Abstract
Study design
Secondary outcome measures analysis of a randomized, controlled study.
Objective
To assess the effects of hybrid-functional electrical stimulation (FES) rowing on motor and sensory recovery in individuals with spinal cord injury (SCI) 6–18 months post injury.
Setting
Outpatient rehabilitation network.
Methods
25 participants 6–12 months after SCI were randomly assigned to hybrid-FES rowing (n = 10) or standard of care (n = 15) groups. The hybrid-FES rowing group completed 6 months of rowing scheduled 3 times per week for 26 weeks at an exercise intensity of 70–85% of maximal heart rate. The standard of care group either participated in an arm ergometer exercise program (n = 6) or a waitlist without an explicit exercise program (n = 9). Changes in motor score and combined sensory score of the International Standards for Neurological Classification of SCI (ISNCSCI) were analyzed.
Results
Both groups demonstrated increases in motor and combined sensory scores, but no significant differences were noted between intervention groups (motor difference mean ↑1.3 (95% CI, −1.9 to 4.4), combined sensory difference mean ↓10 (−30 to 18)). There was an average of 63% adherence to the hybrid-FES rowing protocol, with no significant correlation in changes in motor or combined sensory score in the hybrid-FES rowing group with total distance or time rowed.
Conclusions
No significant effects to neurologic improvement were found with hybrid-FES rowing when compared with standard of care interventions in individuals with SCI 6–18 months post injury.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
Data availability
The datasets analyzed during the current study are available from the corresponding author on reasonable request.
References
Laskin JJ, Ashley EA, Olenik LM, Burnham R, Cumming DC, Steadward RD, et al. Electrical stimulation-assisted rowing exercise in spinal cord injured people. A pilot study. Paraplegia. 1993;31:534–41.
Wheeler GD, Andrews B, Lederer R, Davoodi R, Natho K, Weiss C, et al. Functional electric stimulation-assisted rowing: Increasing cardiovascular fitness through functional electric stimulation rowing training in persons with spinal cord injury. Arch Phys Med Rehabil. 2002;83:1093–9.
Fawcett JW, Curt A, Steeves JD, Coleman WP, Tuszynski MH, Lammertse D, et al. Guidelines for the conduct of clinical trials for spinal cord injury as developed by the ICCP panel: spontaneous recovery after spinal cord injury and statistical power needed for therapeutic clinical trials. Spinal Cord. 2006;45:190–205.
Sadowsky CL, Hammond ER, Strohl AB, Commean PK, Eby SA, Damiano DL, et al. Lower extremity functional electrical stimulation cycling promotes physical and functional recovery in chronic spinal cord injury. J Spinal Cord Med. 2013;36:623–31.
Kapadia NM, Zivanovic V, Furlan J, Craven BC, McGillivray C, Popovic MR. Functional electrical stimulation therapy for grasping in traumatic incomplete spinal cord injury: randomized control trial. Artif Organs. 2011;35:212–6.
Popovic MR, Kapadia N, Zivanovic V, Furlan JC, Craven BC, McGillivray C. Functional electrical stimulation therapy of voluntary grasping versus only conventional rehabilitation for patients with subacute incomplete tetraplegia: a randomized clinical trial. Neurorehabil Neural Repair. 2011;25:433–42.
Beaumont E, Guevara E, Dubeau S, Lesage F, Nagai M, Popovic M. Functional electrical stimulation post-spinal cord injury improves locomotion and increases afferent input into the central nervous system in rats. J Spinal Cord Med. 2014;37:93–100.
Taylor JA, Picard G, Widrick JJ. Aerobic capacity with hybrid FES rowing in spinal cord injury: comparison with arms-only exercise and preliminary findings with regular training. PM R. 2011;3:817–24.
Manns PJ, McCubbin JA, Williams DP. Fitness, inflammation, and the metabolic syndrome in men with paraplegia. Arch Phys Med Rehabil. 2005;86:1176–81.
De Assis GG, Gasanov EV, de Sousa MBC, Kozacz A, Murawska-Cialowicz E. Brain derived neutrophic factor, a linke of aerobic metabolism to neuroplasticity. J Physiol Pharmacol. 2018;69:351–8.
Kirshblum S, Waring W. Updates for the international standards for neurological classification of spinal cord injury. Phy Med Rehabil Clin N Am. 2014;25:505–17.
Akpinar P, Atici A, Ozkan FU, Aktas I, Kulcu DG, Sari A, et al. Reliability of the modified ashworth scale and modified tardieu scale in patients with spinal cord injuries. Spinal Cord. 2017;55:944–9.
Waters RL, Adkins RH, Yakura JS, Sie I. Motor and sensory recovery following complete tetraplegia. Arch Phys Med Rehabil. 1993;74:242–7.
Marino RJ, Jones L, Kirshblum S, Tal J, Dasgupta A. Reliability and repeatability of the motor and sensory examination of the international standards for neurological classification of spinal cord injury. J Spinal Cord Med. 2008;31:166–70.
Solinsky R, Betancourt L, Marino R, Kim A, Schmidt Read M, Schwab, et al. Stakeholder perceptions and clinical assessments of cardiometabolic disease after spinal cord injuries and disorders. Top Spinal Cord Inj Rehabil. 2019;25:122–3.
Acknowledgements
We would like to acknowledge Drs Stephanie Cho, Jayne Donovan, and Chloe Slocum for their assistance with data collection for this study.
Funding
This clinical trial (NCT02139436) was supported by the National Heart, Lung, and Blood Institute (1R01HL117037).
Author information
Authors and Affiliations
Contributions
RCC was responsible for extracting and analyzing data, interpreting results, and writing the report. JAT was responsible for designing the study protocol, overseeing data collection, and providing feedback on the report. RS was responsible for designing the study protocol, analyzing data, interpreting results, and writing the report.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethics
The present study was approved by the Institutional Review Board at Spaulding Rehabilitation Hospital. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary information
Rights and permissions
About this article
Cite this article
Chou, R.C., Taylor, J.A. & Solinsky, R. Effects of hybrid-functional electrical stimulation (FES) rowing whole-body exercise on neurologic improvement in subacute spinal cord injury: secondary outcomes analysis of a randomized controlled trial. Spinal Cord 58, 914–920 (2020). https://doi.org/10.1038/s41393-020-0445-3
Received:
Revised:
Accepted:
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1038/s41393-020-0445-3
This article is cited by
-
An analysis of the effectiveness of rehabilitation protocols for patients with spinal cord injury: A systematic review
Journal of Public Health (2025)
