Body composition changes after 12 months of FES cycling: case report of a 60-year-old female with paraplegia.

STUDY DESIGN: Single-subject (female, 60 years of age) case. OBJECTIVES: The purpose of this case report is to document body composition changes in a 60-year-old female with chronic paraplegia after 12 months of home-based functional electrical stimulation lower extremities cycling (FES-LEC). SETTING: Home-based FES-LEC with internet connection. Southeastern United States. METHODS: FES-LEC three sessions per week for 12 months in participant's home and monitored by the research staff via internet connection. Pre- and post-exercise program testing for body composition including percent body fat, fat mass (FM), lean mass (LM) and whole-body bone mineral density (BMD) via dual-energy x-ray absorptiometry (DXA). RESULTS: There was a 7.7% increase in total body LM and a 4.1% increase in legs LM. There was a 1.2% decrease in total body FM and a 9.9% decrease in legs FM. Percent body fat decreased from 48.4 to 46.3 and whole-body BMD was increased from 0.934 to 1.023, which resulted in an improvement in the DXA T-score from -2.4 to -1.3. CONCLUSION: Positive body compositional changes during this study support the idea that long-term FES-LEC can help restore healthier ratios of LM and FM and possibly decrease the risk of associated diseases. Increased whole-body BMD provides hope that long-term FES-LEC may be beneficial regarding bone health.

The effects of spinal cord injury and exercise on bone mass: a literature review.

INTRODUCTION: Bone loss is a common and often debilitating condition that accompanies spinal cord injury. Because bone loss after spinal cord injury is multifactorial, it can be difficult to assess and treat. This process becomes even more complex as secondary conditions associated with aging are introduced. PURPOSE: There are two purposes of this literature review. The first is to summarize information concerning the mechanisms of bone loss and osteoporosis after spinal cord injury. The second is to summarize existing data concerning the effects of exercise on bone loss after spinal cord injury. METHOD: Literature was reviewed concerning the bone loss process and the non-pharmacological treatment options for ameliorating bone loss after spinal cord injury. RESULTS: (Part One) Osteoporosis is universal in persons with chronic complete spinal cord injury, which increases the risk of bone fracture. Bone loss after spinal cord injury is both sublesional and regional with the greatest areas of bone demineralization being in the sublesional trabecular laden areas of the distal and proximal epiphyses of the femur and tibia. (Part Two) While passive weight bearing of paralyzed lower extremities appears to be ineffective, stressing the bones through muscular contractions initiated by electrical stimulation (FES) have yielded positive results in some cases. The intensity, frequency, and duration of stress to the bones appear to be important determinants of improved bone parameters. Although further quantification of these components is needed, some generalized guidelines can be deduced from completed research. Intensities showing positive results have been loads of one to one and a half times body weight for FES exercise or having participants FES cycle at their highest power output. Safety precautions must be used to decrease risk of bone fracture. Generally, the frequency is effective with three or more weekly exercise sessions. Studies of duration suggest that several months to one or more years of FES are necessary. DISCUSSION: In order to promote healthy and independent aging in patients with spinal cord injury, it is important to understand the processes, consequences and effective treatments involved with bone loss.

Effects of arginine/lysine supplementation and resistance training on glucose tolerance.

The purpose of this study was to evaluate and compare the effects of arginine/lysine supplementation (AL) and resistance training (RT) on changes in glucose tolerance and to determine whether alterations were associated with changes in selected hormonal parameters. The study involved 30 physically active college males, ages 20-30 yr, randomly assigned to one of four groups: placebo/control (P/C, n = 7), P/RT (n = 8), AL/C (n = 7), or AL/RT (n = 8). An AL supplement at a daily morning dose of 132 mg/kg fat-free body mass or placebo was administered orally to controls and training groups. During the 10-wk program, exercise subjects participated in a progressive resistance training program stressing all major muscle groups. Three-hour oral glucose tolerance (OGT) tests were performed on each subject before and after the 10-wk intervention to evaluate resting levels and responses of glucose, insulin, and glucagon. OGT parameters did not significantly change after intervention. It was concluded that neither AL supplementation nor RT had a significant effect on OGT.