ABSTRACT / PROJECT SUMMARY
This postdoctoral F32 Kirschstein NRSA proposes unique research and includes a
comprehensive training plan in the study of functional electrical stimulation row training (FESRT)
as a rehabilitation technique in individuals with spinal cord injuries (SCI). Individuals with spinal
cord injuries have a greater morbidity and mortality risk from cardiovascular disease (CVD) than
able-bodied individuals. The increased risk could be due, in part, to increased fat mass or
dysregulated adipokine production leading to an impaired glucoregulatory control as a result of
muscle atrophy and increased sedentary activity. Functional electrical stimulation (FES)
exercise is increasingly being used in the acute and long-term rehabilitation of individuals with
spinal cord injuries. Our lab uses this technique to induce leg extension and flexion in
combination with voluntary upper body movements allowing for whole body rowing (FESRT).
This exercise, incorporated into a 6-month training regimen, has been shown to increase
aerobic fitness, attenuate gains in fat and loss of paralyzed muscle mass, and control blood
glucose; hence, decreasing risk for CVD. However, there is currently a lack of information
concerning retention of exercise training adaptations in those with SCI. Therefore, we propose a
retrospective study to analyze body composition, adipose tissue adipokine production, serum
adipokine concentrations, and glucoregulatory control in a group of individuals with SCI (n=31)
who participated in 6 months of FESRT and either continued training (n=15) or returned to
standard of care (n=16) (AIM 1). Additionally, these beneficial adaptations to FESRT may be
proportional to exercise training intensity. Pulmonary limitations in SCI likely limit the attainment
of sustainably vigorous FESRT exercise intensities. Therefore, we plan on studying changes in
body composition, adipose tissue adipokine production, serum adipokine concentrations, and
glucoregulatory control in relation to exercise training intensity in a prospective study that
incorporates mechanical (non-invasive ventilation) and pharmaceutical (serotonin receptor
agonist) ergogenic aids to increase ventilatory capacity (AIM 2). The ultimate purpose of this
research is to optimize exercise training protocols for a population that both needs and seeks a
broad range of benefits that exercise can confer. This F32 postdoctoral fellowship research and
training plan will help develop and optimize rehabilitation strategies in individuals with spinal
cord injuries and prepare me to advance as an independent researcher.