A Comparison of Functional Electrical and Magnetic Stimulation for Propelled Cycling of Paretic Patients

• Published in: Archives of physical medicine and rehabilitation Vol. 90; no. 4; pp. 564 - 570
• Main Authors: Szecsi, Johann, MD, Schiller, Martin, MD, Straube, Andreas, MD, Gerling, Dieter, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2009; Elsevier
• Subjects: Aged; Bicycling; Biological and medical sciences; Chronic Disease; Diseases of the osteoarticular system; Electric Stimulation; Exercise Test; Female; Humans; Isometric Contraction; Magnetic Field Therapy; Magnetic stimulation therapy; Male; Medical sciences; Miscellaneous; Neurology; Pain; Paresis - etiology; Paresis - physiopathology; Paresis - rehabilitation; Physical Medicine and Rehabilitation; Power; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation; Spasm - complications; Spinal cord injuries; Spinal Cord Injuries - complications; Spinal Cord Injuries - physiopathology; Spinal Cord Injuries - rehabilitation; Stroke; Torque; Vascular diseases and vascular malformations of the nervous system; spinal cord injury; Stroke; Torque; Magnetic stimulation therapy; Modified Ashworth Scale; FMS; functional electrical stimulation; Pain; FES; functional magnetic stimulation; SCI; Spinal cord injuries; Rehabilitation; Power; MAS; Human; Nervous system diseases; Cardiovascular disease; Cerebral disorder; Vascular disease; Reeducation; Treatment; Orthopedics; Spinal cord trauma; Central nervous system disease; Spinal cord disease; Cerebrovascular disease; Comparative study
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2008.09.572

Abstract Szecsi J, Schiller M, Straube A, Gerling D. A comparison of functional electrical and magnetic stimulation for propelled cycling of paretic patients. Objective To compare isometric torque and cycling power, smoothness and symmetry using repetitive functional magnetic stimulation (FMS) and functional electrical stimulation (FES) in patients with paretic legs with preserved sensibility and in patients without sensibility. Design Repeated-measures design. Setting Laboratory setting. Participants Eleven subjects with complete spinal cord injury (SCI) and 29 subjects with chronic hemiparesis (16.6±5.5mo poststroke) volunteered. Interventions Using a tricycle testbed, participants were exposed to isometric measurements and ergometric cycling experiments, performed during both 20Hz FMS and FES stimulation. Subjects with hemiparesis and with complete SCI were stimulated at maximally tolerable level and maximal intensity, respectively. Main Outcome Measures Maximal isometric pedaling torque and mean ergometric power, smoothness, and symmetry were recorded for voluntary, FES, and FMS conditions. Results Two different patterns of the efficacy of FMS were identified. (1) Patients with complete SCI did not benefit (less torque and power was evoked with FMS than with FES, P <.003 and 10−4 respectively). (2) Patients with hemiplegia and preserved sensibility could improve their torque output ( P <.05), smoothness, and symmetry of pedaling ( P <.05) with FMS more than with FES. Conclusions FMS is a potential alternative to surface FES of the large thigh musculature in stimulation-supported cycling of patients with partially or completely preserved sensibility.