Salbutamol effect in spinal cord injured individuals undergoing functionalelectrical stimulation training

Objective: Preliminary study to investigate possible changes in skeletal mu scle morphology and function, as well as hormonal and metabolic effects, af ter treatment with a selective beta(2)-adrenergic receptor agonist. Design: Double-blind, placebo-controlled trial. Participants: Three individuals with spinal cord injury (SCI). Intervention: Two-week treatment with salbutamol (2mg) or placebo (ascorbic acid, 50mg) twice a day, program of functional electronic stimulation (FES ) cycling for 30 minutes twice a week. Main Outcome Measures: Body weight, three measures of leg circumference (gl uteal furrow, one third of subischial height up from tibial-femoral joint s pace, and minimum circumference above the knee), muscle fiber area, and tot al work output per session. Results: There were increases in body weight (2.30 +/- .70kg), leg circumfe rences (gluteal furrow 1.70 +/- .27cm, one third subischial height 1.53 +/- 1.65cm, minimum circumference above the knee .43 +/- .04cm), and muscle (v astus lateralis) cross-sectional area (1,374 +/- 493 to 2,446 +/- 1,177 mu m(2)) after salbutamol treatment, whereas quadriceps muscle contractile fun ction was not modified. Total work output during FES cycling sessions was i ncreased more during salbutamol treatment (64%) compared with training alon e (27%). Salbutamol treatment was associated with a large decrease in skele tal muscle beta-adrenergic receptor density. Conclusion: Although some side effects were noted, these results suggest th at a short treatment with the beta(2)-adrenergic receptor agonist salbutamo l during a training program with FES cycling could be beneficial in patient s with SCI. (C) 1999 by the American Congress of Rehabilitation Medicine and the Americ an Academy of Physical Medicine and Rehabilitation.