Body composition changes after 12 months of FES cycling: case report of a 60-year-old female with paraplegia

Single-subject (female, 60 years of age) case. The purpose of this case report is to document body composition changes in a 60-year-old female with chronic paraplegia after 12 months of home-based functional electrical stimulation lower extremities cycling (FES-LEC). Home-based FES-LEC with internet connection. Southeastern United States. FES-LEC three sessions per week for 12 months in participant's home and monitored by the research staff via internet connection. Pre- and post-exercise program testing for body composition including percent body fat, fat mass (FM), lean mass (LM) and whole-body bone mineral density (BMD) via dual-energy x-ray absorptiometry (DXA). There was a 7.7% increase in total body LM and a 4.1% increase in legs LM. There was a 1.2% decrease in total body FM and a 9.9% decrease in legs FM. Percent body fat decreased from 48.4 to 46.3 and whole-body BMD was increased from 0.934 to 1.023, which resulted in an improvement in the DXA T-score from -2.4 to -1.3. Positive body compositional changes during this study support the idea that long-term FES-LEC can help restore healthier ratios of LM and FM and possibly decrease the risk of associated diseases. Increased whole-body BMD provides hope that long-term FES-LEC may be beneficial regarding bone health

Improving the Efficiency of Electrical Stimulation Activities After Spinal Cord Injury

In order to enhance spinal cord injury (SCI) rehabilitation programs using neuromuscular electrical stimulation (NMES) and functional electrical stimulation (FES) it is important to examine the manner in which muscle fibers are recruited and the dose–response relationship. A review of the literature suggests that premature force decline and early fatigue with NMES and FES activities may be alleviated with decreased current frequency and increased current intensity. Dose–response relationships with NMES and FES are dependent on the goals of interest as reversing muscle atrophy can be achieved with activities 2–3 times per week for 6 or more weeks while increasing bone mass is more limited and requires more intense activity with greater exercise frequency and duration, e.g., 3–5 days per week for at least 6–12 months. The best known protocol to elicit neurological improvement is massed practice activities-based restorative therapies (ABRT) (3–5 h per day for several weeks)

Associations with being physically active and the achievement of WHO recommendations on physical activity in people with spinal cord injury

Secondary data analysis from the cross-sectional survey of the Swiss Spinal Cord Injury Cohort Study.; To explore associations with physical activity (PA) levels in people with spinal cord injury (SCI) with the specific aim to identify aspects that potentially explain being physically active (PHYS-ACT) and the achievement of the World Health Organization recommendations on PA.; Community sample (n=485).; Participants who completely answered four items of the Physical Activity Scale for Individuals with Physical Disabilities were included. Two outcome measures were defined: (1) being PHYS-ACT vs being completely inactive and (2) achieving WHO recommendations on PA (ACH-WHO-REC) (at least 2.5 h per week of at least moderate intensity) vs performing less. Independent variables were selected from the original questionnaire by applying the ICF framework. Multivariate logistic regression analyses were conducted.; In the participants (aged 52.8±14.8; 73.6% male) older age decreased, but being a manual wheelchair user increased the odds of achieving both outcomes. Social support and self-efficacy increased the odds of being PHYS-ACT. Use of an intermittent catheter increased, whereas dependency in self-care mobility and coping with emotions decreased the odds for ACH-WHO-REC. Experiencing hindrances due to accessibility is associated with increased odds for ACH-WHO-REC.; Being PHYS-ACT at all and achieving the WHO recommendations on PA are associated with different aspects. Applying the ICF framework contributes to a comprehensive understanding of PA behavior in people with SCI, which can tailor the development of interventions. Longitudinal studies should be initiated to test these associations for causal relationships.Spinal Cord advance online publication, 16 August 2016; doi:10.1038/sc.2016.126