PHYSIOLOGICAL-RESPONSES DURING FUNCTIONAL ELECTRICAL-STIMULATION LEG CYCLING AND HYBRID EXERCISE IN SPINAL-CORD INJURED SUBJECTS

Objectives: (1) To determine if a hybrid exercise (leg plus arm) train ing program performed immediately after functional electrical stimulat ion (FES) leg cycle exercise (LCE) training would further improve aero bic capacity when compared with FES leg cycle training alone, and (2) to compare the submaximal responses occurring during both FES-LCE alon e and hybrid exercise in the same SCI subjects. Design: Nonrandomized control trial whereby subjects act as their own control.Setting: Outpa tient rehabilitation in a primary care hospital, Patients: A volunteer sample (n = 11) of men 20 to 50 years old with complete spinal cord i njury, free from cardiovascular and metabolic disease with spasticity. Interventions: Three phases of exercise training: phase I, progressiv e FES-LCE to 30 minutes of exercise (n = 11); phase II, 35.2 +/- 16.2 sessions of FES-LCE (n = 11); phase III, 41.4 +/- 17.7 30-minute sessi ons of hybrid exercise in = 8), Main Outcome Measures: (1) Aerobic cap acity-a further increase after hybrid exercise when compared with FES- LCE alone; (2) submaximal physiologic parameters (oxygen uptake [(V) o ver dot O-2], heart rate [HR], blood lactate [BLa-])-measurement of th ese during constant work rate exercise and a training effect, Results: (V) over dot O-2 (the body's ability to utilize oxygen) significantly improved (p < .05) after both FES-LCE and then further after hybrid t raining, Hybrid exercise training resulted in significantly (p < .05) greater work rates and (V) over dot O-2 values than both FES-LCE at ba seline and training work rates, Conclusion: These subjects demonstrate d that hybrid exercise performed twice a week provided sufficient inte nsity to improve aerobic capacity and provide a medium whereby patient s with SCI can burn more calories than via FES-LCE alone. This has imp ortant implications for improving the health and fitness levels of ind ividuals with SCI and may ultimately reduce their risk of cardiovascul ar disease. (C) 1997 by the American Congress of Rehabilitation Medici ne and the American Academy of Physical Medicine and Rehabilitation.