Health and Fitness Benefits of Functional Electrical Stimulation- Evoked Leg Exercise for Spinal Cord– Injured Individuals: A Position Review

Purpose: To investigate the potential health and fitness benefits of lower extremity functional electrical stimulation (FES) exercise for people with spinal cord injury (SCI). Method: Systematic review strategy conducted from electronic databases from 1830 until July 2008. Studies with randomized and/or controlled designs were highlighted for analysis, but all relevant literature was described to develop an overall position statement. Study selection: (1) leg FES-evoked exercise for (2) people with SCI and (3) effects on health and fitness outcomes. Result: One study was identified as a randomized controlled trial, and 32 investigations were quasi-experimental trials. Six outcome categories were identified on the topic of potential health and fitness benefits for people with SCI. Evidence from FES-evoked exercise studies demonstrated (a) positive changes within skeletal muscle, (b) enhanced cardiovascular and peripheral blood flow, (c) altered metabolic responses and increased aerobic fitness, and (d) improved functional exercise capacity. Bone mineral density changes and alterations of psychosocial outlook were less consistently reported or outcomes were deemed equivocal. Conclusion: Randomized and/or controlled studies reporting on the potential benefits of FES-evoked exercise are sparse. The available literature suggested that across a variety of outcome domains FES-evoked leg exercise promotes certain health and fitness benefits for people with SCI.