Effects of two different paradigms of electrical stimulation exercise on cardio-metabolic risk factors after spinal cord injury. A randomized clinical trial
ObjectiveTo examine the combined effects of neuromuscular electrical stimulation-resistance training (NMES-RT) and functional electrical stimulation-lower extremity cycling (FES-LEC) compared to passive movement training (PMT) and FES-LEC in adults with SCI on (1) oxygen uptake (VO2), insulin sensit...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-09-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1254760/full |
| _version_ | 1797677046837542912 |
|---|---|
| author | Ashraf S. Gorgey Ashraf S. Gorgey Refka E. Khalil William Carter Boyd Ballance Ranjodh Gill Ranjodh Gill Rehan Khan Lance Goetz Lance Goetz Timothy Lavis Timothy Lavis Adam P. Sima Robert A. Adler Robert A. Adler |
| author_facet | Ashraf S. Gorgey Ashraf S. Gorgey Refka E. Khalil William Carter Boyd Ballance Ranjodh Gill Ranjodh Gill Rehan Khan Lance Goetz Lance Goetz Timothy Lavis Timothy Lavis Adam P. Sima Robert A. Adler Robert A. Adler |
| author_sort | Ashraf S. Gorgey |
| collection | DOAJ |
| description | ObjectiveTo examine the combined effects of neuromuscular electrical stimulation-resistance training (NMES-RT) and functional electrical stimulation-lower extremity cycling (FES-LEC) compared to passive movement training (PMT) and FES-LEC in adults with SCI on (1) oxygen uptake (VO2), insulin sensitivity and glucose disposal in adults with SCI; (2) Metabolic and inflammatory biomarkers; (3) skeletal muscle, intramuscular fat (IMF) and visceral adipose tissue (VAT) cross-sectional areas (CSAs).Materials and methodsThirty-three participants with chronic SCI (AIS A-C) were randomized to 24 weeks of NMES-RT + FES or PMT + FES. The NMES-RT + FES group underwent 12 weeks of evoked surface NMES-RT using ankle weights followed by an additional 12 weeks of progressive FES-LEC. The control group, PMT + FES performed 12 weeks of passive leg extension movements followed by an additional 12 weeks of FES-LEC. Measurements were performed at baseline (BL; week 0), post-intervention 1 (P1; week 13) and post-intervention 2 (P2; week 25) and included FES-VO2 measurements, insulin sensitivity and glucose effectiveness using the intravenous glucose tolerance test; anthropometrics and whole and regional body composition assessment using dual energy x-ray absorptiometry (DXA) and magnetic resonance imaging to measure muscle, IMF and VAT CSAs.ResultsTwenty-seven participants completed both phases of the study. NMES-RT + FES group showed a trend of a greater VO2 peak in P1 [p = 0.08; but not in P2 (p = 0.25)] compared to PMT + FES. There was a time effect of both groups in leg VO2 peak. Neither intervention elicited significant changes in insulin, glucose, or inflammatory biomarkers. There were modest changes in leg lean mass following PMT + FES group. Robust hypertrophy of whole thigh muscle CSA, absolute thigh muscle CSA and knee extensor CSA were noted in the NMES-RT + FES group compared to PMT + FES at P1. PMT + FES resulted in muscle hypertrophy at P2. NMES-RT + FES resulted in a decrease in total VAT CSA at P1.ConclusionNMES-RT yielded a greater peak leg VO2 and decrease in total VAT compared to PMT. The addition of 12 weeks of FES-LEC in both groups modestly impacted leg VO2 peak. The addition of FES-LEC to NMES-RT did not yield additional increases in muscle CSA, suggesting a ceiling effect on signaling pathways following NMES-RT.Clinical trial registrationidentifier NCT02660073. |
| first_indexed | 2024-03-11T22:39:18Z |
| format | Article |
