title: Electrical stimulation-evoked resistance exercise therapy improves arterial health after chronic spinal cord injury.
abstract: METHODS
  Repeated measures training intervention.
  
  
  OBJECTIVE
  To evaluate the effects of neuromuscular electrical stimulation (NMES)-induced resistance exercise therapy on lower extremity arterial health in individuals with chronic, complete spinal cord injury (SCI). We define "arterial health" using three surrogate markers: (a) resting diameter, (b) flow-mediated dilation (FMD), and (c) arterial range.
  
  
  METHODS
  Department of Kinesiology, University of Georgia, USA.
  
  
  METHODS
  We assessed five 36+/-5-year-old male individuals with chronic, complete SCI before, during, and after 18 weeks of training. The quadriceps femoris muscle group of both legs were trained twice a week with 4 x 10 repetitions of unilateral, dynamic knee extensions. The health of the posterior tibial artery was assessed using a B-mode ultrasound unit equipped with a high-resolution video capture device. Proximal occlusion was used to evoke ischemia for 5 min and then for 10 min. FMD was calculated using the peak diameter change (above rest) following 5 min occlusion. Arterial range was calculated using minimum (during occlusion) and maximum diameters (post 10 min occlusion). Hierarchical linear modeling accounted for the nested (repeated measures) experimental design.
  
  
  RESULTS
  FMD improved from 0.08+/-0.11 mm (2.7%) to 0.18+/-0.15 mm (6.6%) (P=0.004), and arterial range improved from 0.36+/-0.28 to 0.94+/-0.40 mm (P=0.001), after 18 weeks of training. Resting diameter did not significantly change.
  
  
  CONCLUSIONS
  Home-based, self-administered NMES resistance exercise therapy consisting of 80 contractions/week improved FMD and arterial range. This provides evidence that resistance exercise therapy can improve arterial health after SCI, which may reduce the risk of future cardiovascular disease.
authors.affiliation: Department of Kinesiology, University of Georgia, Ramsey Center, Athens, GA 30602-6552, USA.
authors.forename: L
authors.initials: L
authors.lastname: Stoner
authors.forename: M J
authors.initials: MJ
authors.lastname: Sabatier
authors.forename: E T
authors.initials: ET
authors.lastname: Mahoney
authors.forename: G A
authors.initials: GA
authors.lastname: Dudley
authors.forename: K K
authors.initials: KK
authors.lastname: McCully
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002908:Chronic Disease; D004599:Electric Stimulation Therapy / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D012039:Regional Blood Flow / Q000502:physiology / Q000528:radiation effects; D013119:Spinal Cord Injuries / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D016909:Tibial Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000528:radiation effects; D013997:Time Factors; D014463:Ultrasonography / Q000379:methods