Advanced Weight-Bearing Mat Exercises Combined With Functional Electrical Stimulation to Improve the Ability of Wheelchair-Dependent People With Spinal Cord Injury to Transfer and Attain Independence in Activities of Daily Living: A Randomized Controlled Trial Publisher Pubmed



Rahimi M¹ ; Torkaman G¹ ; Ghabaee M² ; Ghasemzadeh A³
Source: Spinal Cord Published:2020

Abstract

Study design: Randomized controlled trial. Objective: To determine the effects of advanced weight-bearing mat exercises (AWMEs) with/without functional electrical stimulation (FES) of the quadriceps and gastrocnemius muscles on the ability of wheelchair-dependent people with spinal cord injury (SCI) to transfer and attain independence in activities of daily living (ADLs). Setting: An outpatient clinic, Iran. Methods: People with traumatic chronic paraplegia (N = 16) were randomly allocated to three groups. The exercise group (EX; N = 5) performed AWMEs of quadruped unilateral reaching and tall-kneeling for 24 weeks (3 days/week). Sessions were increased from 10 min to 54 min over the 24-week period. The exercise-FES group (EX + FES; N = 5) performed AWMEs simultaneously with FES of the quadriceps and gastrocnemius muscles. The control group performed no exercise and no FES (N = 6). The primary outcomes were the total Spinal Cord Independence Measure-III (SCIM-III) to reflect independence with ADL, and the sum of the four SCIM-III transfer items to reflect ability to transfer. There were six other outcomes. Results: The mean (95% CI) between-group differences of the four transfer items of the SCIM-III for the EX vs. control group was 1.8 points (0.2–3.4), and for the EX + FES vs. control group was 2 points (0.4–3.6). The equivalent differences for the total SCIM-III scores were 2.7 points (−0.6–6.0) and 4.1 points (0.8–7.4), respectively. There were no significant between-group differences for any other outcomes. Conclusions: Advanced weight-bearing mat exercises improve the ability of wheelchair-dependent people with SCI to transfer and attain independence in ADL. © 2019, The Author(s), under exclusive licence to International Spinal Cord Society.