Response to Functional Electrical Stimulation Cycling in Women With Spinal Cord Injuries Using Dual-Energy X-ray Absorptiometry and Peripheral Quantitative Computed Tomography: A Case Series

Background: Loss of bone mass is common after spinal cord injury (SCI). One rehabilitation modality that has shown some promise for maintaining bone health is the functional electrical stimulation (FES) cycle ergometer. Although there has been some research investigating bone health and FES cycle ergometry, few have provided a detailed description of the changes that can occur in bone mass and soft-tissue mass. Objective: To use 2 types of bone imaging, peripheral quantitative computed tomography (pQCT) and dual-energy X-ray absorptiometry (DXA), to provide a detailed description of bone and soft-tissue response to FES cycle ergometry training in women with SCI. Study Design: Case series; a 6-month program of FES cycle ergometry for women with chronic motor complete (n = 2) and incomplete (n = 1) SCI. Setting: Outpatient rehabilitation center in Canada. Methods: Three women participated in a thrice weekly 6-month exercise program of FES cycle ergometry. We used DXA (lower extremity) and pQCT at the midshaft (50%) and distal (5%) sites of the tibia to assess bone density and soft-tissue mass before and after the exercise program. Results: There was an increase or maintenance in bone mineral density by DXA and pQCT in the lower extremity for all 3 participants. Muscle mass by DXA increased in the lower extremity in 2 participants. Conclusion: In this case series, we note a positive response in bone mass and soft-tissue mass in the lower extremity after a 6-month FES cycle ergometry program.