Evaluating the efficacy of functional electrical stimulation therapy assisted walking after chronic motor incomplete spinal cord injury: effects on bone biomarkers and bone strength

The Journal of Spinal Cord Medicine, 2017 · DOI: 10.1080/10790268.2017.1368961 · Published: January 1, 2017

Spinal Cord Injury Neurology Musculoskeletal Medicine

Simple Explanation

This study investigates whether using functional electrical stimulation therapy assisted walking (FES-T) can improve bone health in adults with chronic motor incomplete spinal cord injury (SCI). FES-T involves applying electrical stimulation to muscles to stimulate movement. Participants were divided into two groups: one receiving FES-T assisted walking and the other receiving conventional aerobic and resistance training. The study measured bone biomarkers and bone strength at baseline, 4 months, and 12 months. The results showed that FES-T improved bone turnover, but not bone strength, after four months. This suggests that long-term FES-T might be needed to see improvements in bone strength.

Study Duration

4 months intervention, 12 months outcome assessments

Participants

34 adults with chronic motor incomplete SCI

Evidence Level

Randomized controlled trial

Key Findings

1
Participants in the FES-T arm had a decrease in CTX and a significant increase in OC at intervention completion.
2
Significant biomarker changes were not observed in the CONV group.
3
No within or between group differences from baseline were observed in sclerostin or bone strength.

Research Summary

The study evaluated the efficacy of FES-T assisted walking compared to conventional exercise on bone biomarkers and bone strength in adults with chronic motor incomplete SCI. Four months of FES-T improved bone turnover (increase in OC and decrease in CTX) but not bone strength. The findings suggest that longer-term FES-T may be needed to augment lower extremity bone strength.

Practical Implications

Potential Therapeutic Intervention

FES-T assisted walking may be a potential therapy for SLOP among patients with chronic motor incomplete spinal cord injury.

Need for Longer Studies

Longer duration interventions are needed to evaluate the potential for FES-T to improve bone strength.

Biomarker Monitoring

Serum and urine biomarkers provide useful insight into bone metabolism and are an effective tool for monitoring response to therapy.

Study Limitations

1
Restricted use of our current FES-T protocol
2
The limited sample size (n=34)
3
The study was not adequately powered for the bone biomarkers and bone strength indices

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