Lower extremity functional electrical stimulation cycling promotes physical and functional recovery in chronic spinal cord injury

Cristina L. Sadowsky, Edward R. Hammond, Adam B. Strohl, Paul K. Commean, Sarah A. Eby, Diane L. Damiano, Jason R. Wingert, Kyongtae T. Bae, John W. McDonald

Research output: Contribution to journalArticlepeer-review

70 Scopus citations


Objective: To examine the effect of long-termlower extremity functional electrical stimulation (FES) cycling on the physical integrity and functional recovery in people with chronic spinal cord injury (SCI). Design: Retrospective cohort, mean follow-up 29.1 months, and cross-sectional evaluation. Setting: Washington University Spinal Cord Injury Neurorehabilitation Center, referral center. Participants: Twenty-five people with chronic SCI who received FES during cycling were matched by age, gender, injury level, and severity, and duration of injury to 20 people with SCI who received range of motion and stretching. Intervention: Lower extremity FES during cycling as part of an activity-based restorative treatment regimen. Main outcome measure: Change in neurological function: motor, sensory, and combined motor-sensory scores (CMSS) assessed by the American Spinal Injury Association Impairment scale. Response was defined as ≥1 point improvement. Results: FES was associated with an 80% CMSS responder rate compared to 40% in controls. An average 9.6 CMSS point loss among controls was offset by an average 20-point gain among FES subjects. Quadriceps muscle mass was on average 36% higher and intra/inter-muscular fat 44% lower, in the FES group. Hamstring and quadriceps muscle strength was 30 and 35% greater, respectively, in the FES group. Quality of life and daily function measures were significantly higher in FES group. Conclusion: FES during cycling in chronic SCI may provide substantial physical integrity benefits, including enhanced neurological and functional performance, increased muscle size and force-generation potential, reduced spasticity, and improved quality of life.

Original languageEnglish
Pages (from-to)623-631
Number of pages9
JournalJournal of Spinal Cord Medicine
Issue number6
StatePublished - Nov 2013


  • Activity-based restorative therapy
  • Assistive technology
  • Cycle ergometry
  • Functional electrical stimulation
  • Paraplegia
  • Physical muscle strength
  • Quality of life
  • Rehabilitation
  • Spasticity
  • Spinal cord injury
  • Tetraplegia


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