The addition of electrical stimulation to progressive resistance training does not enhance the wrist strength of people with tetraplegia: a randomized controlled trial.
OBJECTIVE
To determine whether the addition of electrical stimulation to progressive resistance training increases the voluntary strength of the wrist muscles in people with tetraplegia.


METHODS
Assessor-blind within-subject randomised controlled trial.


METHODS
Two Australian spinal cord injury units and the community.


METHODS
Sixty-four wrists of 32 people with tetraplegia and bilateral weakness of the wrist extensor or flexor muscles (grade 2 - 4 Medical Research Council grades).


METHODS
Participants' wrists were randomly allocated to one of two conditions. Wrist muscles of the experimental arm received electrical stimulation superimposed on progressive resistance training. The wrist muscles of the contralateral arm received sham electrical stimulation superimposed on progressive resistance training. Both arms received 6 sets of 10 contractions three times a week for eight weeks such that the only difference between arms was the application of electrical stimulation.


METHODS
The primary outcome was maximal voluntary isometric strength. Secondary outcomes were a fatigue resistance ratio representing voluntary and electrically-stimulated endurance. Measurements were taken at the start and end of the eight-week treatment period.


RESULTS
The mean treatment effect (95% Confidence Interval) of electrical stimulation for voluntary strength was 0.04 Nm (95% CI, -0.5 to 0.6; p =0.89). The mean treatment effect (95% CI) for fatigue ratio representing voluntary endurance and electrically-stimulated endurance was -0.01 (95% CI, -0.1 to 0.1; p =0.78) and -0.07 (95% CI, -0.3 to 0.1; p =0.47), respectively.


CONCLUSIONS
Voluntary strength of the wrist is not enhanced by the addition of electrical stimulation to progressive resistance training programs in people with tetraplegia.
Glinsky
Joanne
J
Rehabilitation Studies Unit, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, Australia. J.Glinsky@usyd.edu.au
Harvey
Lisa
L
van Es
Pauline
P
Chee
Shane
S
Gandevia
Simon C
SC
D000328:Adult; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018763:Muscle Fatigue; D053580:Muscle Strength; D018908:Muscle Weakness / Q000534:rehabilitation; D011782:Quadriplegia / Q000534:rehabilitation*; D055070:Resistance Training; D013119:Spinal Cord Injuries / Q000150:complications; D014953:Wrist / Q000503:physiopathology*; D055815:Young Adult