A report of anticipated benefits of functional electrical stimulation after spinal cord injury.

BACKGROUND: Functional electrical stimulation (FES) has been regularly used to offset several negative body composition and metabolic adaptations following spinal cord injury (SCI). However, the outcomes of many FES trials appear to be controversial and incoherent. OBJECTIVE: To document the potential consequences of several factors (e.g. pain, spasms, stress and lack of dietary control) that may have attenuated the effects on body composition and metabolic profile despite participation in 21 weeks of FES training. PARTICIPANT: A 29-year-old man with T6 complete SCI participated in 21 weeks of FES, 4 days per week. METHODS: Prior to and following training, the participant performed arm-crank-graded exercise testing to measure peak VO(2). Tests conducted included anthropometrics and dual energy X-ray absorptiometry body composition assessments, resting energy expenditure, plasma lipid profiles and intravenous glucose tolerance tests. RESULTS: The participant frequently reported increasing pain, stress and poor eating habits. VO(2) peak decreased by 2.4 ml/kg/minute, body mass increased by 8.5 kg, and body mass index increased from 25 to 28 kg/m(2). Waist and abdominal circumferences increased by 2-4 cm, while %fat mass increased by 5.5%. Absolute increases in fat mass and fat-free mass of 8.4 and 1 kg, respectively, were reported. Fasting and peak plasma glucose increased by 12 and 14.5%, while lipid panel profiles were negatively impacted. CONCLUSION: Failure to control for the listed negative emerging factors may obscure the expected body composition and metabolic profile adaptations anticipated from FES training.

Training response to high-intensity interval training in a 42-year-old man with chronic spinal cord injury.

OBJECTIVE: To review the outcome of 12 weeks of periodized, high-intensity interval training (HIT) in a man with chronic traumatic spinal cord injury (SCI). METHODS: A 42-year-old man (180 cm tall, 68.4 kg and 32.0% Fat) with a C8/T1 motor complete SCI took part in 12 weeks of 3 days per week arm crank ergometry (ACE) interval training. Training consisted of a combination of HIT that included three times 5  min at ∼70% Peak Power (WPeak) and 5  min recovery (HIT5); four times 2.5  min at ∼85% WPeak and 5  min recovery (HIT2.5); ten times 1  min at ∼110% WPeak and 2  min recovery (HIT1). Heart rate (HR) zones were set as <75% HRPeak (Z1), 75-89% (Z2), and 90+% (Z3) and used to monitor overall training efficacy. RESULTS: Thirty-six sessions that included 8 HIT5, 10 HIT2.5, and 5 HIT1 sessions were completed. WPeak and VO2 Peak improved about 45% and 52%, respectively, by week 6, without further improvement at week 12, HR TRIMP scores and power in training sessions trended upward over the 12-week program. CONCLUSIONS: Twelve weeks of HIT resulted in a large increase in peak aerobic power, as well as submaximal endurance performance in our participant. The early plateau in maximal testing supports the use of submaximal training assessment important in the long-term training monitoring for SCI.