Respiratory capacity does influence exercise capacity in the population with spinal cord injury and may play an important role in delimiting aerobic exercise capacity.

Objective To test the hypothesis that hybrid Functional Electrical Stimulation Row Training (FES-RT) would improve aerobic capacity but that it would remain strongly linked to level of spinal cord lesion due to limited maximal ventilation. Design Longitudinal before-after trial of 6 months FES-RT. Setting Exercise for persons with disabilities program. Participants Fourteen volunteers with complete SCI T3_T11, >2 years post-injury, aged 21–63 years. Interventions Six months of FES-RT preceded by a variable period of FES 'strength training.' Main Outcome Measures Peak aerobic capacity, and peak exercise ventilation before and after 6 months of FES-RT Results FES_RT significantly increased VO2peak and Vepeak (both p<0.05). Prior to FES-RT, there was a close relationship between level of spinal cord injury and VO2peak (adj r2=0.40, p=0.009) that was markedly reduced after FES-RT (adj r2=0.15, p=0.10) . In contrast, the relationship between level of injury and VEpeak was comparable before and after FES-RT (adj r2=0.38 vs. adj r2=0.32, both p<0.05). Conclusions The increased aerobic capacity reflects more than increased ventilation; FES_RT effectively circumvents the effect of the spinal cord injury on peak aerobic capacity by engaging more muscle mass for training, independent of level of injury.