| id | doaj.art-e8ff50652d25429a9aa396df22370ec0 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-11T22:39:18Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-e8ff50652d25429a9aa396df22370ec02023-09-22T09:24:04ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-09-011410.3389/fneur.2023.12547601254760Effects of two different paradigms of electrical stimulation exercise on cardio-metabolic risk factors after spinal cord injury. A randomized clinical trialAshraf S. Gorgey0Ashraf S. Gorgey1Refka E. Khalil2William Carter3Boyd Ballance4Ranjodh Gill5Ranjodh Gill6Rehan Khan7Lance Goetz8Lance Goetz9Timothy Lavis10Timothy Lavis11Adam P. Sima12Robert A. Adler13Robert A. Adler14Spinal Cord Injury and Disorders, Richmond VA Medical Center, Richmond, VA, United StatesDepartment of Physical Medicine & Rehabilitation, Virginia Commonwealth University, Richmond, VA, United StatesSpinal Cord Injury and Disorders, Richmond VA Medical Center, Richmond, VA, United StatesDepartment of Physical Medicine & Rehabilitation, Virginia Commonwealth University, Richmond, VA, United StatesSpinal Cord Injury and Disorders, Richmond VA Medical Center, Richmond, VA, United StatesEndocrinology Service, Richmond VA Medical Center, Richmond, VA, United StatesEndocrine Division, School of Medicine, Virginia Commonwealth University, Richmond, VA, United StatesRadiology Service, Richmond VA Medical Center, Richmond, VA, United StatesSpinal Cord Injury and Disorders, Richmond VA Medical Center, Richmond, VA, United StatesDepartment of Physical Medicine & Rehabilitation, Virginia Commonwealth University, Richmond, VA, United StatesSpinal Cord Injury and Disorders, Richmond VA Medical Center, Richmond, VA, United StatesDepartment of Physical Medicine & Rehabilitation, Virginia Commonwealth University, Richmond, VA, United StatesDepartment of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, United StatesEndocrinology Service, Richmond VA Medical Center, Richmond, VA, United StatesEndocrine Division, School of Medicine, Virginia Commonwealth University, Richmond, VA, United StatesObjectiveTo examine the combined effects of neuromuscular electrical stimulation-resistance training (NMES-RT) and functional electrical stimulation-lower extremity cycling (FES-LEC) compared to passive movement training (PMT) and FES-LEC in adults with SCI on (1) oxygen uptake (VO2), insulin sensitivity and glucose disposal in adults with SCI; (2) Metabolic and inflammatory biomarkers; (3) skeletal muscle, intramuscular fat (IMF) and visceral adipose tissue (VAT) cross-sectional areas (CSAs).Materials and methodsThirty-three participants with chronic SCI (AIS A-C) were randomized to 24 weeks of NMES-RT + FES or PMT + FES. The NMES-RT + FES group underwent 12 weeks of evoked surface NMES-RT using ankle weights followed by an additional 12 weeks of progressive FES-LEC. The control group, PMT + FES performed 12 weeks of passive leg extension movements followed by an additional 12 weeks of FES-LEC. Measurements were performed at baseline (BL; week 0), post-intervention 1 (P1; week 13) and post-intervention 2 (P2; week 25) and included FES-VO2 measurements, insulin sensitivity and glucose effectiveness using the intravenous glucose tolerance test; anthropometrics and whole and regional body composition assessment using dual energy x-ray absorptiometry (DXA) and magnetic resonance imaging to measure muscle, IMF and VAT CSAs.ResultsTwenty-seven participants completed both phases of the study. NMES-RT + FES group showed a trend of a greater VO2 peak in P1 [p = 0.08; but not in P2 (p = 0.25)] compared to PMT + FES. There was a time effect of both groups in leg VO2 peak. Neither intervention elicited significant changes in insulin, glucose, or inflammatory biomarkers. There were modest changes in leg lean mass following PMT + FES group. Robust hypertrophy of whole thigh muscle CSA, absolute thigh muscle CSA and knee extensor CSA were noted in the NMES-RT + FES group compared to PMT + FES at P1. PMT + FES resulted in muscle hypertrophy at P2. NMES-RT + FES resulted in a decrease in total VAT CSA at P1.ConclusionNMES-RT yielded a greater peak leg VO2 and decrease in total VAT compared to PMT. The addition of 12 weeks of FES-LEC in both groups modestly impacted leg VO2 peak. The addition of FES-LEC to NMES-RT did not yield additional increases in muscle CSA, suggesting a ceiling effect on signaling pathways following NMES-RT.Clinical trial registrationidentifier NCT02660073.https://www.frontiersin.org/articles/10.3389/fneur.2023.1254760/fullneuromuscular electrical stimulationfunctional electrical stimulationresistance trainingspinal cord injuryrehabilitation |
