title: Functional electrical stimulation cycling does not improve mobility in people with acquired brain injury and its effects on strength are unclear: a randomised trial.
abstract: OBJECTIVE
  Does 4 weeks of active functional electrical stimulation (FES) cycling in addition to usual care improve mobility and strength more than usual care alone in people with a sub-acute acquired brain injury caused by stroke or trauma?
  
  
  METHODS
  Multi centre, randomised, controlled trial.
  
  
  METHODS
  Forty patients from three Sydney hospitals with recently acquired brain injury and a mean composite strength score in the affected lower limb of 7 (SD 5) out of 20 points.
  
  
  METHODS
  Participants in the experimental group received an incremental, progressive, FES cycling program five times a week over a 4-week period. All participants received usual care.
  
  
  METHODS
  Outcome measures were taken at baseline and at 4 weeks. Primary outcomes were mobility and strength of the knee extensors of the affected lower limb. Mobility was measured with three mobility items of the Functional Independence Measure and strength was measured with a hand-held dynamometer. Secondary outcomes were strength of the knee extensors of the unaffected lower limb, strength of key muscles of the affected lower limb and spasticity of the affected plantar flexors.
  
  
  RESULTS
  All but one participant completed the study. The mean between-group differences for mobility and strength of the knee extensors of the affected lower limb were -0.3/21 points (95% CI -3.2 to 2.7) and 7.5 Nm (95% CI -5.1 to 20.2), where positive values favoured the experimental group. The only secondary outcome that suggested a possible treatment effect was strength of key muscles of the affected lower limb with a mean between-group difference of 3.0/20 points (95% CI 1.3 to 4.8).
  
  
  CONCLUSIONS
  Functional electrical stimulation cycling does not improve mobility in people with acquired brain injury and its effects on strength are unclear.
  
  
  BACKGROUND
  ACTRN12612001163897. [de Sousa DG, Harvey LA, Dorsch S, Leung J, Harris W (2016) Functional electrical stimulation cycling does not improve mobility in people with acquired brain injury and its effects on strength are unclear: a randomised controlled trial.Journal of Physiotherapy62: 203-208].
authors.affiliation: Graythwaite Rehabilitation Centre, Ryde Hospital; John Walsh Centre for Rehabilitation Research, Kolling Institute, Northern Sydney Local Health District; Sydney Medical School Northern, University of Sydney.
authors.forename: Davide G
authors.initials: DG
authors.lastname: de Sousa
authors.affiliation: John Walsh Centre for Rehabilitation Research, Kolling Institute, Northern Sydney Local Health District; Sydney Medical School Northern, University of Sydney.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Harvey
authors.affiliation: School of Physiotherapy, Australian Catholic University.
authors.forename: Simone
authors.initials: S
authors.lastname: Dorsch
authors.affiliation: Royal Rehab, Ryde.
authors.forename: Joan
authors.initials: J
authors.lastname: Leung
authors.affiliation: Prince of Wales Hospital, South Eastern Sydney Local Health District, Sydney, Australia.
authors.forename: Whitney
authors.initials: W
authors.lastname: Harris
mesh_terms: D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000503:physiopathology / Q000628:therapy*; D004185:Disability Evaluation; D004599:Electric Stimulation Therapy / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000503:physiopathology*; D016896:Treatment Outcome
keywords: Acquired brain injury; FES cycling; Functional electrical stimulation; Physical therapy; Stroke