Abstract
Objective
To comprehensively and critically appraise the clinical benefits and engineering designs
of functional electrical stimulation (FES)-rowing for management of individuals with
spinal cord injury (SCI).
Data Sources
Electronic database searches were conducted in Cumulative Index to Nursing & Allied
Health Literature, Cochrane Central Register of Controlled Trials, Cochrane Database
of Systematic Reviews, Excerpta Medica database, Emcare, Medline, PubMed, Scopus,
and Web of Science databases from inception to May 12, 2020.
Study Selection
Search terms used were synonyms of “spinal cord injury” for Population and “Electric
Stimulation (Therapy)/ and rowing” for Intervention. Two reviewers independently assessed
articles based on the following inclusion criteria: recruited individuals with SCI;
had aerobic FES-rowing exercise as study intervention; reported cardiovascular, muscular,
bone mineral density, or metabolic outcomes; and examined engineering design of FES-rowing
systems. Of the 256 titles that were retrieved in the primary search, 24 were included
in this study.
Data Extraction
Study characteristics, quality, participants’ characteristics, test descriptions,
and results were independently extracted by 2 reviewers. The quality of studies was
assessed with the Downs and Black checklist.
Data Synthesis
Comparison of peak oxygen consumption (V̇o2peak) rates showed that V̇o2peak during FES-rowing was significantly higher than arm-only exercise; FES-rowing training
improved V̇o2peak by 11.2% on average (95% confidence interval, 7.25-15.1), with a 4.1% (95% confidence
interval, 2.23-5.97) increase in V̇o2peak per month of training. FES-rowing training reduced bone density loss with increased
time postinjury. The rowing ergometer used in 2 studies provided motor assistance
during rowing. Studies preferred manual stimulation control (n=20) over automatic
(n=4).
Conclusions
Our results suggest FES-rowing is a viable exercise for individuals with SCI that
can improve cardiovascular performance and reduce bone density loss. Further randomized
controlled trials are needed to better understand the optimal set-up for FES-rowing
that maximizes the rehabilitation outcomes.
Keywords
List of abbreviations:
AO (arm-only), FES (functional electrical stimulation), RCT (randomized controlled trials), SCI (spinal cord injury), V̇o2peak (peak oxygen consumption)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 05, 2021
Footnotes
Disclosures: Dr Furlan reports grants from Craig H Neilsen Foundation, grants from Ontario Neurotrauma Foundation, grants from J. P. Bickell Foundation, and grants from Cervical Spine Research Society outside the submitted work. The other authors have nothing to disclose.
Identification
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© 2021 by the American Congress of Rehabilitation Medicine
