The effects of functional electrical stimulation leg cycle ergometry training on arterial compliance in individuals with spinal cord injury

Abstract

Study design: A prospective intervention of functional electrical stimulation leg cycle ergometry (FES-LCE) of four women with spinal cord injury (SCI). Objective: To evaluate the effect of FES-LCE training on arterial compliance in individuals with chronic SCI of traumatic origin. Setting: Tertiary rehabilitation center in Canada. Methods: Large and small artery compliance were measured at the radial artery before and after a 3-month training program using FES-LCE. Results: There was no significant change in large artery compliance after FES-LCE (16.0 ± 4.2 to 16.8±6.1 ml mm Hg À1 Â 10, P ¼ NS). There was a marked (63%) increase in small artery compliance after the FES training program (4.2 ± 1.8 to 6.9 ± 3.2 ml mm Hg À1 Â 100, Po0.05).Conclusion: It appears that FES-LCE is effective in improving small artery compliance in females with SCI.

A systematic review of exercise as a therapeutic intervention to improve arterial function in persons living with spinal cord injury

“…51 With such limited data, it is difficult to interpret the value of this exercise technique. More research needs to be completed investigating [64][65][66][67][68] the acute vascular changes in response to stretch-induced contractions.…”

“…Following that, based on the available evidence, FES and hybrid exercise are the most promising types of exercise for improving arterial dynamics as they have been shown to increase femoral artery blood flow, reduce arterial stiffness and improve hyperemic response. 65,[71][72][73][74][75] Finally, according to the available literature, to increase vascular health in those with SCI, hybrid or FES training with increasing levels of intensity should be performed a minimum of two times per week and continued indefinitely. Improvements in arterial structure and function begin to appear as early as 1 week into training and after 8 weeks show a range of arterial health benefits.…”

“…Three of the five papers used electrical stimulation sites at the hamstring, gluteal and quadriceps muscles, 65,71,73 whereas De Groot et al 72 used tibialis anterior, gastrocnemius and quadriceps. Thijs-sen et al 75 have shown that when using FES, only the stimulated muscle tissue receives any improved arterial function or structure.…”

“…All five papers investigating FES cycling showed significant improvements in vascular function in both PARA and TETRA. Overall, FES has led to increased femoral artery blood flow, 70,71,73 improved small artery compliance, 65 femoral artery compliance, 72 normalized femoral flowmediated dilatation, 72 reduced leg vascular resistance 73 and improved hyperemic response. 70 According to work by De Groot et al, 23 a minimum of 2 weeks FES training is required for arterial dynamic improvements (femoral artery flow-mediated dilatation); however, trends start to appear after the first week.…”

“…Two articles were case-control studies, 69,70 11 were of the pre-post design, 24,71-75 one was a case report and one was an RCT. The Non-Acute Exercise category (n ¼ 15) included passive leg exercise (n ¼ 1), 49 FES (n ¼ 5), 65,[70][71][72][73] upper body exercise (n ¼ 2), 69,76 an electrically stimulated resistance training regimen (n ¼ 3), 24,67,68 hybrid exercise (n ¼ 3) 66,74,75 and BWSTT (n ¼ 1). 64 Table 3 is a summary of published investigations examining the effect of non-acute exercise on arterial function in those with SCI.…”