Effects of two different paradigms of electrical stimulation exercise on cardio-metabolic risk factors after spinal cord injury. A randomized clinical trial

Frontiers in Neurology, 2023 · DOI: 10.3389/fneur.2023.1254760 · Published: September 22, 2023

Spinal Cord Injury Cardiovascular Science Neurology

Simple Explanation

This study explores how different types of electrical stimulation exercise affect heart and metabolic health in adults with spinal cord injuries (SCI). Two approaches were compared: neuromuscular electrical stimulation with resistance training (NMES-RT) combined with functional electrical stimulation cycling (FES-LEC), and passive movement training (PMT) also combined with FES-LEC. Participants were assigned to one of these two groups for 24 weeks. Measurements were taken at the beginning, after 12 weeks, and at the end of the study to see how oxygen uptake, insulin sensitivity, body composition, and other health markers changed. The study found that NMES-RT led to a trend of greater oxygen uptake and a decrease in visceral adipose tissue (VAT) compared to PMT. The findings suggest that different electrical stimulation methods can have different effects on the body after SCI.

Study Duration

24 Weeks

Participants

33 participants with chronic SCI (AIS A-C)

Evidence Level

Level 1, Randomized Clinical Trial

Key Findings

1
NMES-RT + FES group showed a trend of a greater VO2 peak in P1 compared to PMT + FES.
2
Robust hypertrophy of whole thigh muscle CSA, absolute thigh muscle CSA and knee extensor CSA were noted in the NMES-RT + FES group compared to PMT + FES at P1.
3
NMES-RT + FES resulted in a decrease in total VAT CSA at P1.

Research Summary

The addition of 12 weeks of FES-LEC following 12 weeks of NMES-RT did not result in additional increase in muscle size. NMES-RT managed to increase leg VO2 peak compared to PMT; however, the addition of FES-LEC resulted in increasing VO2 and relative VO2 in P2 compared to P1 in both groups. NMES-RT + FES resulted in a 12% decrease in the LDL-C level as well as total trunk VAT CSA.

Practical Implications

Clinical Practice

NMES-RT may offer an alternative, simple, and cost-effective rehabilitation approach for individuals with SCI, especially in home-based settings.

Research

Further research is needed to investigate the long-term effects of NMES-RT and FES-LEC on cardio-metabolic health and muscle adaptations in SCI.

Rehabilitation Programs

Rehabilitation programs should consider incorporating NMES-RT as a potential strategy to improve VO2 peak, reduce VAT, and enhance the lipid profile in individuals with SCI.

Study Limitations

1
Several of the current findings were trended towards statistical insignificance.
2
The small sample size may have possibly impacted the overall findings on the primary outcome variables.
3
The COVID-19 pandemic resulted in early discontinuation of the study.

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