Optimization of protocols using neuromuscular electrical stimulation for paralyzed lower-limb muscles to increase energy expenditure in people with spinal cord injury

Yiming Ma, Sonja de Groot, Ad Vink, Wouter Harmsen, Christof A J Smit, Janneke M Stolwijk-Swuste, Peter J M Weijs, Thomas W J Janssen

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

OBJECTIVE: To evaluate if using surface neuromuscular electrical stimulation (NMES) for paralyzed lower-limb muscles results in an increase in energy expenditure and if the number of activated muscles and duty cycle affect the potential increase.

DESIGN: Cross-sectional study.

RESULTS: Energy expenditure during all NMES protocols was significantly higher than the condition without NMES (1.2 ± 0.2 kcal/min), with the highest increase (+ 51%; +0.7 kcal/min, 95% CI: 0.3 - 1.2) for the protocol with more muscles activated and the duty cycle with a shorter rest period. A significant decrease in muscle contraction size during NMES was found with a longer stimulation time, more muscles activated or the duty cycle with a shorter rest period.

CONCLUSION: Using NMES for paralyzed lower-limb muscles can significantly increase the energy expenditure compared to sitting without NMES with the highest increase for the protocol with more muscles activated and the duty cycle with a shorter rest period. Muscle fatigue occurred significantly with the more intense NMES protocols which might cause a lower energy expenditure in a longer protocol. Future studies should further optimize the NMES parameters and investigate the long-term effects of NMES on weight management in people with SCI.

Original languageEnglish
Pages (from-to)489-497
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume102
Issue number6
Early online date11 Oct 2022
DOIs
Publication statusPublished - Jun 2023

Bibliographical note

Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.

Funding

The authors thank the rehabilitation center Reade in Amsterdam which has contributed to the organization of measurements. They also thank China Scholarship Council (CSC), which has supported the PhD career of the corresponding author. The authors appreciate the cooperation of all the participants and the master’s students who performed the measurements.

FundersFunder number
China Scholarship Council

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