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.