Training with FES-assisted cycling in a subject with spinal cord injury: Psychological, physical and physiological considerations

Abstract

Context

People with spinal cord injury (SCI) experience the effects of a sedentary lifestyle very early on. Literature data suggest that programs using FES-assisted cycling would contribute to reduce the consequences of physical inactivity. The objective was to assess the feasibility of 12-month training on a FES-assisted bike of a subject with paraplegia for 21 years, T3, Asia Impairment Scale (AIS) A. An evaluation of morbidity, self-esteem, satisfaction, quality of life and duration of pedaling was performed. The impact on pain, cardiorespiratory function, body composition and bone metabolism were also assessed.

Findings

The acceptability score of the training constraints increased from 51 to 59/65 and satisfaction was high around 8/10. The pedaling duration increased from 1’ to 26’ on the recumbent bike and from 1’ to 15’ on open terrain. No significant changes were found with BMD and cardiorespiratory measures during exercise tests. SF 36 showed significant improvement of more than 10% and the Rosenberg Self Esteem score rapidly improved from 36 to 39/40. At the end of the training, the patient reached the objective of the Cybathlon 2016 by covering 750 m in less than 8 minutes, at an average speed of 5.80 km/hr.

Conclusion/Clinical relevance

A person with high and complete level of SCI for more than 20 years can undertake this type of challenge if the prerequisites are met; this training is without danger if the safety precautions are respected; the challenge of participating in a competition had a powerful impact on JP’s self-esteem and perceived quality of life.

Keywords:

• Spinal cord injury
• Functional electrical stimulation
• Muscle
• Cycling
• Quality of life

Acknowledgments

We are grateful to Jerome Parent for his courage and truly admirable perseverance. We also thank Valerie Piechocki for her valuable aid in preparing the Research Ethics Board application form and to the Fond de Soutien Neuroglia for their generous financial and moral support, without which this challenge would never have been undertaken. We also acknowledge Berkelbike Company for lending us a trike for the training. Special thanks to Catherine Stott for her invaluable help with translation.

Disclaimer statements

Contributors None.

Conflict of interest The Authors of this manuscript have no conflicts of interest to report.

Ethics approval of the Research Ethics Board.

Disclosure Communication at the IFESS, Rehaweek 2017 London (UK), and SOFMER 2017 Congress Nancy (France). Technical report submitted to the European Journal of Translational Myology.

Funding the Fonds de Soutien Neuroglia (France).

ORCID

Charles Fattal http://orcid.org/0000-0002-3042-0941

Emerson Fachin-Martins http://orcid.org/0000-0001-9858-9009

Brigitte Lucas http://orcid.org/0000-0001-7513-3009

Jean-Marie Casillas http://orcid.org/0000-0003-0962-4699