.

Design

Repeated-measures design.

Setting

Laboratory setting.

Participants

Eleven subjects with complete spinal cord injury (SCI) and 29 subjects with chronic hemiparesis (16.6±5.5mo poststroke) volunteered.

Interventions

Using a tricycle testbed, participants were exposed to isometric measurements and ergometric cycling experiments, performed during both 20Hz FMS and FES stimulation. Subjects with hemiparesis and with complete SCI were stimulated at maximally tolerable level and maximal intensity, respectively.

Main Outcome Measures

Maximal isometric pedaling torque and mean ergometric power, smoothness, and symmetry were recorded for voluntary, FES, and FMS conditions.

Results

Two different patterns of the efficacy of FMS were identified. (1) Patients with complete SCI did not benefit (less torque and power was evoked with FMS than with FES, P<.003 and 10−4 respectively). (2) Patients with hemiplegia and preserved sensibility could improve their torque output (P<.05), smoothness, and symmetry of pedaling (P<.05) with FMS more than with FES.

Conclusions

FMS is a potential alternative to surface FES of the large thigh musculature in stimulation-supported cycling of patients with partially or completely preserved sensibility.

Key Words: Magnetic stimulation therapy, Pain, Power, Rehabilitation, Spinal cord injuries, Stroke, Torque

List of Abbreviations: FES, functional electrical stimulation, FMS, functional magnetic stimulation, MAS, Modified Ashworth Scale, SCI, spinal cord injury

 

 Supported by the Else-Kröner Fresenius Foundation, Bad-Homburg, Germany (grant no. P35/06//A09/06).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

 Reprints are not available from the author.

PII: S0003-9993(08)01707-3

doi:10.1016/j.apmr.2008.09.572

Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 4 , Pages 564-570, April 2009

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