Persons with spinal cord injury (SCI) exhibit deficits in volitional motor control and sensation that limit not only the performance of daily tasks but also the overall activity level of these persons. This population has been characterised as extremely sedentary with an increased incidence of secondary complications including diabetes mellitus, hypertension and atherogenic lipid profiles. As the daily lifestyle of the average person with SCI is without adequate stress for conditioning purposes, structured exercise activities must be added to the regular schedule if the individual is to reduce the likelihood of secondary complications and/or to enhance their physical capacity. The acute exercise responses and the capacity for exercise conditioning are directly related to the level and completeness of the spinal lesion. Appropriate exercise testing and training of persons with SCI should be based on the individual's exercise capacity as determined by accurate assessment of the spinal lesion. The standard means of classification of SCI is by application of the International Standards for Classification of Spinal Cord Injury, written by the Neurological Standards Committee of the American Spinal Injury Association. Individuals with complete spinal injuries at or above the fourth thoracic level generally exhibit dramatically diminished cardiac acceleration with maximal heart rates less than 130 beats/min. The work capacity of these persons will be limited by reductions in cardiac output and circulation to the exercising musculature. Persons with complete spinal lesions below the T(10) level will generally display injuries to the lower motor neurons within the lower extremities and, therefore, will not retain the capacity for neuromuscular activation by means of electrical stimulation. Persons with paraplegia also exhibit reduced exercise capacity and increased heart rate responses (compared with the non-disabled), which have been associated with circulatory limitations within the paralysed tissues. The recommendations for endurance and strength training in persons with SCI do not vary dramatically from the advice offered to the general population. Systems of functional electrical stimulation activate muscular contractions within the paralysed muscles of some persons with SCI. Coordinated patterns of stimulation allows purposeful exercise movements including recumbent cycling, rowing and upright ambulation. Exercise activity in persons with SCI is not without risks, with increased risks related to systemic dysfunction following the spinal injury. These individuals may exhibit an autonomic dysreflexia, significantly reduced bone density below the spinal lesion, joint contractures and/or thermal dysregulation. Persons with SCI can benefit greatly by participation in exercise activities, but those benefits can be enhanced and the relative risks may be reduced with accurate classification of the spinal injury.

(Table 1). Definitive quantitative assays include calibrators fit to a regression model to calculate absolute values and reference standards that are well characterized and fully representative of the endogenous measurand. Definitive quantitative assays can be both accurate and precise. Relative quantitative assays utilize responseconcentration calibration, however in this scenario the reference standards are not fully characterized or truly representative of the endogenous measurand. As such, imprecision can be demonstrated for a relative quantitative method, but accuracy can only be estimated. With quasi-quantitative assays there is a relationship between the response and the measurand but calibration standards are not used. Thus, quasi-quantitative methods can be validated for imprecision, but not accuracy. Qualitative methods generate categorical data. Flow cytometric methods largely fall in the two latter categories and are essentially therefore quasi-quantitative or qualitative.Multi-color flow cytometry is a unique technology, which enables the analysis of heterogeneous cellular systems and provides multiparametric information at a cellby-cell level. The strength of flow cytometry lies not only in the ability to simultaneously measure multiple parameters, but also in the flexibility to report them in different ways. The appropriate data output depends on the biology of the system being investigated, the analytical or scientific question being asked, and the intended use of the results. A wide variety of data outputs can be reported usually expressed in terms of several characteristics of cells, or cell subsets, in the sample tested for example, percentage of positive events, absolute counts, median fluorescence intensity, quantitative antigen expression levels, ratiometric indices, markers coexpression, or relative nucleic acid content.

BackgroundResearch has indicated that low-to-moderate dosages of caffeine supplementation are ergogenic for sustained endurance efforts as well as high-intensity exercise. The effects of caffeine supplementation on strength-power performance are equivocal, with some studies indicating a benefit and others demonstrating no change in performance. The majority of research that has examined the effects of caffeine supplementation on strength-power performance has been carried out in both trained and untrained men. Therefore, the purpose of this study was to determine the acute effects of caffeine supplementation on strength and muscular endurance in resistance-trained women.MethodsIn a randomized manner, 15 women consumed caffeine (6 mg/kg) or placebo (PL) seven days apart. Sixty min following supplementation, participants performed a one-repetition maximum (1RM) barbell bench press test and repetitions to failure at 60% of 1RM. Heart rate (HR) and blood pressure (BP) were assessed at rest, 60 minutes post-consumption, and immediately following completion of repetitions to failure.ResultsRepeated measures ANOVA indicated a significantly greater bench press maximum with caffeine (p ≤ 0.05) (52.9 ± 11.1 kg vs. 52.1 ± 11.7 kg) with no significant differences between conditions in 60% 1RM repetitions (p = 0.81). Systolic blood pressure was significantly greater post-exercise, with caffeine (p < 0.05) (116.8 ± 5.3 mmHg vs. 112.9 ± 4.9 mmHg).ConclusionsThese findings indicate a moderate dose of caffeine may be sufficient for enhancing strength performance in resistance-trained women.

