title: Short-term maximal-intensity resistance training increases volitional function and strength in chronic incomplete spinal cord injury: a pilot study.
abstract: OBJECTIVE
  Recent research shows that individuals with an incomplete spinal cord injury (SCI) have a reserve of force-generating capability that is observable during repeated intermittent maximal volitional effort contractions. Previous studies suggest that increased neural drive contributes to the enhanced short-term force-generating capabilities. Whether this reserve can be harnessed with repeated training is unclear. The purpose of this pilot study was to investigate the effects of 4 weeks of maximal-intensity resistance training, compared with conventional progressive resistance training, on lower extremity function and strength in chronic incomplete SCI.
  
  
  METHODS
  Using a randomized crossover design, 5 individuals with chronic (> 1 year postinjury) SCI American Spinal Injury Association Impairment Scale classification C or D were tested before and after 4 weeks of both maximal-intensity training and progressive resistance training paradigms. Outcomes measures included the 6-Minute Walk Test, the Berg Balance Scale, and peak isometric torque for strength of lower extremity muscles.
  
  
  RESULTS
  Maximal-intensity resistance training was associated with an average increase of 12.19 ± 8.29 m on the 6-Minute Walk Test, 4 ± 1.9 points on the Berg Balance Scale, 4 ± 4.5 points on the lower extremity motor score), while no changes on the above scores were seen with conventional training. Furthermore, significant increases in peak volitional isometric torques (mean increase = 20 ± 8 Nm) were observed following maximal-intensity resistance training when compared with conventional training (mean increase = 0.12 ± 3 Nm, P = 0.03).
  
  
  CONCLUSIONS
  Maximal-intensity training paradigm may facilitate rapid gains in volitional function and strength in persons with chronic motor-incomplete SCI, using a simple short-term training paradigm.
authors.affiliation: Center for Bionic Medicine, Rehabilitation Institute of Chicago, Chicago, IL, USA. a-jayaraman@northwestern.edu
authors.forename: Arun
authors.initials: A
authors.lastname: Jayaraman
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Thompson
authors.forename: William Z
authors.initials: WZ
authors.lastname: Rymer
authors.forename: T George
authors.initials: TG
authors.lastname: Hornby
mesh_terms: D000328:Adult; D004576:Electromyography; D005081:Exercise Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000503:physiopathology; D010865:Pilot Projects; D020127:Recovery of Function / Q000502:physiology*; D055070:Resistance Training; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D016138:Walking / Q000502:physiology