Journal CME September 2024, Efficacy of arm crank ergometry on individuals with spinal cord injury: A systematic review of randomized controlled trials-PM R - 2024 - Alashram - Efficacy of arm crank ergometry on individuals with spinal cord injury A systematic review of

PM R - 2024 - Alashram - Efficacy of arm crank ergometry on individuals with spinal cord injury A systematic review of

Pdf Summary

A systematic review led by Anas R. Alashram evaluated the efficacy of arm crank ergometry (ACE) on various outcomes for individuals with spinal cord injury (SCI). The review sourced data from databases like PubMed, Scopus, and MEDLINE, among others, up until July 2023. This investigation specifically targeted randomized controlled trials (RCTs) involving SCI patients treated with ACE interventions.<br /><br />Out of 1013 screened articles, seven RCTs, involving 200 participants (16% female), met the inclusion criteria. The quality of these studies was rated as "good" (PEDro scores ranging from 6 to 8). However, a meta-analysis was not feasible due to the heterogeneity in protocols and outcome measures. The review evaluated the impact of ACE on physical functions, psychological status, and quality of life (QoL).<br /><br />Physical outcomes like muscle strength showed inconsistent results. In studies combining ACE with resistance or neuromuscular stimulation, significant improvements in strength were noted. However, no significant improvements were reported when ACE was combined with general exercises or FES-induced leg exercise. Fatigue was notably reduced in a study with ACE compared to rest.<br /><br />Psychological outcomes were assessed mostly for depression, where mixed results were observed. One study indicated a significant improvement in psychological status following combined ACE and resistance training, while another showed no notable differences when ACE was paired with general exercises.<br /><br />Quality of life outcomes were similarly mixed. Some studies reported improvements when ACE was combined with resistance training or administered alone, while others saw no significant differences compared to controls like general or treadmill-supported exercises.<br /><br />No adverse effects were identified in any of the included studies, confirming ACE as a safe intervention. The review concludes that while ACE shows promise for individuals with SCI, further research with standardized protocols and consideration of individual patient factors is necessary to comprehensively understand its efficacy.<br /><br />Future research directions include long-term studies and individualized ACE programs, recognizing the impact of factors like gender, injury severity, and spasticity.

Keywords

systematic review

arm crank ergometry

spinal cord injury

randomized controlled trials

physical outcomes

psychological status

quality of life

muscle strength

fatigue reduction

future research