MUSCULOSKELETAL EFFECTS OF AN ELECTRICAL-STIMULATION INDUCED CYCLING PROGRAM IN THE SPINAL INJURED

Twelve patients were involved in a 3 month stimulation induced cycling programme at the Royal Perth Rehabilitation Hospital. A number of the patients were less than 1 year post injury, all except one had an inc omplete injury, and most were receiving physiotherapy. All patients wh o completed the programme increased their time of cycling and, in all but one case, the exercise load, indicative of a local training effect . Significant improvements were found in voluntary isometric strength, stimulated isometric strength and stimulated isometric endurance of t he quadriceps, muscle grading of the quadriceps and biceps femoris and the cross-sectional areas of the quadriceps and total thigh muscle. N o change vas found in voluntary isokinetic strength of the quadriceps. All patients with incomplete injuries reported improvements in the ac tivities of daily living (ADL) after the programme. Bone mineral densi ty (BMD) was examined in two patients, one less than 1 year post injur y, and one greater than 4 years post injury. The programme of cycling did not restore BMD in the latter patient. However, while the former p atient still displayed a reduced BMD after the programme, it is unknow n whether this loss of bone was retarded. This needs further investiga tion. This study demonstrates the effectiveness of a combined physioth erapy/cycling programme in the rehabilitation of people with spinal in juries. To be successful this type of programme has to be incorporated into the rehabilitation process, as has been done at the Sir George B edbrook Spinal Unit.