Gains in aerobic capacity with whole-body functional electrical stimulation row training and generalization to arms-only exercise after spinal cord injury

Abstract

Study Design: Longitudinal study in adults (n=27; 19–40 years old) with tetraplegic or paraplegic spinal cord injury (SCI). Objectives: Determine physiological adaptations and generalizable fitness effects of six months of whole-body exercise training using volitional arm and functional electrical stimulation (FES) leg rowing. Setting: Outpatient hospital-based exercise facility and laboratory Methods: Participants enrolled in hybrid FES row training (FESRT) and performed peak exercise tests with arms-only (AO; baseline and 6-Mo) and FES rowing (baseline, 3-Mo, 6-Mo). Results: Participants demonstrated increased aerobic capacity (VO 2peak ) after FESRT (p<0.001, n p 2 =0.56) that tended to be higher when assessed with FES than AO rowing tests (0.15 ± 0.20 vs. 0.04 ± 0.22 L/min; p=0.10). Changes in FES and AO VO 2peak were significantly correlated (r=0.55; p<0.01), and 11 individuals demonstrated improvements (>6%) on both test formats. Younger age was the only difference between those who showed generalization of training effects and those who did not (mean age 26.6 ± 5.6 vs. 32.0 ± 5.7 years; p<0.05) but changes in FES VO 2peak correlated to time since injury in individuals <2 years post-SCI (r=−0.51, p<0.01, n=24). Lastly, VO 2peak improvements were greater during the first three months vs. months 4–6 (+7.0% vs. +3.9%; p<0.01) which suggests early training adaptations during FESRT. Conclusions: Gains in aerobic capacity after whole-body FESRT are better reflected during FES row testing format. They relate to high-intensity exercise and appear early during training, but they may not generalize to equivalent increases in AO exercise in all individuals with SCI.

Effect of hybrid FES exercise on body composition during the sub-acute phase of spinal cord injury

“…Exercise capacity. As described in our prior publications from the larger clinical dataset on the applied intervention of FESRT, maximal aerobic power (VO2max) [36][37][38][39][40][41] was determined from online computer assisted open circuit spirometry (ParvoMedics, Sandy, UT). Ventilation and expired O2 and CO2 were measured to determine O2 consumption (VO2), CO2 production (VCO2), respiratory exchange ratio (RER), and ventilation (VE).…”

“…As part of a larger clinical trial on FES-RT effectiveness [36][37][38][39][40][41], the current work sought to determine if high-intensity exercise training via the addition of stimulated leg muscles provides a sufficient stimulus to mitigate against body fat gain and lean mass loss in the sub-acute 24 months after SCI. We also explored potential effects on cardiometabolic parameters-insulin sensitivity and blood lipids.…”