全面,批判性地评估功能性电刺激(FES)划船对脊髓损伤(SCI)患者的临床益处和工程设计。
在护理和相关健康文献累积索引中进行了电子数据库搜索,Cochrane中央控制试验登记册,Cochrane系统评价数据库,摘录医疗数据库,Emcare,Medline,PubMed,Scopus,和WebofScience数据库从成立到2020年5月12日。
使用的搜索词是人口的“脊髓损伤”和干预的“电刺激(治疗)和划船”的同义词。两名评审员根据以下纳入标准独立评估文章:招募SCI患者;进行有氧FES划船运动作为研究干预;报告心血管疾病,肌肉,骨矿物质密度,或代谢结果;并检查了FES划船系统的工程设计。在主要搜索中检索到的256个标题中,24人被纳入本研究。
研究特征,质量,参与者的特征,测试描述,结果由2名评审员独立提取。使用Downs和Black检查表评估研究质量。
峰值耗氧率(Vo2peak)的比较表明,在FES划船过程中Vo2peak明显高于仅手臂运动;FES划船训练平均使Vo2peak提高了11.2%(95%置信区间,7.25-15.1),4.1%(95%置信区间,2.23-5.97)每月训练的V²o2peak增加。随着伤后时间的增加,FES划船训练可减少骨密度损失。2项研究中使用的划船测功机在划船过程中提供了运动辅助。研究优选手动刺激控制(n=20)而不是自动(n=4)。
我们的结果表明,FES划船是SCI患者的可行运动,可以改善心血管表现并减少骨密度损失。需要进一步的随机对照试验来更好地了解FES划船的最佳设置,以最大程度地提高康复效果。
To comprehensively and critically appraise the clinical benefits and engineering designs of functional electrical stimulation (FES)-rowing for management of individuals with spinal cord injury (SCI).
Electronic database searches were conducted in Cumulative Index to Nursing & Allied Health Literature, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Excerpta Medica database, Emcare, Medline, PubMed, Scopus, and Web of Science databases from inception to May 12, 2020.
Search terms used were synonyms of \"spinal cord injury\" for Population and \"Electric Stimulation (Therapy)/ and rowing\" for Intervention. Two reviewers independently assessed articles based on the following inclusion criteria: recruited individuals with SCI; had aerobic FES-rowing exercise as study intervention; reported cardiovascular, muscular, bone mineral density, or metabolic outcomes; and examined engineering design of FES-rowing systems. Of the 256 titles that were retrieved in the primary search, 24 were included in this study.
Study characteristics, quality, participants\' characteristics, test descriptions, and results were independently extracted by 2 reviewers. The quality of studies was assessed with the Downs and Black checklist.
Comparison of peak oxygen consumption (V̇o2peak) rates showed that V̇o2peak during FES-rowing was significantly higher than arm-only exercise; FES-rowing training improved V̇o2peak by 11.2% on average (95% confidence interval, 7.25-15.1), with a 4.1% (95% confidence interval, 2.23-5.97) increase in V̇o2peak per month of training. FES-rowing training reduced bone density loss with increased time postinjury. The rowing ergometer used in 2 studies provided motor assistance during rowing. Studies preferred manual stimulation control (n=20) over automatic (n=4).
Our results suggest FES-rowing is a viable exercise for individuals with SCI that can improve cardiovascular performance and reduce bone density loss. Further randomized controlled trials are needed to better understand the optimal set-up for FES-rowing that maximizes the rehabilitation outcomes.