EVALUATION OF A TRAINING-PROGRAM FOR PERSONS WITH SCI PARAPLEGIA USING THE PARASTEP(R)1 AMBULATION SYSTEM .2. EFFECTS ON PHYSIOLOGICAL-RESPONSES TO PEAK ARM ERGOMETRY

Objective: To examine the task-nonspecific effects of functional neuro muscular stimulation (FNS)-assisted ambulation training on the physiol ogical responses of persons with paraplegia to upper extremity exercis e challenge. Design: Before-after trial. Setting: Human spinal cord in jury (SCI) applied research laboratory. Participants: Twelve men and t hree women with motor-and sensory-complete thoracic-level SCI (T4-T11) , mean age 28.2 +/- 6.8yrs (range, 21.1 to 45.2yrs), mean injury durat ion 3.7 +/- 3.0yrs (range, 7 to 8.8yrs). Intervention: Thirty-two sess ions of FNS ambulation training using a commercial six-channel system (Parastep(R) 1). This system is composed of a microprocessor-controlle d electrical stimulation unit and a walking frame outfitted with finge r switches that allow the user to independently control the system and stimulation parameters. Outcome Measures: Peak and subpeak physiologi cal responses to arm ergometry testing and upper extremity strength me asures, obtained before and after the FNS ambulation training. Results : Statistically significant increases in peak values for time to fatig ue, peak power output, and peak VO2 (all p < .001). Heart rate was sig nificantly lower throughout subpeak levels of arm ergometry after the ambulation training (p <.05). Values of upper extremity strength were not significantly altered after training. Conclusions: FNS ambulation by persons with SCI paraplegia results in task-nonspecific training ad aptations. Central cardiovascular adaptations were indicated as the pr imary source of these beneficial alterations in exercise responses. (C ) 1997 by the American Congress of Rehabilitation Medicine and the Ame rican Academy of Physical Medicine and Rehabilitation.