Effects of trunk muscle activation on trunk stability, arm power, blood pressure and performance in wheelchair rugby players with a spinal cord injury

Abstract

Objective: In wheelchair rugby (WR) athletes with tetraplegia, wheelchair performance may be impaired due to (partial) loss of innervation of upper extremity and trunk muscles, and low blood pressure (BP). The objective was to assess the effects of electrical stimulation (ES)-induced co-contraction of trunk muscles on trunk stability, arm force/power, BP, and WR performance. Design: Cross-sectional study. Setting: Rehabilitation research laboratory and WR court. Participants: Eleven WR athletes with tetraplegia. Interventions: ES was applied to the rectus abdominis, obliquus externus abdominis and erector spinae muscles. For every test, the ES condition was compared to the non-ES condition. Outcome measures: Stability was assessed with reaching tasks, arm force/power with an isokinetic test on a dynamometer, BP during an ES protocol and WR skill performance with the USA Wheelchair Rugby Skill Assessment. Results: Overall reaching distance (ES 14.6 ± 7.5 cm, non-ES 13.4 ± 8.2 cm), and BP showed a significant increase with ES. Arm force (ES 154 ± 106 N, non-ES 148 ± 102 N) and power (ES 37 ± 26 W, non-ES 36 ± 25 W), and WR skills were not significantly improved. Conclusion: ES-induced trunk muscle activation positively affects trunk stability and BP, but not arm force/power. No effects were found in WR skill performance, probably due to abdominal strapping. More research is needed to assess different ES (training) protocols and longitudinal effects.

Neuromodulation for recovery of trunk and sitting functions following spinal cord injury: a comprehensive review of the literature

“…FES and ES are commonly used for muscle strengthening by directly stimulating the target muscle (Bergmann et al 2019 ; Kouwijzer et al 2022 ), whereas FNS is applied over the nerve supply of the affected muscles to induce muscle contraction (Friederich et al 2020 ). TSCS is a non-invasive transcutaneous approach applying to the skin overlying the spinal cord (Tharu et al 2022b ), while EES uses multichannel electrodes placed invasively on the dorsal epidural surface of the spinal cord (Gill et al 2020 ).…”

The effect of electromyography triggered electrical stimulation to abdominal muscles on sitting balance, respiratory functions, and abdominal muscle thickness in complete spinal cord injury: a randomized controlled trial

“…Kouwijzer et al . [20] conducted a study on cervical complete and incomplete SCI patients, using ES to stimulate the RA, OE and erector spinae muscles. The ES parameters included a 30 Hz frequency, 300 µs stimulation time and amplitude ranging from 30 to 100 mA.…”

The deer play in Wuqinxi and four-point hand−knee kneeling positions for training core muscle function and spinal mobility

“…Frontiers in Bioengineering and Biotechnology frontiersin.org 2019; Kouwijzer et al, 2020). Previous studies showed that people with low back pain were found to have smaller multifidus muscles with a significant amount of intramuscular fat infiltration (Seyedhoseinpoor et al, 2021).…”

“…A previous study showed that HKK with the right lower limb lifted had higher activity of the right EO and MF muscles and lower activity of the RA, which was consistent with our results ( Stevens et al, 2007b ). The ES and MF were thought to play an important role in the active stabilization and movement of the spine ( Sadeghi et al, 2019 ; Kouwijzer et al, 2020 ). Previous studies showed that people with low back pain were found to have smaller multifidus muscles with a significant amount of intramuscular fat infiltration ( Seyedhoseinpoor et al, 2021 ).…”