None listed
Conditions
Brief summary
People with spinal cord injuries (SCI) experience changes in their muscles and health. One of these changes is muscle wasting typically due to disuse. One solution to reduce muscle wasting in people with SCI may be to use an eccentric-concentric strength training modality. Neuromuscular electrical stimulation (NMES) is commonly applied to muscles (using stick-on pad electrodes) to improve muscle strength in people with spinal cord injuries (SCI). This improvement in muscle strength is also thought to decrease muscle spasticity and improve quality of life. One modality that has promising results in muscle strength with lower loads is the use of eccentric contractions in combinations with concentric contractions. However, there is little research on NMES used as an eccentric-concentric mode in people with SCI. Thus, the current study is a proof-of-concept trial for the future use of eccentric-concentric training in people with SCI. The aim of the current study is to quantify the amount of force your thigh muscles produce during this type of electrical stimulation after a 6-week NMES intervention. Also, we will identify if this type of electrical stimulation produces less spasticity in the following days and after the 6-week intervention. Finally, we will identify if this type of NMES makes any changes in quality of life.
Interventions
Neuromuscular electrical stimulation combined with eccentric muscle strength training in people with SCI:
We will conduct a non-randomised 6-week pilot clinical trial study intervention in four persons with spinal cord injury (SCI), lesion below the level of C6 (age range = 18-65 years, ASIA A-D). Participants will be recruited from the local community (Rockhampton).
Description of the intervention
Protocol: NMES eccentric training will commence after the warm-up and testing that will be desc
Neuromuscular electrical stimulation combined with eccentric muscle strength training in people with SCI: We will conduct a non-randomised 6-week pilot clinical trial study intervention in four persons with spinal cord injury (SCI), lesion below the level of C6 (age range = 18-65 years, ASIA A-D). Participants will be recruited from the local community (Rockhampton). Description of the intervention Protocol: NMES eccentric training will commence after the warm-up and testing that will be described under "Control Test". Intensity of the intervention will be informed by the baseline twitch torque knee extension test. 3 sets of 5 repetitions will be completed at half the current intensity used to evoke the maximum isometric tetanic torque as part of the ‘warm-up’. The stimulation amplitude will be controlled manually to make sure the force profile in each repetition does not drop significantly due to fatigue. The dynamometer will flex the knee at 30°·s-1 to provide a concentric action from 90°of flexion to full knee-extension and an eccentric action from full knee extension to 90°of flexion. The bouts of electrical stimulation will only be delivered during the eccentric phase (i.e. from full knee extension to 90 degrees of knee flexion). In-built safety limits will be set so torques 10% greater than the target torque, which may be produced through spasms, will trigger the system to immediately stop the stimulation delivery in order to minimise injury risk. Three attempts will be given for individuals to complete the training without triggering the safety mechanism before the session will be ended. During the consequent intervention session, the current intensity used will evoked 80% of the maximum tetanic torque. Thereafter, current intensities of 100% will be used, with 5 sets of 10 repetitions being completed during all training sessions. The intensity of exercise will increase as the muscle strength increases. Participants who are unable to complete a session due to spasms will repeat exercise at the next session; progression to full training will only occur once the training can be done without detectable spasm. All intervention sessions will be conducted by two people, one is a Senior Physiotherapist with research experience and a the second one is a trained research assistant. The participants will be asked to keep their physical training routine consistent for the duration of the experiment. The duration of each session will be 1 hour approximately. Session attendance checklist will be used to monitor adherence to the intervention. The procedures that will be used in this study will be similar from a methodology used in a previous study in people with spinal cord injury (SCI): Trial ID: ACTRN12618000018213.
Sponsors
Vanesa Bochkezanian
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Inclusion criteria: age 18-65 years; SCI longer than 6 months that led to complete or incomplete paraplegia or tetraplegia; level of injury between C2 and L5; AIS (American Spinal Cord Injury Association Impairment Scale) A, B, C or D; have medical permission to enrol in an intensive exercise program; and able to attend consistently two times per week for 6 weeks in addition to committing to baseline and follow up testings at CQUniversity North Rockhampton, QLD, Australia laboratory located on Building 81.
Exclusion criteria
Acute phase of injury (less than 6 months from injury); ventilator dependent, other associated neurological disease; and complications such as severe urinary infection, pressure ulcers, previous lower-limb fractures or any other health condition that may constrain the participation in an exercise program.
Outcome results
None listed