Energy expenditure and heart rate responses to increased loading in individuals with motor complete spinal cord injury performing body weight-supported exercises.

OBJECTIVE: To examine acute metabolic and heart rate responses in individuals with motor complete spinal cord injury (SCI) during stepping and standing with body weight support (BWS). DESIGN: Cohort study. SETTING: Therapeutic exercise research laboratory. PARTICIPANTS: Nonambulatory individuals with chronic, motor complete SCI between T5 and T12 (n=8) and healthy, able-bodied controls (n=8). INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Oxygen consumption (V˙o2) and heart rate. RESULTS: Individuals with motor complete SCI performed standing and stepping exercises in a BWS system with manual assistance of lower body kinematics. V˙o2 and heart rate responses were assessed in relation to level of BWS. Weight support was provided by an overhead lift at high (≥50% BWS) or low (20%-35% BWS) levels during stepping and standing. Although participants with motor complete SCI were unable to stand or step without assistance, levels of V˙o2 and heart rate were elevated by 38% and 37%, respectively, when load was maximized during stepping (ie, low BWS). Participants without an SCI (able-bodied group) had a similar acute response to exercise. None of the participants met the target range for V˙o2 response in any of the tasks. However, stepping was sufficient to enable half of the participants in the SCI group to attain the target range for heart rate response to exercise. CONCLUSIONS: Individuals with motor complete SCI exhibit cardiovascular responses during body weight-supported exercise. Findings indicate that body weight-supported stepping provides a minimal cardiovascular challenge for individuals with paraplegia. Emphasis on low weight support during locomotor training can trigger additional heart rate adaptations.

Multivariate assessment of differences between a neuromuscular electrical stimulation therapy and robotic treadmill training in the rehabilitation of spinal cord injured rats.

A study was conducted to evaluate and compare the effects of two different rehabilitation therapies on spinal cord injured (SCI) rats: neuromuscular electrical stimulation which is timed to robotic treadmill training (NMES+RTT) and RTT alone. Several electromyography (EMG) based variables were measured, but most did not change significantly after treatment, contrary to observations of overall qualitative stepping ability. However, when the variables are viewed in multi-dimensional space, there are visible differences between changes after NMES+RTT vs. those after RTT only. Principal component analysis (PCA) and k-means clustering were applied to the multivariate data. The data in principal component space was significantly separated, according to the Euclidean distance. PCA also provided a straightforward tool for selecting which combination of measures to compare. The measures which best separated out the differences between NMES+RTT and RTT were percentage of steps associated with bursts, burst-to-step latency, and the standard deviation of this latency, even though these measures did not always show the greatest statistical significance individually. Thus, the rehabilitative effects of NMES+RTT are not necessarily reflected in individual EMG measures, but rather in a combination of the measures representing a multi-dimensional space.

Assessment of the role of MAP kinase in mediating activity-dependent transcriptional activation of the immediate early gene Arc/Arg3.1 in the dentate gyrus in vivo.

Different physiological and behavioral events activate transcription of Arc/Arg3.1 in neurons in vivo, but the signal transduction pathways that mediate induction in particular situations remain to be defined. Here, we explore the relationships between induction of Arc/Arg3.1 transcription in dentate granule cells in vivo and activation of mitogen-activated protein (MAP) kinase as measured by extracellular-regulated kinase 1/2 (ERK1/2) phosphorylation. We show that ERK1/2 phosphorylation is strongly induced in dentate granule cells within minutes after induction of perforant path long-term potentiation (LTP). Phospho-ERK staining appears in nuclei within minutes after stimulation commences, and ERK phosphorylation returns to control levels within 60 min. Electroconvulsive seizures, which strongly induce prolonged Arc/Arg3.1 transcription in dentate granule cells, induced ERK1/2 phosphorylation in granule cells that returned to control levels within 30 min. Following 30, 60, and 120 min of exploration in a novel complex environment, Arc/Arg3.1 transcription was activated in many more granule cells than stained positively for p-ERK at all time points. Although Arc/Arg3.1 transcription was induced in most pyramidal neurons in CA1 following exploration, very few pyramidal neurons exhibited nuclear p-ERK1/2 staining. Local delivery of U0126 during the induction of perforant path LTP blocked transcriptional activation of Arc/Arg3.1 in a small region near the injection site and blocked Arc/Arg3.1 protein expression over a wider region. Our results indicate that activation of Arc/Arg3.1 transcription in dentate granule cells in vivo is mediated in part by MAP kinase activation, but other signaling pathways also contribute, especially in the case of Arc/Arg3.1 induction in response to experience.