title: Muscle changes following cycling and/or electrical stimulation in pediatric spinal cord injury.
abstract: OBJECTIVE
  To determine the effect of cycling, electrical stimulation, or both, on thigh muscle volume and stimulated muscle strength in children with spinal cord injury (SCI).
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Children's hospital specializing in pediatric SCI.
  
  
  METHODS
  Children (N=30; ages, 5-13y) with chronic SCI.
  
  
  METHODS
  Children were randomly assigned to 1 of 3 interventions: functional electrical stimulation cycling (FESC), passive cycling (PC), and noncycling, electrically stimulated exercise (ES). Each group exercised for 1 hour, 3 times per week for 6 months at home.
  
  
  METHODS
  Preintervention and postintervention, children underwent magnetic resonance imaging to assess muscle volume, and electrically stimulated isometric muscle strength testing with the use of a computerized dynamometer. Data were analyzed via analyses of covariance (ANCOVA) with baseline measures as covariates. Within-group changes were assessed via paired t tests.
  
  
  RESULTS
  All 30 children completed the training. Muscle volume data were complete for 24 children (8 FESC, 8 PC, 8 ES) and stimulated strength data for 27 children (9 per group). Per ANCOVA, there were differences between groups (P<.05) for quadriceps muscle volume and stimulated strength, with the ES group having greater changes in volume and the FESC group having greater changes in strength. Within-group analyses showed increased quadriceps volume and strength for the FESC group and increased quadriceps volume for the ES group.
  
  
  CONCLUSIONS
  Children receiving either electrically stimulated exercise experienced changes in muscle size, stimulated strength, or both. These changes may decrease their risk of cardiovascular disease, insulin resistance, glucose intolerance, and type 2 diabetes.
  
  
  BACKGROUND
  NCT00245726.
authors: Department of Physical Therapy, University of the Sciences, Philadelphia, PA 19104, USA. t.johnston@usp.edu
authors: Therese E
authors: TE
authors: Johnston
authors: Christopher M
authors: CM
authors: Modlesky
authors: Randal R
authors: RR
authors: Betz
authors: Richard T
authors: RT
authors: Lauer
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004599:Electric Stimulation Therapy / Q000379:methods; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D053581:Muscle Strength Dynamometer; D018482:Muscle, Skeletal / Q000503:physiopathology*; D009133:Muscular Atrophy / Q000209:etiology / Q000534:rehabilitation*; D052097:Quadriceps Muscle / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000150:complications / Q000534:rehabilitation*; D016896:Treatment Outcome