Changes in spastic muscle tone increase in patients with spinal cord injury using functional electrical stimulation and passive leg movements

Abstract

Objective: Comparison of cycling interventions to reduce spastic muscle tone increase in patients with spinal cord injury. Setting: Neuroprosthetic outpatient clinic in a university hospital. Methods: Five patients with spinal cord injury took part in a crossover study in which the lower limbs (1) were stimulated by functional neuromuscular electrical stimulation (FES) to induce leg cycling movements and (2) were passively moved by an ergometer machine. Patients sat in a comfortable chair fastened to the ergometer while FES was done to induce leg cycling (active session). During the passive leg movement session the ergometer moved their legs for the same period of time at the same velocity and frequency. Main outcome measures: The change in spastic muscle tone increase before and after each training session was tested with the modified Ashworth Scale and the pendulum test of spasticity (relaxation index and peak velocity). Results: The averaged data of the relaxation index increased after FES by about 68%. Compared with the slight increase after the passive movement training of 12%, this is statistically significant (P = 0.01). Peak velocity increased after FES by around 50%, while it was nearly unchanged after the passive intervention (1%); this is also significant (P = 0.01). This was similar with the peak velocity and the modified Ashworth Scale. Conclusion: The study presents further interesting aspects of the usefulness of FES in patients with spinal cord injury to reduce spastic muscle tone. © Sage Publications 2008.