title: Outcomes of a home cycling program using functional electrical stimulation or passive motion for children with spinal cord injury: a case series.
abstract: OBJECTIVE
  Children with spinal cord injury (SCI) are at risk for musculoskeletal and cardiovascular complications. Stationary cycling using functional electrical stimulation (FES) or passive motion has been suggested to address these complications. The purpose of this case series is to report the outcomes of a 6-month at-home cycling program for 4 children with SCI.
  
  
  METHODS
  Two children cycled with FES and 2 cycled passively at home for 1 hour, 3 times per week.
  
  
  METHODS
  Data collected included bone mineral density of the left femoral neck, distal femur, and proximal tibia; quadriceps and hamstring muscle volume; stimulated quadriceps and hamstring muscle strength; a fasting lipid profile; and heart rate and oxygen consumption during incremental upper extremity ergometry testing.
  
  
  RESULTS
  The 2 children cycling with FES and 1 child cycling passively exhibited improved bone mineral density, muscle volume, stimulated quadriceps strength, and lower resting heart rate. For the second child cycling passively, few changes were realized. Overall, the lipid results were inconsistent, with some positive and some negative changes seen.
  
  
  CONCLUSIONS
  This case series suggests that cycling with or without FES may have positive health benefits and was a practical home exercise option for these children with SCI.
authors.affiliation: Research Department, Shriners Hospital for Children, 3551 North Broad Street, Philadelphia, PA, USA. tjohnston@shrinenet.org
authors.forename: Therese E
authors.initials: TE
authors.lastname: Johnston
authors.forename: Brian T
authors.initials: BT
authors.lastname: Smith
authors.forename: Oluwabunmi
authors.initials: O
authors.lastname: Oladeji
authors.forename: Randal R
authors.initials: RR
authors.lastname: Betz
authors.forename: Richard T
authors.initials: RT
authors.lastname: Lauer
mesh_terms: D000367:Age Factors; D001642:Bicycling / Q000706:statistics & numerical data*; D015519:Bone Density; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D002648:Child; D004599:Electric Stimulation Therapy / Q000379:methods*; D005081:Exercise Therapy / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006339:Heart Rate; D006699:Home Care Services / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000294:innervation / Q000503:physiopathology; D008297:Male; D053580:Muscle Strength; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D018482:Muscle, Skeletal / Q000098:blood supply / Q000378:metabolism / Q000503:physiopathology; D009133:Muscular Atrophy / Q000209:etiology / Q000517:prevention & control / Q000534:rehabilitation; D010024:Osteoporosis / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy; D010243:Paralysis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000295:instrumentation* / Q000706:statistics & numerical data; D052097:Quadriceps Muscle / Q000098:blood supply / Q000294:innervation / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D016896:Treatment Outcome