Background: Functional electrical stimulation (FES) therapy has been applied to achieve functional benefits post spinal cord injury (SCI), but little is known about its effects on well-being. Objective: Using a parallel-group randomized controlled trial (RCT) design (NCT00201968), the effects of a FES-assisted walking intervention on quality of life and participation post SCI were compared to a non-FES exercise program. Methods: Individuals with chronic (≥18 months) incomplete SCI (level C2 to T12, AIS C or D) were randomized to a FES-assisted walking (intervention) or aerobic/resistance training (control) sessions 3 times a week for 16 weeks. The Spinal Cord Independence Measure (SCIM), Satisfaction With Life Scale, Lawton Instrumental Activities of Daily Living, Craig Handicap and Assessment Reporting Technique, Reintegration to Normal Living Index, and perceptions of intervention(s) outcomes were completed at baseline, 4, 6, and 12 months. Repeated measures general linear models were used to assess between-group differences. Perceptions of intervention(s) were analyzed using qualitative content analysis. Results: Thirty-four individuals were randomized (17 per group); 27 remained at 12 months. The FES group had a significant increase (P < .01) on SCIM mobility subscores (mean [SD] = 17.27 [7.2] to 21.33 [7.6]) compared to the exercise group (mean [SD] = 19.9 [17.1] to 17.36 [5.5]). Although no significant between-group differences were detected for other outcomes, both groups reported positive gains in well-being from trial participation. Conclusions: The present study provides insight into the perceived benefits acquired by participating in an RCT comparing exercise to FES therapy and serves as a model for pinpointing domains of wellbeing that could be targeted for assessment in future SCI trials.

Popovic MR, Curt A, Keller T, Dietz V. Functional electrical stimulation for grasping and walking: Indications and limitations. Spinal Cord. 2001; 39:403–412.
,
Functional electrical stimulation for grasping and walking: Indications and limitations
,
Spinal Cord.
, vol.
39
(pg.
403
-
412
)
Thrasher TA, Popovic MR. Functional electrical stimulation of walking: Function, exercise and rehabilitation. Ann Readapt Med Phys. 2008;51:452–460.
,
Functional electrical stimulation of walking: Function, exercise and rehabilitation
,
Ann Readapt Med Phys.
, vol.
51
(pg.
452
-
460
)
Thrasher TA, Flett HM, Popovic MR. Gait training regimen for incomplete spinal cord injury using functional electrical stimulation. Spinal Cord. 2006;44:357–361.
,
Gait training regimen for incomplete spinal cord injury using functional electrical stimulation
,
Spinal Cord.
, vol.
44
(pg.
357
-
361
)
Giangregorio LM, Craven BC, Richards K, et al. A randomized trial of functional electrical stimulation for walking in incomplete spinal cord injury: Effects on body composition. J Spinal Cord Med. 2012; 35:351–360.
,
A randomized trial of functional electrical stimulation for walking in incomplete spinal cord injury: Effects on body composition
,
J Spinal Cord Med.
, vol.
35
(pg.
351
-
360
)
Catz A, Itzkovich M, Agranov E, Ring H, Tamir A. SCIM–spinal cord independence measure: A new disability scale for patients with spinal cord lesions. Spinal Cord. 1997;35:850–856.
,
SCIM–spinal cord independence measure: A new disability scale for patients with spinal cord lesions
,
Spinal Cord.
, vol.
35
(pg.
850
-
856
)
Catz A, Itzkovich M, Tesio L, et al. A multi-center international study on the Spinal Cord Independence Measure, Version III: Rasch psychometric validation. Spinal Cord. 2007:45;1–17.
,
A multi-center international study on the Spinal Cord Independence Measure, Version III: Rasch psychometric validation
,
Spinal Cord.
, vol.
45
(pg.
1
-
17
)
Itzkovich M, Gelernter I, Biering-Soerensen F, et al. The Spinal Cord Independence Measure (SCIM) Version III: Reliability and validity in a multi-center international study. Disabil Rehabil. 2007:29;1926–1933.
,
The Spinal Cord Independence Measure (SCIM) Version III: Reliability and validity in a multi-center international study
,
Disabil Rehabil.
, vol.
29
(pg.
1926
-
1933
)
Diener E, Emmons RA, Larsen RJ, Griffin S. The Satisfaction With Life Scale. J Personality Assess. 1985;49:71–75.
,
The Satisfaction With Life Scale
,
J Personality Assess.
, vol.
49
(pg.
71
-
75
)
Dijkers MP. Correlates of life satisfaction among persons with spinal cord injury. Arch Phys Med Rehabil. 1999;80:867–876.
,
Correlates of life satisfaction among persons with spinal cord injury
,
Arch Phys Med Rehabil.
, vol.
80
(pg.
867
-
876
)
Lawton M, Brody E. Assessment of older people: Selfmaintaining and instrumental activities of daily living. Gerontology. 1969;9:179–186.
,
Assessment of older people: Selfmaintaining and instrumental activities of daily living
,
Gerontology.
