Safety and preliminary efficacy of functional electrical stimulation cycling in an individual with cervical cord injury, autonomic dysreflexia, and a pacemaker: Case report. (4th July 2021)

• Record Type: Journal Article
• Authors: Corbin, Gevork N.; Weaver, Kelsi; Dolbow, David R.; Credeur, Daniel; Pattanaik, Sambit; Stokic, Dobrivoje S.
• Is Part Of: Journal of spinal cord medicine. Volume 44:Number 4(2021)
• Page Start: 613
• Page End: 616
• Publication Date: 2021-07-04
• Subjects: Spinal cord injuries -- Functional electrical stimulation -- Autonomic dysreflexia -- Pacemaker; Spinal cord -- Wounds and injuries -- Periodicals; Spinal cord -- Diseases -- Periodicals; 616.8305
• DOI: 10.1080/10790268.2019.1692180
• Languages: English
• ISSNs: 1079-0268

Abstract

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.