***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Severe muscle atrophy occurs rapidly following traumatic spinal cord injury ( SCI ) . Previous research shows that neuromuscular or ‘ functional ’ electrical stimulation ( FES ) , particularly FES-cycle ergometry ( FES-CE ) can cause muscle hypertrophy in individuals with chronic SCI ( > 1 year post-injury ) . However , the modest degree of hypertrophy in these already atrophied muscles has lessened earlier hopes that FES therapy would reduce secondary impairments of SCI . It is not known whether FES treatments are effective when used to prevent , rather than reverse , muscle atrophy in individuals with acute SCI . This study explored whether unloaded isometric FES contractions ( FES-IC ) or FES-CE decreased subsequent muscle atrophy in individual with acute SCI ( <3 months post-injury ) . Twenty-six subjects , 14–15 weeks post-traumatic SCI , were assigned to control , FES-IC , or FES-CE against progessively increasing resistance . Subjects were involved in the study for 3 or 6 months . Total body lean body mass ( TB-LBM ) , lower limb lean body mass ( LL-LBM ) , and gluteal lean body mass ( G-LBM ) were determined before the study , and at 3 and 6 months using dual energy X-ray absorptiometry ( DEXA ) . Controls lost an average of 6.1 % , 10.1 % , 12.4 % , after 3 months and 9.5 % , 21.4 % , 26.8 % after 6 months in TB-LBM , LL-LBM and G-LBM respectively . Subjects in the FES-IC group consistently lost less lean body mass than controls , however , only 6 month G-LBM loss was significantly attenuated in this group relative to the controls . In the FES-CE group , LL-LBM and G-LBM loss were prevented at both 3 and 6 months , and TB-LBM loss was prevented at 6 months . In addition , FES-CE significantly increased G-LBM and LL-LBM after 6 months of training relative to pre-training levels . Within the control group , there was no significant relationship between LL-LBM loss ( 3 and 6 months ) and the number of days between injury and baseline measurement . In summary , this study shows that FES-CE , but not FES-IC , training prevents muscle atrophy in acute SCI after 3 months of training , and causes significant hypertrophy after 6 months . The magnitude of differences in regionalized LBM between controls and FES-CE subject raises hopes that such treatment may indeed be beneficial in preventing secondary impairments of SCI if employed before extensive post-injury atrophy occurs In this clinical study , we report the results of functional electrical stimulation for the ambulation of paraplegic patients without long leg braces ( LLB )  , according to the Parastep approach . Of 13 SCI patients with complete neurological lesions included in this trial , 12 progressed to independent ambulation with the aid of the Parastep . The average walking distance was 76 m , with a maximum of 350 m , and the mean speed 0.2 ms-1 . Compared to the situation with long leg braces , which in fact are given up by most paraplegic patients , long term home use seems to be much more important . Tolerance of this method is satisfactory . The psychological benefits of the device are remarkable . From this experience , it is concluded that this method is valuable for the restoration of st and ing and walking in the long term management of spinal cord injury patients Among the objectives of spinal cord injury ( SCI ) rehabilitation , ( i ) prevention of bony , muscular and joint trophism and ( ii ) limitation of spastic hypertone represent important goals to be achieved . The aim of this study is to use functional electrical stimulation ( FES ) to activate pedaling on cycle-ergometer and analyse effects of this technique for a rehabilitation training in SCI persons . Five spinal cord injured subjects were recruited and underwent a two months FES-cycling training . Our results show an increase of thigh muscular area and endurance after the FES-cycling training , without any increase of spasticity . This approach , which is being vali date d on a larger pool of patients , represents a potential tool for improving the rehabilitation outcome of complete and incomplete SCI persons The goal of this research was to determine if cutaneous electrotherapy would temporarily reduce muscle spasticity .  