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Safety and preliminary efficacy of functional electrical stimulation cycling in an individual with cervical cord injury, autonomic dysreflexia, and a pacemaker: Case report.

Authors
  • Corbin, Gevork N1
  • Weaver, Kelsi1
  • Dolbow, David R1
  • Credeur, Daniel2
  • Pattanaik, Sambit1
  • Stokic, Dobrivoje S3
  • 1 School of Physical Therapy, Department of Biomedical Sciences, and College of Osteopathic Medicine, William Carey University, Hattiesburg, Mississippi, USA.
  • 2 School of Kinesiology, University of Southern Mississippi, Hattiesburg, Mississippi, USA.
  • 3 Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, Jackson, Mississippi, USA.
Type
Published Article
Journal
The journal of spinal cord medicine
Publication Date
Jul 01, 2021
Volume
44
Issue
4
Pages
613–616
Identifiers
DOI: 10.1080/10790268.2019.1692180
PMID: 31809247
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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.

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