| spellingShingle | Ashraf S. Gorgey Ashraf S. Gorgey Refka E. Khalil William Carter Boyd Ballance Ranjodh Gill Ranjodh Gill Rehan Khan Lance Goetz Lance Goetz Timothy Lavis Timothy Lavis Adam P. Sima Robert A. Adler Robert A. Adler Effects of two different paradigms of electrical stimulation exercise on cardio-metabolic risk factors after spinal cord injury. A randomized clinical trial Frontiers in Neurology neuromuscular electrical stimulation functional electrical stimulation resistance training spinal cord injury rehabilitation |
| title | Effects of two different paradigms of electrical stimulation exercise on cardio-metabolic risk factors after spinal cord injury. A randomized clinical trial |
| title_full | Effects of two different paradigms of electrical stimulation exercise on cardio-metabolic risk factors after spinal cord injury. A randomized clinical trial |
| title_fullStr | Effects of two different paradigms of electrical stimulation exercise on cardio-metabolic risk factors after spinal cord injury. A randomized clinical trial |
| title_full_unstemmed | Effects of two different paradigms of electrical stimulation exercise on cardio-metabolic risk factors after spinal cord injury. A randomized clinical trial |
| title_short | Effects of two different paradigms of electrical stimulation exercise on cardio-metabolic risk factors after spinal cord injury. A randomized clinical trial |
| title_sort | effects of two different paradigms of electrical stimulation exercise on cardio metabolic risk factors after spinal cord injury a randomized clinical trial |
| topic | neuromuscular electrical stimulation functional electrical stimulation resistance training spinal cord injury rehabilitation |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1254760/full |
| work_keys_str_mv | AT ashrafsgorgey effectsoftwodifferentparadigmsofelectricalstimulationexerciseoncardiometabolicriskfactorsafterspinalcordinjuryarandomizedclinicaltrial AT ashrafsgorgey effectsoftwodifferentparadigmsofelectricalstimulationexerciseoncardiometabolicriskfactorsafterspinalcordinjuryarandomizedclinicaltrial AT refkaekhalil effectsoftwodifferentparadigmsofelectricalstimulationexerciseoncardiometabolicriskfactorsafterspinalcordinjuryarandomizedclinicaltrial AT williamcarter effectsoftwodifferentparadigmsofelectricalstimulationexerciseoncardiometabolicriskfactorsafterspinalcordinjuryarandomizedclinicaltrial AT boydballance effectsoftwodifferentparadigmsofelectricalstimulationexerciseoncardiometabolicriskfactorsafterspinalcordinjuryarandomizedclinicaltrial AT ranjodhgill effectsoftwodifferentparadigmsofelectricalstimulationexerciseoncardiometabolicriskfactorsafterspinalcordinjuryarandomizedclinicaltrial AT ranjodhgill effectsoftwodifferentparadigmsofelectricalstimulationexerciseoncardiometabolicriskfactorsafterspinalcordinjuryarandomizedclinicaltrial AT rehankhan effectsoftwodifferentparadigmsofelectricalstimulationexerciseoncardiometabolicriskfactorsafterspinalcordinjuryarandomizedclinicaltrial AT lancegoetz effectsoftwodifferentparadigmsofelectricalstimulationexerciseoncardiometabolicriskfactorsafterspinalcordinjuryarandomizedclinicaltrial AT lancegoetz effectsoftwodifferentparadigmsofelectricalstimulationexerciseoncardiometabolicriskfactorsafterspinalcordinjuryarandomizedclinicaltrial AT timothylavis effectsoftwodifferentparadigmsofelectricalstimulationexerciseoncardiometabolicriskfactorsafterspinalcordinjuryarandomizedclinicaltrial AT timothylavis effectsoftwodifferentparadigmsofelectricalstimulationexerciseoncardiometabolicriskfactorsafterspinalcordinjuryarandomizedclinicaltrial AT adampsima effectsoftwodifferentparadigmsofelectricalstimulationexerciseoncardiometabolicriskfactorsafterspinalcordinjuryarandomizedclinicaltrial AT robertaadler effectsoftwodifferentparadigmsofelectricalstimulationexerciseoncardiometabolicriskfactorsafterspinalcordinjuryarandomizedclinicaltrial AT robertaadler effectsoftwodifferentparadigmsofelectricalstimulationexerciseoncardiometabolicriskfactorsafterspinalcordinjuryarandomizedclinicaltrial |