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Evaluation of a training program for persons with SCI paraplegia using the Parastep 1 ambulation system: part 2.
P L Jacobs1, M S Nash, K J Klose
1The Miami Project to Cure Paralysis and the Department of Neurological Surgery, University of Miami School of Medicine, FL 33136, USA.
Objective:
To examine the task-nonspecific effects of functional neuromuscular stimulation (FNS)-assisted ambulation training on the physiological responses of persons with paraplegia to upper extremity exercise challenge.
Design:
Before-after trial.
Setting:
Human spinal cord injury (SCI) applied research laboratory.
Participants:
Twelve men and three 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 duration 3.7 +/- 3.0yrs (range, 7 to 8.8yrs).
Intervention:
Thirty-two sessions of FNS ambulation training using a commercial six-channel system (Parastep 1). This system is composed of a microprocessor-controlled electrical stimulation unit and a walking frame outfitted with finger switches that allow the user to independently control the system and stimulation parameters.
Outcome Measures:
Peak and subpeak physiological responses to arm ergometry testing and upper extremity strength measures, obtained before and after the FNS ambulation training.
Results:
Statistically significant increases in peak values for time to fatigue, peak power output, and peak VO2 (all p < .001). Heart rate was significantly 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 adaptations. Central cardiovascular adaptations were indicated as the primary source of these beneficial alterations in exercise responses.