Effects of a Functional Electrical Stimulation–Assisted Cycling Program on Immune and Cardiovascular Health in Persons with Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2016 · DOI: 10.1310/sci2201-71 · Published: January 1, 2016

Spinal Cord Injury Cardiovascular Science Neurology

Simple Explanation

Cardiovascular disease (CVD) is a prevalent health complication after spinal cord injury (SCI), with higher morbidity and mortality rates than renal and pulmonary complications. The purpose of this study was to examine the effects of 12 weeks of FES training performed 3 times per week on physiological indices of cardiovascular function as well as molecular indices of inflammation and cardiovascular health. The exercise protocol consisted of FES cycling ergometer training performed on the RT-300 rehabilitation system (Restorative Therapies, Baltimore, MD).

Study Duration

12 weeks

Participants

10 individuals with chronic SCI

Evidence Level

Not specified

Key Findings

1
Enhancements in exercise performance as well as a corresponding increase in peripheral cardiovascular function were achieved, as shown by a significant 34% increase in pulse volume (P = .04) and trends toward increases in cross-sectional area (P = .09) and arterial inflow volume (P = .11) of the common femoral artery.
2
No change in any hematological or immunological markers was evident.
3
Improvements in exercise capacity were demonstrated by significant increases in total exercise duration, distance, and speed, while the number of bouts needed to complete each session was significantly reduced.

Research Summary

Spinal cord injury (SCI) is associated with both a state of chronic inflammation and an increased prevalence of cardiovascular disease (CVD). These disorders are closely linked and have been shown to negatively influence one another. The purpose of this study was to examine the effects of 12 weeks of FES training performed 3 times per week on physiological indices of cardiovascular function as well as molecular indices of inflammation and cardiovascular health. Although the efficacy of FES exercise in enhancing exercise performance (time and distance to fatigue) and peripheral cardiovascular function has been reaffirmed, no alterations in any molecular indices of cardiovascular risk were achieved.

Practical Implications

Exercise-Induced Improvements

The study demonstrated exercise-induced improvements in exercise capacity and lower limb blood flow.

Peripheral Blood Flow

There was a 17% increase in resting femoral artery diameter (CSA), a 34% increase in PV within the femoral artery, and a 34% increase in resting femoral artery blood flow (arterial inflow volume).

Molecular Indices

Twelve weeks of thrice weekly FES cycling was not sufficient to cause a corresponding reduction in clinical risk in terms of any of hematological or immunological markers of cardiovascular disease.

Study Limitations

1
FES cycling program may simply not be of high enough intensity to induce such molecular changes or a program of longer duration may be required.
2
Other clinical risk factors not assessed in this study may have been reduced.
3
Physiological improvements, such as enhanced peripheral blood flow, do not necessarily translate to a reduction in clinical risk.

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