title: Report of practicability of a 6-month home-based functional electrical stimulation cycling program in an individual with tetraplegia.
abstract: BACKGROUND
  Sedentarism is common among people with spinal cord injury (SCI). However, new technologies such as functional electrical stimulation cycles with internet connectivity may provide incentive by removing some of the limitations and external barriers.
  
  
  OBJECTIVE
  To determine the effectiveness of a long-term home-based functional electrical stimulation lower extremities cycling (FES-LEC) program on exercise adherence, body composition, energy expenditure, and quality of life (QOL) in an adult with chronic tetraplegia.
  
  
  METHODS
  A 53-year-old man, 33 years post-motor complete C4 SCI participated in FES-LEC in his home, three sessions per week for 24 weeks.
  
  
  METHODS
  Exercise adherence was calculated as the percentage of performed cycling sessions relative to the recommended number of cycling  sessions. Body composition was measured by dual-energy X-ray absorptiometry. Energy expenditure was measured using a COSMED K4b2 and QOL via the World Health Organization Quality of Life (WHO-QOL) Brief Questionnaire. Testing was performed before and after the 24-week exercise program.
  
  
  RESULTS
  The participant cycled 59 out of a recommended 72 sessions which is an exercise adherence rate of 82%. Body composition displayed increases in total body lean mass (LM) with an increase of 3.3% and an increase in leg LM of 7.1%. Energy expenditure increased by 1.26 kcal/minute  or greater than 200%. The physical and psychological domain scores of QOL increased by 25 and 4.5%, respectively.
  
  
  CONCLUSIONS
  This case study provides encouragement concerning the practicality of a home-based FES-LEC program for those with SCI.
authors.affiliation: Spinal Cord Injury and Disorders Center, McGuire VAMC, Richmond, VA 23249, USA. david.dolbow@va.gov
authors.forename: David R
authors.initials: DR
authors.lastname: Dolbow
authors.forename: Ashraf S
authors.initials: AS
authors.lastname: Gorgey
authors.forename: Jewel R
authors.initials: JR
authors.lastname: Moore
authors.forename: David R
authors.initials: DR
authors.lastname: Gater
mesh_terms: D001823:Body Composition / Q000502:physiology; D015992:Body Mass Index; D004599:Electric Stimulation Therapy / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D010349:Patient Compliance; D011782:Quadriplegia / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life; D016896:Treatment Outcome