The effects of electrical stimulation on body composition and metabolic profile after spinal cord injury - Part II

被引:61
作者
Gorgey, Ashraf S. [1 ,2 ]
Dolbow, David R. [3 ]
Dolbow, James D. [1 ]
Khalil, Refka K. [1 ]
Gater, David R. [4 ]
机构
[1] Hunter Holmes McGuire VAMC, Spinal Cord Injury & Disorders Ctr, Richmond, VA USA
[2] Virginia Commonwealth Univ, Dept Phys Med & Rehabil, Richmond, VA USA
[3] Univ So Mississippi, Sch Human Performance & Recreat, Hattiesburg, MS 39406 USA
[4] Penn State Univ, Penn State Coll Med, Dept Phys Med & Rehabil, Hershey, PA USA
关键词
Spinal cord injury; Electrical stimulation exercise; Body composition; Metabolic profile; Glucose metabolism; Lipid metabolism; CORONARY-HEART-DISEASE; FUNCTIONAL NEUROMUSCULAR STIMULATION; CROSS-SECTIONAL AREA; PHYSICAL-ACTIVITY; CYCLING PROGRAM; INSULIN SENSITIVITY; MUSCLE HYPERTROPHY; INTRAMUSCULAR FAT; GLUCOSE-TOLERANCE; LIPID-METABOLISM;
D O I
10.1179/2045772314Y.0000000244
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Diet and exercise are cornerstones in the management of obesity and associated metabolic complications, including insulin resistance, type 2 diabetes, and disturbances in the lipid profile. However, the role of exercise in managing body composition adaptations and metabolic disorders after spinal cord injury (SCI) is not well established. The current review summarizes evidence about the efficacy of using neuromuscular electrical stimulation or functional electrical stimulation in exercising the paralytic lower extremities to improve body composition and metabolic profile after SCI. There are a number of trials that investigated the effects on muscle cross-sectional area, fat-free mass, and glucose/lipid metabolism. The duration of the intervention in these trials varied from 6 weeks to 24 months. Training frequency ranged from 2 to 5 days/week. Most studies documented significant increases in muscle size but no noticeable changes in adipose tissue. While increases in skeletal muscle size after twice weekly training were greater than those trials that used 3 or 5 days/week, other factors such as differences in the training mode, i.e. resistance versus cycling exercise and pattern of muscle activation may be responsible for this observation. Loading to evoke muscle hypertrophy is a key component in neuromuscular training after SCI. The overall effects on lean mass were modest and did not exceed 10% and the effects of training on trunk or pelvic muscles remain unestablished. Most studies reported improvement in glucose metabolism with the enhancement of insulin sensitivity being the major factor following training. The effect on lipid profile is unclear and warrants further investigation.
引用
收藏
页码:23 / 37
页数:15
相关论文
共 87 条
[1]   Muscle atrophy is prevented in patients with acute spinal cord injury using functional electrical stimulation [J].
Baldi, JC ;
Jackson, RD ;
Moraille, R ;
Mysiw, WJ .
SPINAL CORD, 1998, 36 (07) :463-469
[2]   Coronary heart disease in individuals with spinal cord injury: assessment of risk factors [J].
Bauman, W. A. ;
Spungen, A. M. .
SPINAL CORD, 2008, 46 (07) :466-476
[3]   BLUNTED GROWTH-HORMONE RESPONSE TO INTRAVENOUS ARGININE IN SUBJECTS WITH A SPINAL-CORD INJURY [J].
BAUMAN, WA ;
SPUNGEN, AM ;
FLANAGAN, S ;
ZHONG, YG ;
ALEXANDER, LR ;
TSITOURAS, PD .
HORMONE AND METABOLIC RESEARCH, 1994, 26 (03) :152-156
[4]   Long-term spinal cord injury increases susceptibility to isometric contraction-induced muscle injury [J].
Bickel, CS ;
Slade, JM ;
Dudley, GA .
EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY, 2004, 91 (2-3) :308-313
[5]   ELECTRICALLY-STIMULATED MUSCLE HYPERTROPHY IN PARAPLEGIA - ASSESSMENT BY QUANTITATIVE CT [J].
BLOCK, JE ;
STEINBACH, LS ;
FRIEDLANDER, AL ;
STEIGER, P ;
ELLIS, W ;
MORRIS, JM ;
GENANT, HK .
JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 1989, 13 (05) :852-854
[6]   A CLINICAL EXERCISE SYSTEM FOR PARAPLEGICS USING FUNCTIONAL ELECTRICAL-STIMULATION [J].
BREMNER, LA ;
SLOAN, KE ;
DAY, RE ;
SCULL, ER ;
ACKLAND, T .
PARAPLEGIA, 1992, 30 (09) :647-655
[7]   A review of body mass index and waist circumference as markers of obesity and coronary heart disease risk in persons with chronic spinal cord injury [J].
Buchholz, AC ;
Bugaresti, JM .
SPINAL CORD, 2005, 43 (09) :513-518
[8]   Physical activity levels are low in free-living adults with chronic paraplegia [J].
Buchholz, AC ;
McGillivray, CF ;
Pencharz, PB .
OBESITY RESEARCH, 2003, 11 (04) :563-570
[9]   Effect of Exercise on Disorders of Carbohydrate and Lipid Metabolism in Adults With Traumatic Spinal Cord Injury: Systematic Review of the Evidence [J].
Carlson, Kathleen F. ;
Wilt, Timothy J. ;
Taylor, Brent C. ;
Goldish, Gary D. ;
Niewoehner, Catherine B. ;
Shamliyan, Tatyana A. ;
Kane, Robert L. .
JOURNAL OF SPINAL CORD MEDICINE, 2009, 32 (04) :361-378
[10]   Intra-abdominal fat is a major determinant of the national cholesterol education program adult treatment panel III criteria for the metabolic syndrome [J].
Carr, DB ;
Utzschneider, KM ;
Hull, RL ;
Kodama, K ;
Retzlaff, BM ;
Brunzell, JD ;
Shofer, JB ;
Fish, BE ;
Knopp, RH ;
Kahn, SE .
DIABETES, 2004, 53 (08) :2087-2094