Related Experiment Video
Updated: May 27, 2026
Paradigms of Lower Extremity Electrical Stimulation Training After Spinal Cord Injury
Published on: February 1, 2018
Muscle changes following cycling and/or electrical stimulation in pediatric spinal cord injury
Therese E Johnston1, Christopher M Modlesky, Randal R Betz
1Department of Physical Therapy, University of the Sciences, Philadelphia, PA 19104, USA. t.johnston@usp.edu
Insights
Electrical stimulation exercise, including functional electrical stimulation cycling, improved thigh muscle volume and strength in children with spinal cord injury (SCI). These interventions may reduce risks of cardiovascular disease and diabetes.
Area of Science:
- Pediatric Rehabilitation
- Neuromuscular Electrical Stimulation
- Spinal Cord Injury Research
Background:
- Children with spinal cord injury (SCI) face increased risks for secondary health conditions.
- Muscle atrophy and weakness are common in pediatric SCI, contributing to metabolic and cardiovascular issues.
Purpose of the Study:
- To evaluate the impact of functional electrical stimulation cycling (FESC), passive cycling (PC), and electrical stimulation (ES) on thigh muscle volume and strength in children with SCI.
- To compare the effectiveness of these interventions in a home-based setting.
Main Methods:
- A randomized controlled trial involving 30 children (ages 5-13) with chronic SCI.
- Participants were assigned to FESC, PC, or ES groups, exercising for 6 months.
- Muscle volume (MRI) and stimulated strength (dynamometer) were measured pre- and post-intervention.
Main Results:
- All participants completed the 6-month intervention.
- Significant differences in quadriceps muscle volume and stimulated strength were observed between groups.
- The ES group showed greater muscle volume gains, while the FESC group demonstrated greater strength improvements.
Conclusions:
- Electrically stimulated exercise interventions, including FESC and ES, can enhance muscle size and strength in children with SCI.
- These improvements may contribute to mitigating risks of cardiovascular disease, insulin resistance, and type 2 diabetes.
Objective:
To determine the effect of cycling, electrical stimulation, or both, on thigh muscle volume and stimulated muscle strength in children with spinal cord injury (SCI).
Design:
Randomized controlled trial.
Setting:
Children's hospital specializing in pediatric SCI.
Participants:
Children (N=30; ages, 5-13y) with chronic SCI.
Interventions:
Children were randomly assigned to 1 of 3 interventions: functional electrical stimulation cycling (FESC), passive cycling (PC), and noncycling, electrically stimulated exercise (ES). Each group exercised for 1 hour, 3 times per week for 6 months at home.
Main Outcome Measures:
Preintervention and postintervention, children underwent magnetic resonance imaging to assess muscle volume, and electrically stimulated isometric muscle strength testing with the use of a computerized dynamometer. Data were analyzed via analyses of covariance (ANCOVA) with baseline measures as covariates. Within-group changes were assessed via paired t tests.
Results:
All 30 children completed the training. Muscle volume data were complete for 24 children (8 FESC, 8 PC, 8 ES) and stimulated strength data for 27 children (9 per group). Per ANCOVA, there were differences between groups (P<.05) for quadriceps muscle volume and stimulated strength, with the ES group having greater changes in volume and the FESC group having greater changes in strength. Within-group analyses showed increased quadriceps volume and strength for the FESC group and increased quadriceps volume for the ES group.
Conclusions:
Children receiving either electrically stimulated exercise experienced changes in muscle size, stimulated strength, or both. These changes may decrease their risk of cardiovascular disease, insulin resistance, glucose intolerance, and type 2 diabetes.
Clinical Trials Registration Number:
NCT00245726.
