A report of anticipated benefits of functional electrical stimulation after spinal cord injury

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 VO₂. 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. VO₂ 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/m². 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.