Five traumatically brain injured ( TBI ) and five spinal cord injured ( SCI ) subjects , all with clinical ly evident spasticity , received surface electrical stimulation over the tibialis anterior muscle . Using the Spasticity Measurement System , stiffness around the ankle was measured before , immediately after , and 24 hours after treatment . With stimulation , ipsilateral ankle viscoelastic stiffness immediately decreased in 9 of 10 subjects and remained significantly depressed for up to 24 hours . Contralateral ankle spasticity did not significantly change . Using the same subjects under sham conditions , no significant decrements in spasticity occurred . In a subjective survey , only SCI participants reported functionally evident spasticity reductions . Also within this subgroup , efficacy of treatment was directly proportional to the severity of pre-stimulation clonus . We conclude that ( 1 ) cutaneous electrotherapy transiently decreases both TBI and SCI related spasticity and ( 2 ) pre-stimulation clonus may function as a clinical indicator of SCI patients most likely to benefit from this process Training of spinal cord circuits using sensorimotor stimulation has been proposed as a strategy to improve movement after spinal injury . How sensory stimulation may lead to long-lasting changes is not well understood . We studied whether sensory stimulation might induce changes in the strength of a specific spinal interneuronal circuit : spinally mediated reciprocal Ia inhibition . In healthy humans , the strength of reciprocal inhibition between ankle flexor and extensor muscles was assessed before and after 30 min of peroneal nerve stimulation at motor threshold intensity . Three stimulation protocol s were assessed : patterned nerve stimulation ( 10 pulses at 100 Hz every 1.5 sec ) , uniform nerve stimulation ( one pulse every 150 msec ) , and combined stimulation of the peroneal nerve and the motor cortex with transcranial magnetic stimulation .  Short-latency reciprocal inhibition from ankle flexor to extensor muscles was measured by conditioning the soleus H-reflex with stimulation of the common peroneal nerve . The strength of the reciprocal inhibition was measured at baseline and for 20 min after each stimulation session . Patterned stimulation , with or without motor cortex stimulation , enhanced reciprocal inhibition for at least 5 min afterward . The uniform pattern of stimulation was ineffective . These results demonstrate the presence of short-term plasticity within spinal inhibitory circuits . We conclude that the pattern of sensory input is a crucial factor for inducing changes in the spinal circuit for reciprocal inhibition in humans . These findings may have implication s for the use of repetitive patterned sensory stimulation in rehabilitative efforts to improve walking ability in patients with spinal injury The objective of this prospect i ve cohort study was to investigate alterations in body composition variables and spasticity following subtetanic neuromuscular electrical stimulation ( NMES ) training in an adult population with spinal cord injury ( SCI ) . Fourteen sedentary adults with SCI ( thoracic [T]4-T11 ; American Spinal Injury Association Impairment Scale A/B ; time since injury : 10.17 + /- 11.17 yr ) were recruited from the National SCI data base .  Four adhesive electrodes ( 175 cm2 each ) were placed bilaterally on the proximal and distal quadriceps and hamstrings muscle groups and subtetanic contractions were elicited using a h and held NMES device .  Lean body mass ( LBM ) and other body composition variables were measured using dual-energy X-ray absorptiometry . Spasticity was measured using the Spinal Cord Assessment Tool for Spastic Reflexes ( SCATs ) and visual analog scales . Verbal and written feedback was obtained to subjectively evaluate spasticity . LBM and spasticity measurements were taken before and after an 8 wk NMES training program in order to assess change . A statistically significant increase in lower-limb LBM , i.e. , muscle tissue ( p > 0.001 ) , and a reduction in SCATs ( p < 0.001 ) score , indicating reduced spasticity , was observed . Subjective responses were positive . Improvements in body composition and SCATs scores indicate that subtetanic NMES training elicits favorable responses and may have important clinical implication s for an SCI population Objective : To determine the clinical efficacy of functional electrical therapy in the rehabilitation of grasping function for quadriplegics . Study design : R and omized intervention-versus-control trial . Setting : Rehabilitation hospital for spinal cord injury in Toronto , Canada . Methods : A total of 21 people with new spinal cord injuries ranging from C3 to C7 were r and omly assigned to two groups : Control ( N=9 ) and Intervention ( N=12 ) . The intervention was functional electrical therapy , which consisted of repetitive grasping exercises using a neuroprosthesis that applied surface electrical stimulation to the arm to generate and /or assist grasping movements . It was applied by registered Occupational Therapists in a clinical setting . Main outcome measures were : Functional Independence Measure ( FIM ) , Spinal Cord Independence Measure ( SCIM ) , and the Rehabilitation Engineering Laboratory H and Function Test . Consumer perceptions of functional electrical therapy  were