Monitoring of spasticity and functional ability in individuals with incomplete spinal cord injury with a functional electrical stimulation cycling system

BACKGROUND: The aim of this study was to investigate the integration of motor function and spasticity assessment of individuals with spinal cord injury into cycling therapy. METHODS: Twenty-three participants with incomplete spinal cord injury performed 18 training sessions (standard deviation (SD) 14) on an instrumented tricycle combined with functional electrical stimulation. Each therapy session included a power output test to assess the participants' ability to pedal actively and a spasticity test routine that measures the legs' resistance to the pedalling motion. In addition, the required time for the therapy phases was monitored. RESULTS: The results of the power output test showed a monthly increase in power output of 4.4 W (SD 13.7) at 30 rpm and 18.2 W (SD 23.9) at 60 rpm. The results of the spasticity assessment indicate a 12.2 W (SD 9.7) reduction in resistance at 60 rpm after the FES training for the subject group with spasticity. CONCLUSION: In clinical use over a time-period of 2 years this combined form of therapy and motor function assessment was well accepted by participants. The active power output test and the spasticity test routine offered a proper tool to monitor participants' progress in functional rehabilitation and changes in spasticity.