Strength and endurance adaptations to functional electrical stimulation leg cycle ergometry in spinal cord injury.
OBJECTIVE
To describe adaptations in power output, quadriceps muscle strength, and fatigability that occur during a 13-week regimen of Functional Electrical Stimulation Leg Cycle Ergometry (FES-LCE) in Spinal Cord Injury (SCI). To identify differences in outcomes between individuals with complete and incomplete motor impairment.


METHODS
Observational and longitudinal.


METHODS
Rehabilitation and biomechanics research laboratory.


METHODS
Eleven (N = 11) individuals with SCI and no previous FES-LCE experience.


METHODS
40 sessions of FES-LCE at a rate of three sessions per week. Continuous exercise was performed at a pedal cadence of 45 RPM against a constant resistance for up to 60 minutes.


METHODS
Mean power output was recorded for each session. Before and after the training regimen, each subject performed a fatigue test in which electrically stimulated knee extension torque and Fatigue Index were measured.


RESULTS
Participants demonstrated significant increases in mean power output (9.0 to 20.3 W; p < 0.001), peak isometric knee extension torque (3.8 to 16.9 Nm; p = 0.006) and sustainable isometric knee extension torque (4.9 to 14.4 Nm; p = 0.001) after FES-LCE training (95% confidence intervals). Participants with incomplete motor impairment demonstrated a decrease in Fatigue Index (p = 0.021), and improved mean power output more than those with complete motor impairment (p = 0.037).


CONCLUSIONS
Significant improvements in muscle conditioning and exercise performance are possible following the 13-week regimen of FES-LCE described in this article. Individuals with incomplete motor impairment experience greater improvements in mean power output than individuals with complete motor impairment.
Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX 77204-6015, USA. athrasher3@uh.edu
Timothy Adam
TA
Thrasher
John Stanley
JS
Ward
Stanley
S
Fisher
D000222:Adaptation, Physiological; D000328:Adult; D004599:Electric Stimulation Therapy; D016552:Ergometry; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007866:Leg / Q000502:physiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010807:Physical Endurance; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D055815:Young Adult