The effects of upper extremity progressive resistance and endurance exercises in patients with spinal cord injury.

BACKGROUND AND OBJECTIVES: Exercises aiming to strengthen the upper extremities are recommended to increase activities of daily living (ADLs) in patients with spinal cord injury (SCI). The aim of this study was to compare the effects of upper extremity progressive resistance exercises (PRE) and endurance exercises (EE) performed with an arm ergometer in patients with paraplegia due to SCI. MATERIALS AND METHODS: A total of 19 SCI patients were included in the study, and randomly divided into two groups. The first group performed PRE while the second group performed arm EE. The functional independence measurement (FIM) was used on each patient at the beginning and at the end of the study. The elbow flexion and extension muscle strengths of each patient were determined with the computerized isokinetic dynamometer at the beginning and end of the study. RESULTS: Post-training increased the FIM scores in both PRE (p=0.005) and EE groups (p=0.008). There were increases in the extension peak torque (PT) and total work (TW) at 180°/sec and 60°/sec angular velocity in the PRE group compared to the EE group (all p<0.05). CONCLUSION: There were improvement in post-training muscle strength values in both the PRE (found to be more effective) and EE groups. LEVEL OF EVIDENCE: Randomized trial (Level I).

Effects of functional electrical stimulation on trunk control in children with diplegic cerebral palsy.

PURPOSE: This study aimed to investigate the efficiency of FES application on the abdomen-posterior back muscles in children with CP that were enrolled into physical therapy and rehabilitation (PTR) program. METHOD: The study included 55 spastic diplegic children that were hospitalized for rehabilitation. Those with deformities that could disrupt the balance in sitting and cause problems in evaluations were excluded. The patients were randomly divided into two equal groups according to their time of presentation. Thirty-two children completed the study. The control group received PTR program only for 4 weeks. The children in the FES group received PTR in addition to electrical stimulation. Electrical stimulation was applied 5 days a week for 4 weeks to abdomen-posterior back muscles in 30-minute-long sessions. To evaluate the balance in sitting, sitting score of gross motor function measurement (GMFM) and to evaluate the trunk asymmetry in sitting, radiographic measurements were used. Thus, kyphosis, Cobb and sacral angles were measured. RESULTS: The comparisons of the measurements of the two groups before and after the treatment showed that the GMFM sitting score and the sacral angle were statistically significantly increased, and the kyphotic and Cobb angles were statistically significantly decreased. After the treatment, both groups demonstrated an increase in the GMFM score, but the increase in the FES group was statistically significantly higher than that in the control group. With respect to radiological measurements, the changes observed in both the kyphotic and Cobb angles after the treatment were statistically significantly higher in the FES group than in the control group. The rates of the changes in the sacral angle did not differ among the groups. CONCLUSION: We believe to provide balance in sitting for children with CP, FES applied on abdomen-back muscles along with conventional therapy to maintain trunk control is more effective than conventional therapy alone.