The objective of this review was to summarize and appraise evidence on functional electrical stimulation (FES) cycling exercise after spinal cord injury (SCI), in order to inform the development of evidence-based clinical practice guidelines. PubMed, the Cochrane Central Register of Controlled Trials, EMBASE, SPORTDiscus, and CINAHL were searched up to April 2021 to identify FES cycling exercise intervention studies including adults with SCI. In order to capture the widest array of evidence available, any outcome measure employed in such studies was considered eligible. Two independent reviewers conducted study eligibility screening, data extraction, and quality appraisal using Cochranes’ Risk of Bias or Downs and Black tools. Each study was designated as a Level 1, 2, 3 or 4 study, dependent on study design and quality appraisal scores. The certainty of the evidence for each outcome was assessed using GRADE ratings (‘High’, ‘Moderate’, ‘Low’, or ‘Very low’). Ninety-two studies met the eligibility criteria, comprising 999 adults with SCI representing all age, sex, time since injury, lesion level and lesion completeness strata. For muscle health (e.g., muscle mass, fiber type composition), significant improvements were found in 3 out of 4 Level 1–2 studies, and 27 out of 32 Level 3–4 studies (GRADE rating: ‘High’). Although lacking Level 1–2 studies, significant improvements were also found in nearly all of 35 Level 3–4 studies on power output and aerobic fitness (e.g., peak power and oxygen uptake during an FES cycling test) (GRADE ratings: ‘Low’). Current evidence indicates that FES cycling exercise improves lower-body muscle health of adults with SCI, and may increase power output and aerobic fitness. The evidence summarized and appraised in this review can inform the development of the first international, evidence-based clinical practice guidelines for the use of FES cycling exercise in clinical and community settings of adults with SCI. Registration review protocol: CRD42018108940 (PROSPERO)

中文翻译：

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脊髓损伤后功能性电刺激骑自行车运动：对健康和健身相关结果的系统评价

本综述的目的是总结和评估脊髓损伤 (SCI) 后功能性电刺激 (FES) 自行车运动的证据，以便为循证临床实践指南的制定提供信息。检索了 PubMed、Cochrane 对照试验中央登记册、EMBASE、SPORTDiscus 和 CINAHL，直至 2021 年 4 月，以确定 FES 自行车运动干预研究，包括成人 SCI。为了获得最广泛的证据，此类研究中采用的任何结果测量都被认为是合格的。两名独立审查员使用 Cochranes 的偏差风险或唐氏风险和布莱克工具进行了研究资格筛选、数据提取和质量评估。每项研究都被指定为 1、2、3 或 4 级研究，具体取决于研究设计和质量评估分数。使用 GRADE 等级（“高”、“中”、“低”或“非常低”）评估每个结果的证据的确定性。92 项研究符合资格标准，包括 999 名 SCI 成人，代表所有年龄、性别、受伤时间、病变水平和病变完整性层。对于肌肉健康（例如，肌肉质量、纤维类型组成），4 项 1-2 级研究中有 3 项显着改善，32 项 3-4 级研究中有 27 项显着改善（等级评级：“高”）。尽管缺乏 1-2 级研究，但几乎所有 35 项 3-4 级研究都发现了关于功率输出和有氧健康（例如，FES 自行车测试期间的峰值功率和摄氧量）的显着改善（等级评级：“低” ）。目前的证据表明，FES 自行车运动可以改善 SCI 成人的下肢肌肉健康，并可能增加功率输出和有氧健身。本综述中总结和评估的证据可以为第一个国际循证临床实践指南的制定提供信息，该指南用于在 SCI 成人的临床和社区环境中使用 FES 自行车运动。注册审查协议：CRD42018108940（PROSPERO）