Abstract

Context: Spasticity is one of the most common secondary impairment after spinal cord injury (SCI). It can lead to an increase in the level of disability. The functional electrical stimulation cycling (FES-cycling) promotes recovery in patients with SCI. No systematic review has been published examining the influence of FES-cycling on the spasticity of lower extremities post-SCI.

Objective: This review aimed to investigate the effects of the FES-cycling on the lower extremities spasticity in patients with SCI.

Methods: PubMed, Scopus, PEDro, REHABDATA, Web of Science, and MEDLINE were searched until December 2019. The methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale.

Results: Ten studies were met the inclusion criteria. Two were randomized clinical trials, cohort study (n = 2), and pilot study (n=6). The scores on the PEDro scale ranged from one to nine, with a median score of three. The results showed evidence for the beneficial effects of FES-cycling on the spasticity of lower extremities in individuals with SCI.

Conclusion: The FES-cycling intervention may reduce the lower extremities spasticity in patients with various injury levels of SCI. It is not a suitable intervention for medically unstable patients or with contraindication for lower extremities movement. Further randomized controlled trials with a large sample size strongly warranted to confirm our findings.

摘要

背景：痉挛是脊髓损伤 (SCI) 后最常见的继发性损伤之一。它可能导致残疾程度的增加。功能性电刺激循环 (FES-cycling) 可促进 SCI 患者的康复。尚未发表系统评价来检查 FES 循环对 SCI 后下肢痉挛的影响。

目的：本综述旨在探讨 FES 循环对 SCI 患者下肢痉挛的影响。

方法：检索 PubMed、Scopus、PEDro、REHABDATA、Web of Science 和 MEDLINE，直至 2019 年 12 月。使用物理治疗证据数据库 (PEDro) 量表评估方法学质量。

结果：十项研究符合纳入标准。其中两项是随机临床试验、队列研究（n  = 2）和初步研究（n = 6）。PEDro 量表的分数从 1 到 9 不等，中位分数为 3。结果显示了 FES 循环对 SCI 患者下肢痉挛的有益影响的证据。

结论： FES循环干预可减轻不同损伤程度SCI患者的下肢痉挛。对于医学上不稳定的患者或有下肢运动禁忌症的患者，它不适合进行干预。进一步的大样本随机对照试验非常有必要证实我们的发现。