Paradigms of Lower Extremity Electrical Stimulation Training after Spinal Cord Injury
Skeletal muscle atrophy, increased adiposity and reduced physical activity are key changes seen after spinal cord injury and are associated with numerous health risks. These changes likely increase the risk of developing secondary conditions that can impact the quality of life in individuals with spinal cord injury. Surface neuromuscular electrical stimulation evoked resistance training (NMES-RT) was developed to reduce muscle atrophy, improve insulin sensitivity and enhance mitochondrial capacity. However, NMES-RT is limited to only a single muscle group. Expanding it to involve multiple muscle groups may maximize health benefits associated with training. Functional electrical stimulation-lower extremity cycling allows for the activation of 6 muscle groups, which can evoke greater metabolic and cardiovascular adaptation. The current manuscript hypothesized that muscles conditioned for 12 weeks prior to cycling will be capable of generating greater power, cycle against higher resistance, and result in greater adaptation in individuals with spinal cord injuries.