A Randomized Controlled Trial on the Effects of Cycling With and Without Electrical Stimulation on Cardiorespiratory and Vascular Health in Children With Spinal Cord Injury

Johnston TE, Smith BT, Mulcahey MJ, Betz RR, Lauer RT. A randomized controlled trial on the effects of cycling with and without electrical stimulation on cardiorespi- ratory and vascular health in children with spinal cord injury. Arch Phys Med Rehabil 2009;90:1379-88. Objective: To examine the cardiorespiratory/vascular ef- fects of cycling with and without functional electrical stimula- tion (FES) in children with spinal cord injury (SCI). Design: Randomized controlled trial. Setting: Pediatric referral hospital. Participants: Children with SCI (N30), ages 5 to 13 years, with injury levels from C4 to T11, and American Spinal Injury Association grades A, B, or C. Interventions: Children were randomly assigned to 1 of 3 groups: FES leg cycling exercise, passive leg cycling, or non- cycling control group receiving electrical stimulation therapy. After receiving instruction on the use of the equipment, chil- dren exercised for 1 hour 3 times per week for 6 months at home with parental supervision. Main Outcome Measures: Oxygen uptake (VO2) during an incremental arm ergometry test, resting heart rate, forced vital capacity, and a fasting lipid profile. Results: There were no differences (P.05) between groups after 6 months of exercise when comparing pre- and postval- ues. However, there were differences between groups for some variables when examining percent change. The FES cycling group showed an improvement (P.035) in VO2 (16.2% 25.0%) as compared with the passive cycling group (-28.7% 29.1%). For lipid levels, the electrical stimulation-only group showed declines (P.032) in cholesterol levels (-17.1% 8.5%) as compared with the FES cycling group (4.4% 20.4%). Conclusions: Cycling with FES led to gains in VO2, whereas electrical stimulation alone led to improvements in cholesterol.