The Effect of Electrically Induced Cycling and Nutritional Counseling on Cardiometabolic Health in Upper and Lower Motor Neuron Chronic Spinal Cord Injury: Dual Case Report

Int J Neurorehabil, 2019 · DOI: 10.4172/2376-0281.1000336 · Published: January 1, 2019

Spinal Cord Injury Cardiovascular Science Rehabilitation

Simple Explanation

This study explores how electrically stimulated cycling, combined with nutritional advice, affects heart and metabolic health in people with long-term spinal cord injuries. It focuses on two types of injuries: those affecting the upper motor neurons (UMN) and those affecting the lower motor neurons (LMN). The study looks at body composition, blood vessel stiffness, and how the body handles glucose before and after the cycling and nutrition program. The results showed that both subjects experienced improvements in vascular stiffness and glucose levels, but these changes were more noticeable in the UMN-SCI case. The study suggests that while there might be some benefits for individuals with LMN-SCI, more research is needed.

Study Duration

15 weeks (LMN-SCI), 9.5 weeks (UMN-SCI)

Participants

Two individuals with chronic SCI; one person with LMN-SCI and one with UMN-SCI

Evidence Level

Dual Case Report

Key Findings

1
The LMN-SCI subject decreased body weight but increased body fat percentage, while the UMN-SCI subject had a minimal decrease in body weight and a decrease in body fat percentage.
2
Both subjects showed a decrease in blood glucose and HbA1c levels, indicating improved glucose metabolism.
3
Both subjects exhibited a decrease in markers of central vascular stiffness, but the changes were more pronounced in the UMN-SCI subject.

Research Summary

This dual case study examined the cardiometabolic health response to FES cycling combined with nutritional counseling in two individuals with chronic SCI; one person with LMN-SCI and one with UMN-SCI. Despite the decrease in body mass in the case of LMN-SCI but not UMN-SCI, the fat mass-to-lean mass ratio in the lower limbs and trunk increased +4% and +8% respectively, in the former and decreased −10% and −8% respectively in the latter. Both subjects decreased markers of central vascular stiffness (AIx@75, reflection magnitude) as well as blood glucose and HbA1c levels, however, the changes were greater in the case of UMN-SCI.

Practical Implications

FES Cycling Benefits

FES cycling, along with nutritional counseling, can potentially reverse metabolic and cardiovascular deterioration in individuals with long-standing UMN-SCI.

Passive Cycling Potential

Passive cycling may improve glucose deposition and vascular stiffness in individuals with LMN-SCI.

Further Research Needed

More comprehensive studies are required to explore the potential benefits of FES cycling and nutritional counseling on cardiometabolic health in both UMN-SCI and LMN-SCI populations.

Study Limitations

1
The results cannot be generalized to the broader SCI population.
2
Small sample size (two individuals).
3
Gender was not matched between the two participants which is a potential confounder.

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