Muscle oxygenation during hybrid arm and functional electrical stimulation–evoked leg cycling after spinal cord injury

Abstract

This study compared muscle oxygenation (StO2) during arm cranking (ACE), functional electrical stimulation–evoked leg cycling (FES-LCE), and hybrid (ACE+FES-LCE) exercise in spinal cord injury individuals. Eight subjects with C7-T12 lesions performed exercises at 3 submaximal intensities. StO2 was measured during rest and exercise at 40%, 60%, and 80% of subjects’ oxygen uptake (VO2) peak using near-infrared spectroscopy. StO2 of ACE showed a decrease whereas in ACE+FES-LCE, the arm muscles demonstrated increasing StO2 from rest in all of VO2) peak respectively. StO2 of FES-LCE displayed a decrease at 40% VO2 peak and steady increase for 60% and 80%, whereas ACE+FES-LCE revealed a steady increase from rest at all VO2 peak. ACE+FES-LCE elicited greater StO2 in both limbs which suggested that during this exercise, upper- and lower-limb muscles have higher blood flow and improved oxygenation compared to ACE or FES-LCE performed alone.

Skeletal Muscle Hypertrophy and Attenuation of Cardio-Metabolic Risk Factors (SHARC) Using Functional Electrical Stimulation-Lower Extremity Cycling in Persons with Spinal Cord Injury. Study Protocol for a randomized clinical trial

“…To offset for these limitations, the use of hybrid exercise by combining both upper extremities and FES cycling has been shown to improve cardiovascular outcomes more than FES-LEC. 62 Arm cranking exercise (ACE) in combination with FES-LEC displayed increasing muscle oxygenation (StO ) at 40%, 60%, and 80% of subjects' peak VO 2 compared to ACE only that showed decreases in StO 2 and FES-LEC only that had steady increases in just 60% and 80% peak VO 2 .…”

“…The combination of ACE+FES-LEC demonstrates better oxygenation than either ACE or FES-LEC alone. 62 These forms of hybrid-FES training are more suited for high-intensity, high-volume exercise training than FES-cycling only and require intact upper extremity function.…”

Mechanomyography and tissue oxygen saturation during electrically‐evoked wrist extensor fatigue in people with tetraplegia

“…[10][11][12] Individuals with tetraplegia benefit from transcutaneous FES training for muscle strengthening, enablement of voluntary muscle activity, 13 enhanced blood flow, and improved tissue oxygenation. 14 Thorsen et al noted that three out of 5 SCI patients demonstrated positive improvements in wrist extension and improved thumb flexion during FES-evoked muscle contractions. 10 However, muscle fatigue occurs more rapidly during FES-evoked muscle contractions, especially in individuals with SCI.…”

Gains in aerobic capacity with whole-body functional electrical stimulation row training and generalization to arms-only exercise after spinal cord injury

“…( 6 ) The beneficial and protective cardiovascular health effects of aerobic exercise require training at sufficient intensity and volume. ( 7 ) ( 8 ) ( 9 ) In fact, moderate to vigorous intensity training that engages muscle mass beyond what is typically used is necessary to increase peak aerobic capacity (VO 2 peak )( 10 , 11 ) and decrease cardiovascular risk in those with SCI. ( 12 )…”