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.
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Data archiving
The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
We gratefully acknowledge all participants who participated in this study.
Funding
This project was supported by a grant from Medical Sciences Faculty of Tarbiat Modares University, Tehran, Iran.
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MR was responsible for designing and planning the study, data collection, analysis, and interpretation, and writing the report. GT was responsible for designing and planning the study, analysis and interpretation of the results, and revision of the manuscript critically for important intellectual content. MG contributed to the neurological and related clinical conception and design. AG-Z contributed to the conception and design. All authors read and approved the final manuscript.
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The authors declare that they have no conflict of interest.
Ethics
The Research Ethics Committee of Tarbiat Modares University (Tehran, Iran) approved the study protocol #52D/5326. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.
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Rahimi, M., Torkaman, G., Ghabaee, M. et al. 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. Spinal Cord 58, 78–85 (2020). https://doi.org/10.1038/s41393-019-0328-7
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DOI: https://doi.org/10.1038/s41393-019-0328-7
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