Institute of Biomedical Engineering, University of Toronto, Toronto, ON; KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON.
Institute of Biomedical Engineering, University of Toronto, Toronto, ON.
Arch Phys Med Rehabil. 2021 Aug;102(8):1595-1605. doi: 10.1016/j.apmr.2021.01.075. Epub 2021 Feb 6.
To comprehensively and critically appraise the clinical benefits and engineering designs of functional electrical stimulation (FES)-rowing for management of individuals with spinal cord injury (SCI).
Electronic database searches were conducted in Cumulative Index to Nursing & Allied Health Literature, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Excerpta Medica database, Emcare, Medline, PubMed, Scopus, and Web of Science databases from inception to May 12, 2020.
Search terms used were synonyms of "spinal cord injury" for Population and "Electric Stimulation (Therapy)/ and rowing" for Intervention. Two reviewers independently assessed articles based on the following inclusion criteria: recruited individuals with SCI; had aerobic FES-rowing exercise as study intervention; reported cardiovascular, muscular, bone mineral density, or metabolic outcomes; and examined engineering design of FES-rowing systems. Of the 256 titles that were retrieved in the primary search, 24 were included in this study.
Study characteristics, quality, participants' characteristics, test descriptions, and results were independently extracted by 2 reviewers. The quality of studies was assessed with the Downs and Black checklist.
Comparison of peak oxygen consumption (V̇) rates showed that V̇ during FES-rowing was significantly higher than arm-only exercise; FES-rowing training improved V̇ by 11.2% on average (95% confidence interval, 7.25-15.1), with a 4.1% (95% confidence interval, 2.23-5.97) increase in V̇ per month of training. FES-rowing training reduced bone density loss with increased time postinjury. The rowing ergometer used in 2 studies provided motor assistance during rowing. Studies preferred manual stimulation control (n=20) over automatic (n=4).
Our results suggest FES-rowing is a viable exercise for individuals with SCI that can improve cardiovascular performance and reduce bone density loss. Further randomized controlled trials are needed to better understand the optimal set-up for FES-rowing that maximizes the rehabilitation outcomes.
全面、批判性地评价功能性电刺激（FES）划船对脊髓损伤（SCI）患者管理的临床益处和工程设计。
从建库至 2020 年 5 月 12 日，在 Cumulative Index to Nursing & Allied Health Literature、Cochrane Central Register of Controlled Trials、Cochrane Database of Systematic Reviews、Excerpta Medica database、Emcare、Medline、PubMed、Scopus 和 Web of Science 数据库中进行电子数据库检索。
使用同义词“脊髓损伤”作为人群，“电刺激（疗法）/划船”作为干预措施，检索了 256 篇文章的标题，由 2 位评审员独立根据以下纳入标准评估文章：招募 SCI 患者；有氧 FES 划船运动为研究干预措施；报告心血管、肌肉、骨密度或代谢结果；并检查 FES 划船系统的工程设计。在初步检索中检索到的 256 个标题中，有 24 个被纳入本研究。
由 2 位评审员独立提取研究特征、质量、参与者特征、测试描述和结果。使用 Downs 和 Black 清单评估研究质量。
峰值摄氧量（V̇）率的比较表明，FES 划船时的 V̇明显高于仅手臂运动；FES 划船训练平均使 V̇提高 11.2%（95%置信区间，7.25-15.1），训练 1 个月 V̇增加 4.1%（95%置信区间，2.23-5.97）。FES 划船训练减少了损伤后时间的骨密度损失。在 2 项研究中使用的划船测功计在划船过程中提供了动力辅助。研究更倾向于手动刺激控制（n=20）而非自动刺激控制（n=4）。
我们的结果表明，FES 划船是一种可行的 SCI 患者运动，可以提高心血管性能，减少骨密度损失。需要进一步的随机对照试验来更好地了解 FES 划船的最佳设置，以最大限度地提高康复效果。