, vol.
9
(pg.
179
-
186
)
Lawton G, Lundgren-Nilsson A, Biering-Sorensen F, et al. Cross-cultural validity of FIM in spinal cord injury. Spinal Cord. 2006;44:746–752.
,
Cross-cultural validity of FIM in spinal cord injury
,
Spinal Cord.
, vol.
44
(pg.
746
-
752
)
Whiteneck GG, Charlifue SW, Gerhart KA, Overholser JD, Richardson GN. Quantifying handicap: A new measure of long-term rehabilitation outcomes. Arch Phys Med Rehabil. 1992;73:519–526.
,
Quantifying handicap: A new measure of long-term rehabilitation outcomes
,
Arch Phys Med Rehabil.
, vol.
73
(pg.
519
-
526
)
Hall KM, Dijkers M, Whiteneck G, Brooks CA, Krause JS. The Craig Handicap Assessment and Reporting Technique (CHART): Metric properties and scoring. Top Spinal Cord Inj Rehabil. 1998:4:16–30.
,
The Craig Handicap Assessment and Reporting Technique (CHART): Metric properties and scoring
,
Top Spinal Cord Inj Rehabil.
, vol.
4
(pg.
16
-
30
)
Wood-Dauphinée SL, Opzoomer MA, Williams JI, Marchand B, Spitzer WO. Assessment of global function: The Reintegration to Normal Living Index. Arch Phys Med Rehabil. 1988;69:583–590.
,
Assessment of global function: The Reintegration to Normal Living Index
,
Arch Phys Med Rehabil.
, vol.
69
(pg.
583
-
590
)
Hitzig SL, Romero Escobar EM, Noreau L, Craven BC. Validation of the Reintegration to Normal Living Index for community-dwelling persons with chronic spinal cord injury. Arch Phys Med Rehabil. 2012;93:108–114.
,
Validation of the Reintegration to Normal Living Index for community-dwelling persons with chronic spinal cord injury
,
Arch Phys Med Rehabil.
, vol.
93
(pg.
108
-
114
)
Eser P, de Bruin ED, Telley I, Lechner HE, Knecht H, Stussi E. Effect of electrical stimulation-induced cycling on bone mineral density in spinal cord-injured patients. Eur J Clin Invest. 2003;33:412–419.
,
Effect of electrical stimulation-induced cycling on bone mineral density in spinal cord-injured patients
,
Eur J Clin Invest.
, vol.
33
(pg.
412
-
419
)
Altheide DL. Ethnographic content analysis. Qual Sociol. 1987;10:65–77.
,
Ethnographic content analysis
,
Qual Sociol.
, vol.
10
(pg.
65
-
77
)
Morgan DL. Qualitative content analysis: A guide to paths not taken. Qual Health Res. 1993;1:112–121.
,
Qualitative content analysis: A guide to paths not taken
,
Qual Health Res.
, vol.
1
(pg.
112
-
121
)
Cavanagh S. Content analysis: Concepts, methods and applications. Nurse Res. 1997;4:5–16.
,
Content analysis: Concepts, methods and applications
,
Nurse Res.
, vol.
4
(pg.
5
-
16
)
Bailey SN, Hardin EC, Kobetic R, Boggs LM, Pinault G, Triolo RJ. Neurotherapeutic and neuroprosthetic effects of implanted functional electrical stimulation for ambulation after incomplete spinal cord injury. J Rehabil Res Dev. 2010;47:7–16.
,
Neurotherapeutic and neuroprosthetic effects of implanted functional electrical stimulation for ambulation after incomplete spinal cord injury
,
J Rehabil Res Dev.
, vol.
47
(pg.
7
-
16
)
Hicks AL, Adams MM, Martin Ginis K, et al. Longterm body-weight-supported treadmill training and subsequent follow-up in persons with chronic SCI: Effects on functional walking ability and measures of subjective well-being. Spinal Cord. 2005;43:291–298.
,
Longterm body-weight-supported treadmill training and subsequent follow-up in persons with chronic SCI: Effects on functional walking ability and measures of subjective well-being
,
Spinal Cord.
, vol.
43
(pg.
291
-
298
)
Guest RS, Klose KJ, Needham-Shropshire BM, Jacobs PL. Evaluation of a training program for persons with SCI paraplegia using the Parastep 1 ambulation system: Part 4. Effect on physical self-concept and depression. Arch Phys Med Rehabil. 1997;78:804–807.
,
Evaluation of a training program for persons with SCI paraplegia using the Parastep 1 ambulation system: Part 4. Effect on physical self-concept and depression
,
Arch Phys Med Rehabil.
, vol.
78
(pg.
804
-
807
)
Muraki S, Tsunawake N, Hiramatsu S, Yamasaki M. The effect of frequency and mode of sports activity on the psychological status in tetraplegics and paraplegics. Spinal Cord. 2000;38:309–314.
,
The effect of frequency and mode of sports activity on the psychological status in tetraplegics and paraplegics
,
Spinal Cord.
