Home-Based Electrical Stimulation Training for SCI Persons with Lower Motor Neuron Injury.

Spinal cord injury (SCI) results in skeletal muscle atrophy and dramatic changes in body composition. Lower motor neuron (LMN) injury results in denervation of the lower extremity muscles which exacerbates muscle atrophy. Our recent unpublished work demonstrated that compared to innervated group with SCI (Figure), LMN resulted in remarkably lower cross-sectional area of the whole thigh and knee extensor muscles. This is accompanied with increased intramuscular fat and decreased leg lean mass. Furthermore, knee bone mineral density of the distal femur and proximal tibia is severely impacted following LMN. In the RISE project, long pulse width stimulation (LPWS) has shown promising outcomes in stimulation of the denervated muscles. However, applications of LPWS are clearly limited in North America. We have previously shown that using testosterone treatment in conjunction with surface neuromuscular resistance training augmented muscle hypertrophy and enhanced metabolic profile after SCI. We, hereby, present our preliminary evidence about conducting home-based and lab-based trial of combining TT + either short or LPWS stimulation in SCI persons with LMN. The overall goal is to increase skeletal muscle size, leg lean mass and to improve metabolic health in this sub-population with SCI https://clinicaltrials.gov/ct2/show/NCT03345576. The-12 month trial demonstrated the safety and feasibility of using LPWS with TT in restoring muscle size after chronic LMN. Furthermore, home-based approach is likely to provide an opportunity for long-term commitment and adherence for this population; especially during the era of COVID-19 pandemic. [ABSTRACT FROM AUTHOR]