Both the (simulated) 5-km and 40-km TT can be used to estimate the MLSS in cyclists. In addition, HLa at MLSS shows a large degree of variation between riders.
Background: Functional electrical stimulation (FES) has been regularly used to offset several negative body composition and metabolic adaptations following spinal cord injury (SCI). However, the outcomes of many FES trials appear to be controversial and incoherent. Objective: To document the potential consequences of several factors (e.g. pain, spasms, stress and lack of dietary control) that may have attenuated the effects on body composition and metabolic profile despite participation in 21 weeks of FES training. Participant: A 29-year-old man with T6 complete SCI participated in 21 weeks of FES, 4 days per week. Methods: Prior to and following training, the participant performed arm-crank-graded exercise testing to measure peak VO 2 . Tests conducted included anthropometrics and dual energy X-ray absorptiometry body composition assessments, resting energy expenditure, plasma lipid profiles and intravenous glucose tolerance tests. Results: The participant frequently reported increasing pain, stress and poor eating habits. VO 2 peak decreased by 2.4 ml/kg/minute, body mass increased by 8.5 kg, and body mass index increased from 25 to 28 kg/m 2 . Waist and abdominal circumferences increased by 2-4 cm, while %fat mass increased by 5.5%. Absolute increases in fat mass and fat-free mass of 8.4 and 1 kg, respectively, were reported. Fasting and peak plasma glucose increased by 12 and 14.5%, while lipid panel profiles were negatively impacted. Conclusion: Failure to control for the listed negative emerging factors may obscure the expected body composition and metabolic profile adaptations anticipated from FES training.
Objectives: Locomotor training (LT) enhances walking in individuals with spinal cord injuries (SCIs). We tested the acute effects of 4 days of LT using BWSTT combined with Robotic Locomotor therapy compared to BWSTT twice weekly. Design: Two non-ambulatory participants with an American Spinal Injury Association Impairment Scale (AIS) D. Both received LT for 2 weeks as a portion of their clinical inpatient rehabilitation program and both used wheelchairs as their primary method of mobility. Over a 2 week period, one participant received a total of 8 visits consisting of manual BWSTT (twice weekly) combined with Robotic locomotor therapy (twice weekly). The other participant preformed manual BWSTT (twice weekly) for a total of 4 visits. Resting energy expenditure, body composition, muscle strength, submaximal oxygen consumption (VO2) and blood lactate during LT were measured pre and post-training. Results: The average maximum voluntary contraction of both knee extensor muscle groups increased by 28-34% with associated reduction in spasticity to the BWSTT participant. Two week interventions resulted in a downward shift of the lactate concentrations for both participants, increase in resting energy expenditure and shift in substrate utilization. Discussion and conclusion: A clinical paradigm of incorporating BWSTT with robotic locomotor therapy for 4 days/ week did not provide additional physiological benefits to skeletal muscle strength, spasticity or metabolic profile compared to twice weekly of LT using BWSTT.
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