Factors influencing thigh muscle volume change with cycling exercises in acute spinal cord injury – a secondary analysis of a randomized controlled trial

The Journal of Spinal Cord Medicine, 2022 · DOI: 10.1080/10790268.2020.1815480 · Published: July 1, 2022

Spinal Cord Injury Rehabilitation Musculoskeletal Medicine

Simple Explanation

This study examines how cycling exercises, with and without electrical stimulation, affect thigh muscle size in people with recent spinal cord injuries. The research looks at factors like exercise frequency and intensity to understand what might help maintain or increase muscle volume. The findings could help doctors decide which patients might benefit most from these types of exercises early after a spinal cord injury.

Study Duration

12 weeks

Participants

24 adults (1 female) within four weeks of motor complete or incomplete spinal cord injury (SCI)

Evidence Level

Secondary analysis from an assessor-blind randomized, controlled trial.

Key Findings

1
A strong, significant correlation was found between mean weekly exercise frequency and quadriceps and hamstring volumes.
2
Average watts was significantly correlated with quadriceps volumes only.
3
Total number of sessions was strongly correlated with hamstring volumes only.

Research Summary

This study analyzed data from a trial comparing functional electrical stimulation-assisted cycling (FESC) and passive cycling (PC) in patients with acute spinal cord injury (SCI). The analysis focused on how exercise dose (frequency, intensity) relates to changes in thigh muscle volume. The study identified potential factors, such as low BMI or pressure injuries, that may affect a patient's response to these interventions.

Practical Implications

Personalized Exercise Plans

Tailor exercise frequency and intensity to target specific muscle groups (quadriceps vs. hamstrings) based on individual needs.

Patient Selection

Consider patient characteristics like BMI, presence of pressure injuries, and pain levels when prescribing cycling interventions early after SCI.

Further Research

Conduct larger studies to confirm these findings and develop evidence-based guidelines for the optimal timing and type of exercise in acute SCI.

Study Limitations

1
Small sample size, limiting the ability to detect significant between-group differences.
2
The use of different MRI scanners at multiple sites.
3
The simultaneous effects of atrophy due to sudden disruption of descending drive, decreased mobility post-injury, and inflammatory stress system activation

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