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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. Three independent reviewers searched PubMed, Web of Science, Scopus, Cochrane Central, and Virtual Health Library until March 2020. 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. 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. 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. [ABSTRACT FROM AUTHOR]

Objective To investigate the feasibility and preliminary outcomes of a home progressive resistance training (PRT) program augmented by neuromuscular electrical stimulation (NMES). Design Randomized controlled pilot trial. Setting Participant homes. Participants People with multiple sclerosis (MS) (N=37) who use a walking aid. Interventions A 12-week home PRT program or the same program augmented by NMES. Main Outcome Measures Strength using hand-held dynamometry; repeated sit to stand test; Berg Balance Scale; timed Up & Go test; 12-Item Multiple Sclerosis Walking Scale; Multiple Sclerosis Impact Scale-29, version 2; and Modified Fatigue Impact Scale (MFIS). The NMES group also completed a device usability questionnaire. Results Only change in MFIS score was significantly greater in the NMES group than the PRT group ( P =.012). The NMES group improved significantly in quadriceps endurance (median of change, 8.5; P =.043), balance (median of change, 3.5; P =.001), physical impact of MS (median of change, −8.3; P =.001), and impact of fatigue (median of change, −17; P =.001). Participants rated the device as highly usable. Conclusions This pilot study suggests that a home PRT program with NMES is feasible, and the neuromuscular electrical stimulation device is usable by this population. Only reduction in impact of fatigue was greater in the NMES than the PRT group. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To investigate the long-term effects of functional electrical stimulation (FES)-evoked cycle training cadence on leg muscle hypertrophy and electrically evoked strength. Design: Open intervention study. Setting: Laboratory setting. Participants: Untrained individuals with chronic spinal cord injury (N=8). Interventions: Six weeks (3d/wk) of training on an isokinetic FES cycle ergometer. For each subject, 1 leg was randomly allocated to cycling at 10 revolutions per minute (rpm) (LOW) for 30min/d, and the other cycling at 50rpm (HIGH) for 30min/d. Main Outcome Measures: Pre- and posttraining measurements of lower limb circumference were performed at the distal and middle position of each thigh. Electrically evoked quadriceps muscle torque during an isometric contraction was also assessed. Results: Six weeks of FES cycle training significantly increased thigh girth in both LOW and HIGH groups. At midthigh, girth increases induced by LOW (6.6%±1.2%) were significantly greater than those by HIGH (3.6%±0.8%). LOW also produced greater gains in electrically evoked isometric torque than HIGH after training. Conclusions: These results suggest that lower pedaling cadences evoke greater muscle hypertrophy and electrically stimulated muscle strength compared with higher cadences. [Copyright &y& Elsevier]