title: Physiologic responses during functional electrical stimulation leg cycling and hybrid exercise in spinal cord injured subjects.
abstract: OBJECTIVE
  (1) To determine if a hybrid exercise (leg plus arm) training program performed immediately after functional electrical stimulation (FES) leg cycle exercise (LCE) training would further improve aerobic capacity when compared with FES leg cycle training alone, and (2) to compare the submaximal responses occurring during both FES-LCE alone and hybrid exercise in the same SCI subjects.
  
  
  METHODS
  Nonrandomized control trial whereby subjects act as their own control.
  
  
  METHODS
  Outpatient rehabilitation in a primary care hospital.
  
  
  METHODS
  A volunteer sample (n = 11) of men 20 to 50 years old with complete spinal cord injury, free from cardiovascular and metabolic disease with spasticity.
  
  
  METHODS
  Three phases of exercise training: phase I, progressive FES-LCE to 30 minutes of exercise (n = 11); phase II, 35.2 +/- 16.2 sessions of FES-LCE (n = 11); phase III, 41.4 +/- 17.7 30-minute sessions of hybrid exercise (n = 8).
  
  
  METHODS
  (1) Aerobic capacity-a further increase after hybrid exercise when compared with FES-LCE alone; (2) submaximal physiologic parameters (oxygen uptake [VO2], heart rate [HR], blood lactate [BLa-])-measurement of these during constant work rate exercise and a training effect.
  
  
  RESULTS
  VO2 (the body's ability to utilize oxygen) significantly improved (p < .05) after both FES-LCE and then further after hybrid training. Hybrid exercise training resulted in significantly (p < .05) greater work rates and VO2 values than both FES-LCE at baseline and training work rates.
  
  
  CONCLUSIONS
  These subjects demonstrated that hybrid exercise performed twice a week provided sufficient intensity to improve aerobic capacity and provide a medium whereby patients with SCI can burn more calories than via FES-LCE alone. This has important implications for improving the health and fitness levels of individuals with SCI and may ultimately reduce their risk of cardiovascular disease.
authors.affiliation: Physical Medicine and Rehabilitation Service, West Los Angeles Veterans Affairs Medical Center, CA 90073, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Mutton
authors.forename: A M
authors.initials: AM
authors.lastname: Scremin
authors.forename: T J
authors.initials: TJ
authors.lastname: Barstow
authors.forename: M D
authors.initials: MD
authors.lastname: Scott
authors.forename: C F
authors.initials: CF
authors.lastname: Kunkel
authors.forename: T G
authors.initials: TG
authors.lastname: Cagle
mesh_terms: D000328:Adult; D001132:Arm; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy / Q000379:methods*; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D006339:Heart Rate; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D007866:Leg; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D013119:Spinal Cord Injuries / Q000097:blood / Q000503:physiopathology* / Q000534:rehabilitation*
chemical_list: D019344:Lactic Acid