A feasibility pilot using telehealth videoconference monitoring of home-based NMES resistance training in persons with spinal cord injury.

INTRODUCTION: The objective of the study was to investigate the feasibility and initial efficacy of telehealth communication in conjunction with surface neuromuscular electrical stimulation (NMES) resistance training (RT) to induce muscle hypertrophy. MATERIALS AND METHODS: This was a home-based setting of within-subject control design of trained vs controlled limbs. Five men with chronic (>1 year postinjury) motor-complete spinal cord injury (SCI) participated in a twice-weekly telehealth videoconference program using home-based NMES-RT for 8 weeks. Stimulation was applied to the knee extensor muscle group of the trained leg, while the untrained leg served as a control. Participants received real-time feedback to ensure a proper setup of electrodes and stimulator to monitor subject safety throughout the entire training session. Magnetic resonance imaging was used to measure cross-sectional areas (CSAs) and intramuscular fat (IMF) of the whole thigh and individual muscle groups. Average two-way travel time, distance traveled in miles and total cost of gas per mile were calculated. RESULTS: Participants had 100% compliance. Trained whole and absolute knee extensor muscle CSA increased by 13% (P=0.002) and 18% (P=0.0002), with no changes in the controlled limb. Absolute knee flexor and adductor CSAs increased by 3% (P=0.02) and 13% (P=0.0001), respectively. Absolute whole thigh and knee extensor IMF CSAs decreased significantly in the trained limb by 14% (P=0.01) and 36% (P=0.0005), respectively, with no changes in controlled limb. DISCUSSION: The pilot work documented that using telehealth communication is a safe, feasible and potentially cost-reducing approach for monitoring home-based NMES-RT in persons with chronic SCI. All trained muscles showed detectable muscle hypertrophy with concomitant decrease in ectopic adipose tissue.