Aerobic capacity with hybrid FES rowing in spinal cord injury: comparison with arms-only exercise and preliminary findings with regular training.

OBJECTIVE

To determine the magnitude and range of increases in peak aerobic capacity with hybrid-functional electrical stimulation (FES) rowing versus arms-only rowing in persons with spinal cord injury.

DESIGN

Comparison of graded exercise tests for peak responses during FES rowing and arms-only rowing. Preliminary data on adaptations to FES row training were gathered in a subset of individuals.

SETTING

Outpatient cardiovascular research laboratory.

PARTICIPANTS

Six male patients with spinal cord injury (T4-T9, American Spinal Injury Association class A). METHODS OR INTERVENTION: Arms-only rowing was compared with FES rowing, in which the person who is exercising synchronizes the voluntarily controlled upper body movement with the FES-controlled leg movement via stimulation to the paralyzed leg muscles. A subgroup (n = 3) completed at least 6 months of a progressive FES row training exercise program with graded exercise tests every 6 months.

MAIN OUTCOME MEASUREMENTS

Peak oxygen consumption, peak ventilation, peak respiratory exchange ratio, peak heart rate, and peak oxygen pulse.

RESULTS

Peak oxygen consumption was greater during FES rowing than during arms-only rowing (20.0 ± 1.9 mL/kg/min versus 15.7 ± 1.5 mL/kg/min, P = .01). Peak ventilation was similar, whereas peak respiratory exchange ratio and peak heart rate tended to be lower (P = .14 and P = .19, respectively). As a result, oxygen pulse was greater by 35% during FES rowing. Two of the three persons who completed at least 6 months of FES row training demonstrated increases in aerobic capacity greater than those previously observed in able-bodied individuals.

CONCLUSIONS

FES rowing may provide a more robust exercise stimulus for persons with spinal cord injury than most options currently available because of the greater aerobic demand.