Exercise to Reduce Obesity in Spinal Cord Injury
Condition: Diabetes Mellitus; Obesity; Paraplegia; Quadriplegia; Spinal Cord Injury
MeSH terms: Spinal Cord Injuries; Paraplegia; Quadriplegia; Obesity; Wounds and Injuries
Study type: Interventional

Summary: 
      The purpose of this proposal was to evaluate and compare the health benefits of using upper
      extremity exercise versus functional electrical stimulation for lower extremity exercise. It
      was our hypothesis that both Functional Electrical Stimulation Leg Cycle Ergometry (FES LCE)
      exercise and voluntary Arm Crank Ergometry (ACE) upper extremity exercise would increase
      whole body energy expenditure, thereby increasing muscle mass, insulin sensitivity, glucose
      effectiveness and improving lipid profiles in adults with paraplegia.
    

Detailed description: 
      Objective: Spinal cord injuries (SCI) predispose individuals to impaired fitness, obesity,
      glucose intolerance and insulin resistance, placing them at greater risk for diabetes,
      coronary artery disease, and upper extremity overuse syndrome as body weight increases. The
      specific objectives for the current proposal were to compare the impact of FES (functional
      electrical stimulation) lower extremity exercise versus upper extremity arm crank ergometry
      on energy metabolism, body composition and fat deposition, insulin sensitivity, glucose
      effectiveness, lower extremity bone mineral density and lipid profiles, in adults with
      complete paraplegia. Research Plan: A randomized, baseline-controlled, prospective, 16-week
      interventional trial was employed to assess the impact of FES LCE versus volitional arm crank
      ergometry exercise on energy metabolism, body composition and fat deposition, insulin
      sensitivity, glucose effectiveness, lower extremity bone mineral density and lipid profiles
      in adults with complete paraplegia. Methods: Twenty-four 18-65 y.o. individuals with motor
      complete T4-L2 SCI were assigned to either FES lower extremity exercise or upper extremity
      arm crank ergometry to compare impact on energy expenditure, obesity, and insulin
      sensitivity. Both groups were provided similar nutritional assessments and intervention.
      Exercise training consisted of five, 40-minute sessions at 70% maximal heart rate (HRmax)
      each week for a total of 16 weeks. Resting metabolic rate, exercise energy expenditure, body
      composition by DXA, insulin sensitivity, glucose effectiveness, lipid profiles, and lower
      extremity bone mineral density (BMD) were determined before and after 16-week exercise
      interventions.
    

Intervention name(s): Arm Crank Ergometry; FES Cycle Ergometer
Intervention type(s): Procedure; Procedure
Intervention description(s): Use of an upper body cycle to perform exercise. 10-minute warm up, 40 minutes @ 70%HRMax (50RPM), 10 minute cool down 5x/week x 16 weeks; Use of an FES cycle ergometer to perform exercise. 10-minute warm up, 40 minutes @ 70%HRMax (50RPM), 10 minute cool down 5x/week x 16 weeks
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Body Composition; Exercise; Glucose Tolerance; Insulin Sensitivity; Functional Electric Stimulation