A pilot study investigating arm and leg FES-assisted cycling as an intervention for improving ambulation after Incomplete Spinal Cord Injury

Abstract

People with incomplete spinal cord injury (iSCI) have the potential for recovering walking through plasticity-induced changes in the remaining neural circuitry. Current rehabilitation for walking attempts to induce such changes by providing relevant sensory inputs and motor commands through repetitive practice. Current rehabilitation fails to actively incorporate arm movements despite being naturally involved in human walking. The overall goal of my thesis was to demonstrate that active arm involvement through arm and leg FES-assisted cycling improves overground walking after iSCI. Specifically, my pilot study evaluated the changes in walking after 12 weeks of the intervention in individuals with chronic iSCI. Arm and leg FES-assisted cycling was effective in improving walking speed and endurance. Balance, motor and sensory scores, and gait kinematics improved in most cases. The reflex modulation improved in every case suggesting that neuronal reorganization (plasticity) was involved. Hence, arm and leg FES-assisted cycling is worthy of further investigation.