Feasibility of functional electrical stimulated cycling in subjects with spinal cord injury: an energetic assessment.

OBJECTIVE To determine the functional electrical stimulated (FES) cycling volume necessary to reach the recommended weekly exercise caloric expenditure of 1000-2200 kcal in FES-trained subjects with paraplegia. SUBJECTS Eight (7 males, 1 female) FES-trained subjects with traumatic motor and sensory complete paraplegia (AIS A, lesion level between Th3 and Th9) of at least 3 years duration were included. METHODS Subjects performed an FES-training session at the highest workload they were able to sustain for 60 min. During the training session respiratory gas exchange was measured, which allowed the calculation of mean fat and carbohydrate oxidation rates, and of total energy expenditure by means of indirect calorimetry. RESULTS Subjects revealed a mean energy expenditure of 288 (standard deviation 104) kcal/h. This corresponded to a mean oxidation rate of 49.5 (standard deviation 35.2) g/h for carbohydrate and 8.5 (standard deviation 8.4) g/hour for fat. Thus, 4-8 hours of FES-cycling are necessary to reach the recommended weekly exercise caloric expenditure of 1000-2200 kcal. CONCLUSION FES-cycling appears to be a feasible and promising training alternative to upper body exercise for subjects with spinal cord injury. Four to 8 h of FES-cycling are necessary to reach the recommended weekly exercise caloric expenditure that seems to be essential to induce persistent health benefits.