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功能性电刺激辅助划船对脊髓损伤手动轮椅使用者有氧适能和肩部疼痛的影响

Effects of functional electrical stimulation assisted rowing on aerobic fitness and shoulder pain in manual wheelchair users with spinal cord injury.

作者信息

Wilbanks Susan R, Rogers Rebecca, Pool Sean, Bickel C Scott

机构信息

a Department of Physical Therapy , University of Alabama at Birmingham , Birmingham , AL , USA.

b UAB-Lakeshore Foundation Research Collaborative , Birmingham , AL , USA.

出版信息

J Spinal Cord Med. 2016 Nov;39(6):645-654. doi: 10.1179/2045772315Y.0000000052. Epub 2016 Apr 1.

Abstract

OBJECTIVE

Test the effectiveness of a 6-week functional electrical stimulation (FES)-assisted rowing intervention to increase aerobic fitness and decrease shoulder pain in manual wheelchair users with spinal cord injury (SCI) Methods: Ten adults with SCI (47 ± 12 years, 86 ± 19.7 kg, 175.5 ± 13.2 cm) 18 ± 14 years since injury, AIS classification A-C who had pain in one or both shoulders for >6 months took part in a pre-test, post-test experiment in our human performance laboratory. Participants took part in 30 minutes of FES-assisted rowing, 3 days/week × 6 weeks. Participants were evaluated for VO peak (FES-row and arm bike), distance rowed, arm power output, Wheelchair User Shoulder Pain Index (WUSPI), upper extremity isokinetic strength, scapular stabilization, participation (LIFE-H), quality of life (QOL-SCI), qualitative exit interview.

RESULTS

Participants increased distance rowed by 257 ± 266 m and increased arm power output by 6.7 ± 7.9 W. An 8% increase in VO peak and 10.5 ± 4.4 point decrease in shoulder pain were observed (all P < 0.05). There were no changes in upper extremity strength, scapular stabilization, or survey-based measures of participation or quality of life. Qualitative interviewing indicated overall enjoyment of the intervention and improvement in perceived quality of life.

CONCLUSIONS

FES-assisted rowing is effective to increase aerobic fitness and decrease shoulder pain in manual wheelchair users with SCI. Further research is necessary to determine if rowing without FES can provide similar benefits, and to determine mechanisms driving improvements in shoulder pain, as no changes in measures of upper extremity strength or scapular stabilization were observed.

摘要

目的

测试为期6周的功能性电刺激(FES)辅助划船干预对提高脊髓损伤(SCI)手动轮椅使用者的有氧适能和减轻肩部疼痛的效果。方法:10名成年SCI患者(年龄47±12岁,体重86±19.7千克,身高175.5±13.2厘米),受伤后18±14年,美国脊髓损伤协会(AIS)分级为A - C级,肩部一处或两处疼痛超过6个月,在我们的人体运动实验室参加了一项前测、后测实验。参与者每周3天、共6周,每次进行30分钟的FES辅助划船。对参与者进行了最大摄氧量(FES划船和手臂自行车)、划船距离、手臂功率输出、轮椅使用者肩部疼痛指数(WUSPI)、上肢等速肌力、肩胛骨稳定性、参与度(LIFE - H)、生活质量(QOL - SCI)评估以及定性退出访谈。

结果

参与者划船距离增加了257±266米,手臂功率输出增加了6.7±7.9瓦。最大摄氧量增加了8%,肩部疼痛减轻了10.5±4.4分(所有P<0.05)。上肢力量、肩胛骨稳定性或基于调查的参与度及生活质量测量指标均无变化。定性访谈表明参与者总体上享受该干预措施,且感觉生活质量有所改善。

结论

FES辅助划船对于提高SCI手动轮椅使用者的有氧适能和减轻肩部疼痛是有效的。由于未观察到上肢力量或肩胛骨稳定性测量指标的变化,因此有必要进一步研究无FES划船是否能带来类似益处,以及确定减轻肩部疼痛的驱动机制。

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