Functional Electrical Stimulation: Cardiorespiratory Adaptations and Applications for Training in Paraplegia

International audienceRegular exercise can be broadly beneficial to health and quality of life in humans with spinal cord injury (SCI). However, exercises must meet certain criteria, such as the intensity and muscle mass involved, to induce significant benefits. SCI patients can have difficulty achieving these exercise requirements since the paralysed muscles cannot contribute to overall oxygen consumption. One solution is functional electrical stimulation (FES) and, more importantly, hybrid training that combines volitional arm and electrically controlled contractions of the lower limb muscles. However, it might be rather complicated for therapists to use FES because of the wide variety of protocols that can be employed, such as stimulation parameters or movements induced. Moreover, although the short-term physiological and psychological responses during different types of FES exercises have been extensively reported, there are fewer data regarding the long-term effects of FES. Therefore, the purpose of this brief review is to provide a critical appraisal and synthesis of the literature on the use of FES for exercise in paraplegic individuals. After a short introduction underlying the importance of exercise for SCI patients, the main applications and effects of FES are reviewed and discussed. Major findings reveal an increased physiological demand during FES hybrid exercises as compared with arms only exercises. In addition, when repeated within a training period, FES exercises showed beneficial effects on muscle characteristics, force output, exercise capacity, bone mineral density and cardiovascular parameters. In conclusion, there appears to be promising evidence of beneficial effects of FES training, and particularly FES hybrid training, for paraplegic individuals

One year of training with FES has impressive beneficial effects in a 36-year-old woman with spinal cord injury

International audienceCONTEXT:Reductions of muscular and cardiorespiratory functions are often observed in people with spinal cord injury (SCI) and several studies demonstrated the benefits of aerobic and strengthening exercise training for this population. Functional Electrical Stimulation (FES) of paralyzed muscles has been proposed as a strategy to assist patients in executing functional movement but its utilization during long durations has never been investigated. The purpose of the present study was to assess the effects of a one-year training program with FES (strengthening and rowing) in one subject with SCI. Evoked torque, quadriceps muscle thickness, aerobic exercise capacity and bone mineral density were tested.FINDINGS:All parameters increased after training: average evoked torque +151%, quadriceps muscle thickness +136%, thigh circumference +14%, bone density +19%, maximal oxygen uptake +76% and oxygen uptake at ventilatory threshold +111%.CONCLUSION:These impressive improvements demonstrate that FES training offers several interesting clinical benefits in a patient with SCI

Effects of electrical stimulation pattern on quadriceps isometric force and fatigue in individuals with spinal cord injury

International audienceIntroduction : Variable frequency trains (VFT) or train combinations have been suggested as useful strategies to offset the rapid fatigue induced by constant frequency trains (CFT) during electrical stimulation. However, most studies have been of short duration with limited functional application in those with spinal cord injury (SCI). We therefore tested force and fatigue in response to VFT, CFT, and combined patterns in strength training-like conditions (6-s contractions).Methods : Ten SCI individuals underwent either CFT or VFT patterns until target torque was no longer produced and then switched immediately to the other pattern.Results : Target torque was reached more times when VFT was used first (VFT: 6.70.8 vs. CFT: 3.5 +/- 0.2 contractions, P<0.05) and when it was followed by the CFT pattern (VFT-CFT: 10.3 +/- 1.2 vs. CFT-VFT: 6.9 +/- 1.2 contractions, P<0.05).Conclusions : These findings suggest that for the same initial forces the VFT pattern is less fatiguing than CFT and that when combining train types, VFT should be used first. Muscle Nerve52: 260-264, 201