Functional electric stimulation: its efficacy and safety in improving pulmonary function and musculoskeletal fitness.

The efficacy and safety of functional electric stimulation (FES) in improving cardiovascular and musculoskeletal fitness in individuals with spinal cord injury was evaluated. Ten males and two females aged 16 to 46 years began an FES program from three months to 22 years after injury. Seven patients had paraplegia and five had quadriplegia. The FES protocol consisted of three phases: (1) leg extension, the stimulation of the quadriceps muscle group only, first without and then with weights; (2) ergometry, the stimulation of quadriceps, hamstrings, and gluteal muscles to produce a bicycling motion; and (3) resistance, the addition of resistance during the bicycling motion described in phase 2. Values for tidal volume, oxygen consumption, and the respiratory quotient were obtained during each phase. Tidal volume and oxygen consumption levels increased significantly (p less than .001) from the start of FES to both the ergometry and the resistance phases. The respiratory quotient improved significantly (p less than .001) from the start of FES to resistance but not from the start of FES to ergometry. Thigh and calf girths were measured at the start of FES and during resistance. Thigh girths increased significantly from the beginning of the program to the resistance phase, p less than .002 for the right leg and p less than .001 for the left. Calf girth, however, showed no significant increase. Based on these improvements and the absence of any serious complications, we believe that FES is an effective and safe method to improve cardiovascular and musculoskeletal fitness in individuals with spinal cord injury.