assessed via qualitative interviews . Results : Differences between the Control and Intervention groups could be observed although they are not significant due to an insufficient number of participants . Consumer perceptions were positive , including improved Activities of Daily Living and self-satisfaction . Conclusion : Functional electrical therapy has the potential to be an effective treatment modality to restore grasping function in quadriplegia . It can be implemented by occupational therapists in a clinical setting . Further research is required to establish suitable indications for participant selection . In addition , a larger number of participants is needed to demonstrate statistical significance of the Functional Electrical Therapy Study design : A r and omized controlled trial . Objectives : To determine the effectiveness of electrical stimulation (ES)-evoked muscle contractions superimposed on progressive resistance training ( PRT ) for increasing voluntary strength in the quadriceps muscles of people with spinal cord injuries ( SCI ) . Setting : Sydney , Australia . Methods : A total of 20 people with established SCI and neurologically induced weakness of the quadriceps muscles participated in the trial . Participants were r and omized between experimental and control groups . Volunteers in the experimental group received ES superimposed on PRT to the quadriceps muscles of one leg thrice weekly for 8 weeks . Participants in the control group received no intervention . Assessment s occurred at the beginning and at the end of the 8-week period . The four primary outcomes were voluntary strength ( Nm ) and endurance ( fatigue ratio ) as well as the performance and satisfaction items of the Canadian Occupational Performance Measure ( COPM ; points ) . Results : The between-group mean differences ( 95 % confidence interval ( CI ) ) for voluntary strength and endurance were 14 Nm ( 1–27 ; P=0.034 ) and 0.1 ( −0.1 to 0.3 ; P=0.221 ) , respectively . The between-group median differences ( 95 % CI ) for the performance and satisfaction items of the COPM were 1.7 points ( −0.2 to 3.2 ; P=0.103 ) and 1.4 points ( −0.1 to 4.6 ; P=0.058 ) , respectively . Conclusion : ES superimposed on PRT  improves voluntary strength , although there is uncertainty about whether the size of the treatment effect is clinical ly important . The relative effectiveness of ES and PRT is yet to be determined The purpose of this single-site r and omized control trial was to assess the short-term and long-term efficacy of functional electrical stimulation ( FES ) therapy over conventional occupational therapy in improving voluntary h and function in incomplete C4-C7 spinal cord injury individuals . All 22 participants recruited in this r and omized control trial received treatment for both the left and right upper extremities . Every participant , irrespective of group allocation , received one dose ( 60 min per day , 5 days per week for the duration of 8 weeks ) of conventional occupational therapy for h and function . Of the 22 participants , 12 individuals received an additional dose of conventional occupational therapy , while the remaining 10 participants received a dose of FES h and therapy . The primary outcome measure was Functional Independence Measure ( FIM ) self-care subscore . The secondary outcome measures were Spinal Cord Independence Measure ( SCIM ) self-care subscore and Toronto Rehabilitation Institute H and Function Test ( TRI-HFT ) . The participants who received FES therapy showed significantly greater improvements in h and function at discharge , and were able to maintain their gains at long-term follow-up as assessed using FIM self-care subscore , SCIM self-care subscore , and TRI-HFT . The FES therapy effectively increased independence and thereby improved quality of life of individuals with tetraplegia when compared with conventional occupational therapy QUESTION Does functional electrical stimulation ( FES ) cycling increase urine output and decrease lower limb swelling and spasticity in people with recent spinal cord injury ? DESIGN R and omised cross-over trial . PARTICIPANTS Fourteen participants with a recent motor complete spinal cord injury were consecutively recruited from two spinal cord injury units in Sydney . INTERVENTION Participants were r and omised to an experimental phase followed by a control phase or vice versa , with a 1-week washout period in between . The experimental phase involved FES cycling four times a week for two weeks and the control phase involved st and ard rehabilitation for two weeks . Assessment s by a blinded assessor occurred at the beginning and end 
    Output:
    
Conclusions Electrical stimulation was found to be an effective method for increasing muscle volume in SCI patients , but had no effect on spasticity .