Optimization of Protocols Using Neuromuscular Electrical Stimulation for Paralyzed Lower-Limb Muscles to Increase Energy Expenditure in People With Spinal Cord Injury.
Yiming Ma, Sonja de Groot, Ad Vink and 5 others
PMID 36228281WHAT IT FOUND
Neuromuscular electrical stimulation of paralyzed lower-limb muscles significantly increased energy expenditure in men with spinal cord injury.
The most effective protocol stimulated four muscle groups with a 1:4 second duty cycle, raising energy use by 51% compared to sitting still.
Key findings
01All four NMES protocols resulted in a significant increase in energy expenditure compared to sitting without NMES, with the most intense protocol increasing energy use by 51%.
02Muscle fatigue occurred significantly with more intense protocols, characterized by a larger decrease in muscle contraction size over time.
03There was substantial individual variability, with three participants showing very positive increases in energy expenditure while others had limited responses.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample size was very small (n=9), and all participants were men. The protocols were short (10 minutes), so the sustainability of energy expenditure and the extent of fatigue over longer, clinically realistic sessions are unknown. Individual variability was high, with three participants driving much of the positive response, suggesting that current amplitude and time since injury may significantly affect outcomes. The measures used to estimate muscle fatigue (contraction size and pressure variance) have not been validated for this specific purpose. Spasticity was not measured, which could influence both energy expenditure and NMES tolerance.
Declared interests
The authors declare no conflicts of interest. The study was supported by non-U.S. government funding.
The easy way to misread this
Do not interpret the 51% increase in energy expenditure as a standalone weight management solution. The absolute increase was small (0.7 kcal/min), and the study did not evaluate long-term effects or weight change. Additionally, the high variability between participants means this response is not guaranteed for all individuals with SCI.