Skeletal muscle conditioning may be an effective rehabilitation intervention preceding functional electrical stimulation cycling

Neural Regeneration Research, 2016 · DOI: 10.4103/1673-5374.189174 · Published: August 1, 2016

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

Functional electrical stimulation lower-extremity cycling (FES-LEC) can improve cardiovascular health in people with spinal cord injury (SCI). However, SCI can cause muscle atrophy and changes in muscle fiber types, leading to rapid fatigue during FES-LEC. Therefore, conditioning muscles with neuromuscular electrical stimulation (NMES) before FES-LEC may improve outcomes by increasing muscle mass and reducing fatigue.

Study Duration

Not specified

Participants

Persons with spinal cord injury

Evidence Level

Level 5, Perspective

Key Findings

1
FES-LEC relies heavily on carbohydrate storage as a primary energy source, which may limit oxygen uptake and cardiovascular benefits.
2
SCI leads to muscle atrophy, intramuscular fat infiltration, and a shift to fast-twitch muscle fibers, contributing to rapid muscle fatigue during FES-LEC.
3
NMES with progressive resistance training can increase muscle size, reduce intramuscular fat, and improve glucose homeostasis in individuals with SCI.

Research Summary

This perspective proposes that conditioning skeletal muscle via surface neuromuscular electrical stimulation (NMES) may be an essential rehabilitation intervention to improve the outcomes of FES-LEC applications. Limited oxygen uptake following spinal cord injury is a major limitation of FES-LEC training. Conditioning prior to beginning FES-LEC training has potential to increase the viability of FES-LEC and provide extensive training benefits.

Practical Implications

Improved FES-LEC Outcomes

Skeletal muscle conditioning using NMES prior to FES-LEC may enhance the effectiveness of FES-LEC in individuals with SCI.

Enhanced Cardio-metabolic Profile

Conditioning can potentially improve body composition and cardio-metabolic profile of those with SCI.

Increased Muscle Power Output

Prior conditioning maintains a realistic method for improving the skeletal musculature prior to beginning FES-LEC and could potentially increase power output and exercise capacity.

Study Limitations

1
The study is a perspective, lacking empirical data.
2
The specific NMES protocols and parameters for optimal conditioning are not detailed.
3
The long-term effects of pre-conditioning on FES-LEC outcomes require further investigation.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury