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

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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 & Rehabilitation
Volume102
Issue number6
DOIs
Publication statusPublished - Jun 2023

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