Chronic survivors of paraplegia safely improve their upper extremity cardiorespiratory endurance and muscle strength when undergoing a short-term circuit resistance training program. Gains in fitness and strength exceeded those usually reported after either arm endurance exercise conditioning or strength training in this subject population.

Objective: To compare two forms of device-specific training -body-weight-supported (BWS) ambulation on a fixed track (TRK) and BWS ambulation on a treadmill (TM) -to comprehensive physical therapy (PT) for improving walking speed in persons with chronic, motor-incomplete spinal cord injury (SCI). Methods: Thirty-five adult subjects with a history of chronic SCI (>1 year; AIS 'C' or 'D') participated in a 13-week (1 hour/day; 3 days per week) training program. Subjects were randomized into one of the three training groups. Subjects in the two BWS groups trained without the benefit of additional input from a physical therapist or gait expert. For each training session, performance values and heart rate were monitored. Pre-and post-training maximal 10-m walking speed, balance, muscle strength, fitness, and quality of life were assessed in each subject. Results: All three training groups showed significant improvement in maximal walking speed, muscle strength, and psychological well-being. A significant improvement in balance was seen for PT and TRK groups but not for subjects in the TM group. In all groups, post-training measures of fitness, functional independence, and perceived health and vitality were unchanged. Conclusions: Our results demonstrate that persons with chronic, motor-incomplete SCI can improve walking ability and psychological well-being following a concentrated period of ambulation therapy, regardless of training method. Improvement in walking speed was associated with improved balance and muscle strength. In spite of the fact that we withheld any formal input of a physical therapist or gait expert from subjects in the device-specific training groups, these subjects did just as well as subjects receiving comprehensive PT for improving walking speed and strength. It is likely that further modest benefits would accrue to those subjects receiving a combination of device-specific training with input from a physical therapist or gait expert to guide that training.

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The purpose of this study was to examine the effects of different durations of static stretching on dynamic balance. Women (N = 28) were tested before and after 2 stretching interventions and a control condition on 3 separate days, at least 48 hours apart. The stretching sessions involved a cycle ergometer warm-up at 70 rpm and 70 W followed by passive stretching of the lower-body muscles. Each stretching position was held at a point of mild discomfort and repeated 3 times with 15 seconds between stretches. In the 2 stretching protocols, the positions were maintained for 15 or 45 seconds. The control condition involved the same cycle ergometer warm-up, with a 26-minute rest period between pre- and posttests. Balance was assessed using the Biodex Balance System. A 2-way repeated-measures analysis of variance was used with the effects of study condition (control, 15 seconds, 45 seconds) and time (pre-, postscores). Post hoc paired t-tests were used when appropriate to determine possible statistical significance between pre- and posttest scores. Analyses indicated no significant main effects for either study condition or time. However, there was a significant condition x time interaction (p < 0.05). Post hoc analyses indicated that the 15-second condition produced a significant improvement in the balance scores (p < 0.01), with no significant effects with the control condition or the 45-second treatment. The results of this study reveal that a stretching protocol of 45-second hold durations does not adversely affect balance when using the current stabilometry testing procedure. Furthermore, a stretching intervention with 15-second hold durations may improve balance performance by decreasing postural instability. Strength and conditioning professionals concerned with reported performance limitations associated with static stretching should consider applying shorter-duration stretching protocols when aiming to improve balance performance.

Spinal cord injury (SCI) is a devastating neurological trauma that is prevalent predominantly in young individuals. Several interventions in the areas of neuroregeneration, pharmacology and rehabilitation engineering/neuroscience are currently under investigation for restoring function after SCI. In this paper, we focus on the use of neuroprosthetic devices for restoring standing and ambulation as well as improving general health and wellness after SCI. Four neuroprosthetic approaches are discussed along with their demonstrated advantages and their future needs for improved clinical applicability. We first introduce surface functional electrical stimulation (FES) devices for restoring ambulation and highlight the importance of these devices for facilitating exercise activities and systemic physiological activation. Implanted muscle-based FES devices for restoring standing and walking that are currently undergoing clinical trials are then presented. The use of implanted peripheral nerve intraneural arrays of multi-site microelectrodes for providing fine and graded control of force during sit-to-stand maneuvers is subsequently demonstrated. Finally, intraspinal microstimulation (ISMS) of the lumbosacral spinal cord for restoring standing and walking is introduced and its results to date are presented. We conclude with a general discussion of the common needs of the neuroprosthetic devices presented in this paper and the improvements that may be incorporated in the future to advance their clinical utility and user satisfaction.