Abstract
Objective
To determine the effects of neuromuscular electrical stimulation (NMES) or functional
electrical stimulation (FES), or both, training on different body composition parameters
in individuals with spinal cord injury.
Data sources
Three independent reviewers searched PubMed, Web of Science, Scopus, Cochrane Central,
and Virtual Health Library until March 2020.
Study selection
Studies were included if they applied NMES/FES on the lower limb muscles after spinal
cord injury, reported stimulation parameters (frequency, pulse duration, and amplitude
of current), and body composition parameters, which included muscle cross-sectional
area (CSA), fat-free mass, lean mass (LM), fat mass, visceral adipose tissue, and
intramuscular fat.
Data synthesis
A total of 46 studies were included in the final analysis with a total sample size
of 414 subjects. NMES loading exercise and FES cycling exercise were commonly used
for training. Increases in muscle CSA ranged from 5.7-75%, with an average of 26%
(n=33). Fifteen studies reported changes (both increase and decrease) in LM or fat-free
mas ranged from -4% to 35%, with an average of less than 5%. Changes in fat mass (n=10)
were modest. The effect on ectopic adipose tissue is inconclusive, with 2 studies
showing an average reduction in intramuscular fat by 9.9%. Stimulation parameters
ranged from 200-1000 μs for pulse duration, 2-60 Hz for the frequency, and 10-200
mA in amplitude. Finally, increase in weekly training volumes after NMES loading exercise
resulted in a remarkable increase in percentage changes in LM or muscle CSA.
Conclusions
NMES/FES is an effective rehabilitation strategy for muscle hypertrophy and increasing
LM. Weekly training volumes are associated with muscle hypertrophy after NMES loading
exercise. Furthermore, positive muscle adaptations occur despite the applied stimulation
parameters. Finally, the included studies reported wide range of stimulation parameters
without reporting rationale for such selection.
Keywords
List of abbreviations:
CSA (cross-sectional area), FES (function electrical stimulation), FFM (fat-free mass), FM (fat mass), IMF (intramuscular fat), LM (lean mass), NMES (neuromuscular electrical stimulation), SCI (spinal cord injury), VAT (visceral adipose tissue)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 20, 2021
Accepted:
September 5,
2021
Received in revised form:
August 10,
2021
Received:
January 28,
2021
Footnotes
Disclosures: none.
Identification
Copyright
© 2021 by the American Congress of Rehabilitation Medicine.
