In clinical and community settings, one of the most commonly available and researched FES exercise modalities is FES-evoked cycling. ![]() It is a neuroprosthetic, therapeutic or exercise modality for individuals with a nervous system injury to reactivate the peripheral nervous system without significant lower motor neuron damage. Registration review protocol: CRD42018108940 (PROSPERO)įunctional electrical stimulation (FES) applies low-level electrical pulses to paretic or paralyzed muscles to restore or improve their functional capacity. The evidence summarized and appraised in this review can inform the development of the first international, evidence-based clinical practice guidelines for the use of FES cycling exercise in clinical and community settings of adults with SCI. ConclusionĬurrent evidence indicates that FES cycling exercise improves lower-body muscle health of adults with SCI, and may increase power output and aerobic fitness. Although lacking Level 1–2 studies, significant improvements were also found in nearly all of 35 Level 3–4 studies on power output and aerobic fitness (e.g., peak power and oxygen uptake during an FES cycling test) (GRADE ratings: ‘Low’). For muscle health (e.g., muscle mass, fiber type composition), significant improvements were found in 3 out of 4 Level 1–2 studies, and 27 out of 32 Level 3–4 studies (GRADE rating: ‘High’). Ninety-two studies met the eligibility criteria, comprising 999 adults with SCI representing all age, sex, time since injury, lesion level and lesion completeness strata. The certainty of the evidence for each outcome was assessed using GRADE ratings (‘High’, ‘Moderate’, ‘Low’, or ‘Very low’). Each study was designated as a Level 1, 2, 3 or 4 study, dependent on study design and quality appraisal scores. Two independent reviewers conducted study eligibility screening, data extraction, and quality appraisal using Cochranes’ Risk of Bias or Downs and Black tools. In order to capture the widest array of evidence available, any outcome measure employed in such studies was considered eligible. ![]() PubMed, the Cochrane Central Register of Controlled Trials, EMBASE, SPORTDiscus, and CINAHL were searched up to April 2021 to identify FES cycling exercise intervention studies including adults with SCI. The objective of this review was to summarize and appraise evidence on functional electrical stimulation (FES) cycling exercise after spinal cord injury (SCI), in order to inform the development of evidence-based clinical practice guidelines.
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