Body weight supported treadmill training in acute spinal cord injury: impact on muscle and bone

Giangregorio, Lora; Hicks, Audrey L.; Webber, Colin E.; Phillips, Stuart M.; Craven, B. Catharine; Bugaresti, J; McCartney, Neil

doi:10.1038/sj.sc.3101774

Cited by 118 publications

(86 citation statements)

References 45 publications

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“…In one study, there was an increase of 4.9% in thigh muscle area and 8.2% in the lower leg after 12 months of gait training (three times a week, totaling 144 sessions) without NMES; however, this study included only incomplete spinal cord injuries, paraplegia and quadriplegia [14]. A reversal of muscle atrophy in acute patients with incomplete quadriplegia (American Spinal Cord Injury Association B and C) after 48 sessions of treadmill gait training twice a week also was reported [13]. Stewart et al [24] reported an increase in size of Types I and IIa fibers with restoration of the normal size of muscle fibers after 6 months of gait (68 sessions) without NMES beginning with 65% ± 3% and ending with 23% ± 5% of BWS in individuals with incomplete (American Spinal Cord Injury Association C) paraplegia and quadriplegia.…”

Section: Discussionmentioning

confidence: 82%

Electrical Stimulation During Gait Promotes Increase of Muscle Cross-sectional Area in Quadriplegics: A Preliminary Study

Abreu

Cliquet

Rondina

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Increases in muscular cross-sectional area (CSA) occur in quadriplegics after training, but the effects of neuromuscular electrical stimulation (NMES) along with training are unknown. Thus, we addressed two questions: (1) Does NMES during treadmill gait training increase the quadriceps CSA in complete quadriplegics?; and (2) Is treadmill gait training alone enough to observe an increase in CSA? Fifteen quadriplegics were divided into gait (n = 8) and control (n = 7) groups. The gait group performed training with NMES for 6 months twice a week for 20 minutes each time. After 6 months of traditional therapy, the control group received the same gait training protocol but without NMES for an additional 6 months. Axial images of the thigh were acquired at the beginning of the study, at 6 months (for both groups), and at 12 months for the control group to determine the average quadriceps CSA. After 6 months, there was an increase of CSA in the gait group (from 49.8 ± 9.4 cm 2 to 57.3 ± 10.3 cm 2 ), but not in the control group (from 43.6 ± 7.6 cm 2 to 41.8 ± 8.4 cm 2 ). After another 6 months of gait without NMES in the control group, the CSA did not change (from 41.8 ± 8.4 cm 2 to 41.7 ± 7.9 cm 2 ). The increase in quadriceps CSA after gait training in patients with chronic complete quadriplegia appears associated with NMES.

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Section: Discussionmentioning

confidence: 82%

Electrical Stimulation During Gait Promotes Increase of Muscle Cross-sectional Area in Quadriplegics: A Preliminary Study

Abreu

Cliquet

Rondina

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…In people with acute SCI, lean mass is only 60-65% that of able-bodied controls and body fat can increase to levels corresponding to 100-113% of that of controls. 15 Reduced muscle mass and increased fat mass are both considered risk factors for secondary health complications and chronic disease.…”

Section: G3mentioning

confidence: 99%

“…17 Lean (muscle) and fat mass: Two level 4 studies examined body composition changes. Giangregorio et al 15 examined the effects of a 2 Â per week body-weight-supported treadmill training (BWSTT) program and reported increases in thigh and calf muscle cross-sectional area (4-57%) and increased leg fat. Another study involving arm ergometry showed no significant changes in lean or fat mass.…”

Section: Body Weightmentioning

confidence: 99%

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The effects of exercise training on physical capacity, strength, body composition and functional performance among adults with spinal cord injury: a systematic review

et al. 2011

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Study design: Systematic review. Objectives: To conduct a systematic review of evidence surrounding the effects of exercise on physical fitness in people with spinal cord injury (SCI). Setting: Canada. Methods: The review was limited to English-language studies (published prior to March 2010) of people with SCI that evaluated the effects of an exercise intervention on at least one of the four main components of physical fitness (physical capacity, muscular strength, body composition and functional performance). Studies reported at least one of the following outcomes: oxygen uptake/consumption, power output, peak work capacity, muscle strength, body composition, exercise performance or functional performance. A total of 166 studies were identified. After screening, 82 studies (69 chronic SCI; 13 acute SCI) were included in the review. The quality of evidence derived from each study was evaluated using established procedures. Results: Most studies were of low quality; however, the evidence was consistent that exercise is effective in improving aspects of fitness. There is strong evidence that exercise, performed 2-3 times per week at moderate-to-vigorous intensity, increases physical capacity and muscular strength in the chronic SCI population; the evidence is not strong with respect to the effects of exercise on body composition or functional performance. There were insufficient high-quality studies in the acute SCI population to draw any conclusions. Conclusions: In the chronic SCI population, there is good evidence that exercise is effective in improving both physical capacity and muscular strength, but insufficient quality evidence to draw meaningful conclusions on its effect on body composition or functional capacity.

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“…BWST training involves assisted walking while supported over a treadmill by a harness mechanism and overhead pulley system that can support a percentage of the participant's body weight. It has been shown to improve ambulation, 11,12 partially reverse muscle atrophy, 13 improve whole body lean mass 14 and muscle morphology, 15 improve heart rate and blood pressure variability, and increase femoral artery compliance 16,17 after SCI. Tilt-table standing (TTS) is an alternative weight-bearing training technique, which is less labor intensive than BWST training.…”

Section: Introductionmentioning

confidence: 99%

Leg skin temperature with body-weight-supported treadmill and tilt-table standing training after spinal cord injury

et al. 2010

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Study design: Randomized crossover. Objectives: Effects of body-weight-supported treadmill (BWST) and tilt-table standing (TTS) training on skin temperature and blood flow after spinal cord injury (SCI). Setting: McMaster University, Canada. Methods: Seven individuals with SCI participated in BWST and TTS training (3 times per week for 4 weeks, 4-week detraining between protocols). Skin temperature was measured before and after a single session of BWST or TTS, pre-and post-training. Leg blood flow was measured at rest pre-and post-training. Results: Resting skin temperature decreased at four sites after 4 weeks of BWST training in comparison with the pre-training. Four weeks of TTS training resulted in resting skin temperature decreases posttraining at the right thigh only. Both BWST and TTS training resulted in altered reactivity of skin temperature at all sites except the right calf in response to a single session of BWST and TTS. Post-BWST training, a single session of BWST stimulated increased temperature at all sites, whereas after TTS training a single session of TTS resulted in temperature decreases at two of the six sites. No changes were observed in resting blood flow with either BWST or TTS training. Conclusion: Increased resting skin temperature and decreased skin temperature reactivity have been linked to the development of pressure sores. BWST and TTS may stimulate different skin temperature responses and the impact on pressure sore development warrants further investigation. Sponsorship: NSERC, ONF and GSSI.

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Body weight supported treadmill training in acute spinal cord injury: impact on muscle and bone

Cited by 118 publications

References 45 publications

Electrical Stimulation During Gait Promotes Increase of Muscle Cross-sectional Area in Quadriplegics: A Preliminary Study

Electrical Stimulation During Gait Promotes Increase of Muscle Cross-sectional Area in Quadriplegics: A Preliminary Study

The effects of exercise training on physical capacity, strength, body composition and functional performance among adults with spinal cord injury: a systematic review

Leg skin temperature with body-weight-supported treadmill and tilt-table standing training after spinal cord injury

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