Hybrid Functional Electrical Stimulation Improves Anaerobic Threshold in First Three Years after Spinal Cord Injury

Journal of Neurotrauma, 2022 · DOI: 10.1089/neu.2021.0459 · Published: August 1, 2022

Simple Explanation

This study investigates how whole-body exercise affects the anaerobic threshold (AT) in individuals with spinal cord injury (SCI). AT is the point where muscles need to use anaerobic processes, leading to fatigue. The research focuses on hybrid functional electrical stimulation (FES) row training and its impact on both maximal oxygen uptake (VO2max) and AT in SCI patients. The key finding is that this type of training improves both aerobic capacity and AT, but only significantly in those starting the exercise within three years of their injury.

Study Duration

6 Months

Participants

47 participants with SCI

Evidence Level

Not specified

Key Findings

1
VO2max increased significantly in the early chronic group (<3 years since injury) after six months of FES row training, while it did not change in the late chronic group (>3 years since injury).
2
AT increased in the early chronic group but did not change in the late chronic group, consistent with VO2max changes.
3
Cumulative duration of exercise training was positively correlated to change in VO2max only in the early chronic group.

Research Summary

The study assessed the impact of hybrid functional electrical stimulation (FES) row training on anaerobic threshold (AT) and maximal oxygen uptake (VO2max) in 47 individuals with spinal cord injury (SCI). The results indicated that individuals with less than three years since injury (early chronic group) experienced significant increases in both VO2max and AT after six months of training, while those with more than three years since injury (late chronic group) did not show significant changes. The findings suggest that initiating hybrid-FES exercise early after SCI is critical for maximizing the benefits of exercise training on aerobic capacity and anaerobic threshold.

Practical Implications

Early Intervention

Initiate hybrid-FES exercise within three years of spinal cord injury to maximize benefits on aerobic capacity and anaerobic threshold.

Exercise Intensity

Exercise interventions for SCI patients should aim for intensities high enough to reduce cardiovascular risk, which is dependent on anaerobic threshold.

Training Approaches

Consider alternative or augmented training approaches for individuals with chronic SCI (>3 years) to improve anaerobic threshold, as hybrid-FES may be less effective for this group.

Study Limitations

1
The inability to provide a clear mechanism to explain changes, or lack thereof, in AT.
2
A prospective, randomized study that includes tissue samples from the stimulated muscles may provide insight to whether the lack of adaptations in AT do relate to ﬁber type changes.
3
The relatively short duration (6 months) of our hybrid-FES training intervention may not be sufﬁcient to generate the changes in muscle needed to increase AT

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