Safety and Preliminary Efficacy of Functional Electrical Stimulation Cycling In an Individual With Cervical Cord Injury, Autonomic Dysreflexia, and a Pacemaker: Case Report
Kinesiology and Nutrition
Context: Functional electric stimulation (FES) cycling is a commonly used therapeutic exercise modality after spinal cord injury (SCI); however, additional precautions must be taken in certain situations. The purpose of this study was to develop and apply a safety monitoring protocol for autonomic dysreflexia (AD) during FES cycling and to determine if an interval-FES cycling program can be safe and beneficial to an individual with cervical SCI, a history of AD, and a non-dependent cardiac pacemaker.
The participant was a 36-year-old male with C6 AIS-C SCI sustained 9 years earlier, intermittent AD, and implanted cardiac pacemaker. Ten sessions of interval-FES cycling were performed twice weekly for 5 weeks. Rating of perceived exertion (RPE), blood pressure (BP), oxygen saturation (O2sat), and heart rate (HR) were monitored before, after, and every 5 min during cycling. ECG and cardiac pacemaker were evaluated by a cardiologist after ending the program.
Findings: The participant reported self-limited chills 27 times over 10 sessions (19 “light”, 3 “moderate”, 5 “sharp”). Chills coincided with BP increases 59% of the time and their magnitudes moderately correlated (r = 0.32). The ECG was determined to be normal and the pacemaker fully functional at the end of the study, while blood glucose decreased (111–105 mg/dl), HbA1c levels increased (5.5–5.9%), and resting BP decreased (118/84–108/66 mmHg).
Conclusion/Clinical Relevance: A person with cervical SCI, symptomatic AD, and a non-dependent pacemaker can safely participate and benefit from the interval-FES cycling program provided adequate monitoring of symptoms and vital signs.
The Journal of Spinal Cord Medicine
Corbin, G. N.,
Dolbow, D. R.,
Stokic, D. S.
(2019). Safety and Preliminary Efficacy of Functional Electrical Stimulation Cycling In an Individual With Cervical Cord Injury, Autonomic Dysreflexia, and a Pacemaker: Case Report. The Journal of Spinal Cord Medicine.
Available at: https://aquila.usm.edu/fac_pubs/18074