Functional Electrical Stimulation Cycling in SCI
Spinal Cord Injury, Acute, Paraplegia, Tetraplegia
About this trial
This is an interventional treatment trial for Spinal Cord Injury, Acute focused on measuring Functional Electrical Stimulation Cycling, Physical Therapy
Eligibility Criteria
Inclusion Criteria:
- identified as being medically stable by the treating consultant,
- within the first 6 weeks post-injury,
- able to sit for 2 hours in a wheelchair,
- over 18 years old,
- acquired non progressive SCI - traumatic, spinal cord stroke, surgical injury,
- an incomplete SCI, graded as American Spinal Injury Association (ASIA) B (motor complete, sensation present below the lesion); C (some but not useful motor function) or D (useful motor function present),
Exclusion Criteria:
- acute condition impairing participant's ability to cycle (eg, leg fracture),
- proven or suspected neuromuscular weakness affecting the legs due to another condition (eg, stroke or Guillain-Barré syndrome),
- unable to follow instruction in English
- symptomatic cardiac disease,
- ventilator dependency,
- severe spasticity,
- uncontrolled autonomic dysreflexia,
- possible, suspected or confirmed pregnancy,
- likely to be discharged before the end of the exercise intervention.
- unable to tolerate the sensation of FES
Sites / Locations
- The Queen Elizabeth National Spinal Injuries UnitRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Intervention
Control
FES cycle training will be performed on the RT300 FES cycle ideally 3 times per week for 6 weeks, each session lasting up to 90 minutes. Electrical stimulation will be delivered through up to 12 independent channels each delivering up to 140 mA current on the following muscles (both on the right and left leg): quadriceps, femoral biceps and gluteus, gastrocnemius and tibialis anterior. Abdominal and back extensor muscles may also be stimulated if the participant presents with neurological trunk weakness (SCI above T6). The FES unit will stimulate the muscles that extend the hip (gluteals), flex the knee (hamstrings) and extend the knee (quadriceps) in the correct order to bring about a cycling motion. The feet and lower legs of the participants will be strapped into the pedals and the wheelchair will be coupled in a rigid manner with the training device.
Participants in the control group will receive usual care, consistent with standard NHS care in this population. Usual physiotherapy care is provided, up to 2 times per day, 4 to 5 days per week, each lasting approximately 90 minutes. Physiotherapists provide one to one function-oriented physiotherapy session to improve balance, muscle strength and transfer skills.