, vol.
38
(pg.
309
-
314
)
Semerjian TZ, Montague SM, Dominguez JF, Mejy Davidian A, de Leon RD. Enhancement of quality of life and body satisfaction through the use of adapted exercise devices for individuals with spinal cord injuries. Top Spinal Cord Inj Rehabil. 2005;11:95–108.
,
Enhancement of quality of life and body satisfaction through the use of adapted exercise devices for individuals with spinal cord injuries
,
Top Spinal Cord Inj Rehabil.
, vol.
11
(pg.
95
-
108
)
Sipski ML, Delisa JA, Schweer S. Functional electrical stimulation bicycle ergometry: Patient perceptions. Am J Phys Med Rehabil. 1989; 68:147–149.
,
Functional electrical stimulation bicycle ergometry: Patient perceptions
,
Am J Phys Med Rehabil.
, vol.
68
(pg.
147
-
149
)
Twist DJ, Culpepper-Morgan JA, Ragnarsson KT, Petrillo CR, Kreek MJ. Neuroendocrine changes during functional electrical stimulation. Am J Phys Med Rehabil. 1992;71:156–163.
,
Neuroendocrine changes during functional electrical stimulation
,
Am J Phys Med Rehabil.
, vol.
71
(pg.
156
-
163
)
Putzke JD, Richards JS, Hicken BL, DeVivo MJ. Predictors of life satisfaction: A spinal cord injury cohort study. Arch Phys Med Rehabil. 2002;83:555–561.
,
Predictors of life satisfaction: A spinal cord injury cohort study
,
Arch Phys Med Rehabil.
, vol.
83
(pg.
555
-
561
)
Geyh S, Ballert C, Sinnott A, Charlifue S, Catz A, D’Andrea Greve JM, Post MW. Quality of life after spinal cord injury: A comparison across six countries. Spinal Cord. 2013;51:322–326.
,
Quality of life after spinal cord injury: A comparison across six countries
,
Spinal Cord.
, vol.
51
(pg.
322
-
326
)
Hastings J, Robins H, Griffiths Y, Hamilton C. The differences in self-esteem, function, and participation between adults with low cervical motor tetraplegia who use power or manual wheelchairs. Arch Phys Med Rehabil. 2011;92:1785–1788.
,
The differences in self-esteem, function, and participation between adults with low cervical motor tetraplegia who use power or manual wheelchairs
,
Arch Phys Med Rehabil.
, vol.
92
(pg.
1785
-
1788
)
Hicken BL, Putzke JD, Richards JS. Bladder management and quality of life after spinal cord injury. Am J Phys Med Rehabil. 2001;80:916–922.
,
Bladder management and quality of life after spinal cord injury
,
Am J Phys Med Rehabil.
, vol.
80
(pg.
916
-
922
)
Dijkers MP. Quality of life of individuals with spinal cord injury: A review of conceptualization, measurement, and research findings. J Rehabil Res Dev. 2005;42:87–110.
,
Quality of life of individuals with spinal cord injury: A review of conceptualization, measurement, and research findings
,
J Rehabil Res Dev.
, vol.
42
(pg.
87
-
110
)
Post M, Noreau L. Quality of life after spinal cord injury. J Neuro Phys Ther. 2005;29:139–146.
,
Quality of life after spinal cord injury
,
J Neuro Phys Ther.
, vol.
29
(pg.
139
-
146
)
Bonder BR, Rohde LM, Triolo RJ. Exploratory study of perceived quality of life with implanted standing neuroprostheses. J Rehabil Res Dev. 2012;49:265–278.
,
Exploratory study of perceived quality of life with implanted standing neuroprostheses
,
J Rehabil Res Dev.
, vol.
49
(pg.
265
-
278
)
Hicks AL, Martin Ginis KA. Treadmill training after spinal cord injury: It’s not just about the walking. J Rehabil Res Dev. 2008;45:241–248.
,
Treadmill training after spinal cord injury: It’s not just about the walking
,
J Rehabil Res Dev.
, vol.
45
(pg.
241
-
248
)
Bandura A. Social Foundations of Thought and Actions: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall; 1986.
,
Social Foundations of Thought and Actions: A Social Cognitive Theory.
Collins TC, Lunos S, Ahluwalia JS. Self-efficacy is associated with walking ability in persons with diabetes mellitus and peripheral arterial disease. Vascular Med. 2010;15;19–95.
,
Self-efficacy is associated with walking ability in persons with diabetes mellitus and peripheral arterial disease
,
Vascular Med.
, vol.
15
(pg.
19
-
95
)
Phang SH, Martin Ginis KA, Routhier F, Lemay V. The role of self-efficacy in the wheelchair skills-physical activity relationship among manual wheelchair users with spinal cord injury. Disabil Rehabil. 2012;34:625–632.
,
The role of self-efficacy in the wheelchair skills-physical activity relationship among manual wheelchair users with spinal cord injury
,
Disabil Rehabil.
, vol.
34
(pg.
625
-
632
)
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