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J Rehabil Res Dev. 2013;50(2):193-202.

Alterations in body composition and spasticity following subtetanic neuromuscular electrical stimulation training in spinal cord injury.

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Physiotherapy Department, National Rehabilitation Hospital, Rochestown Ave., Dun Laoghaire, Co. Dublin, Ireland.


The objective of this prospective cohort study was to investigate alterations in body composition variables and spasticity following subtetanic neuromuscular electrical stimulation (NMES) training in an adult population with spinal cord injury (SCI). Fourteen sedentary adults with SCI (thoracic [T]4-T11; American Spinal Injury Association Impairment Scale A/B; time since injury: 10.17 +/- 11.17 yr) were recruited from the National SCI database. Four adhesive electrodes (175 cm2 each) were placed bilaterally on the proximal and distal quadriceps and hamstrings muscle groups and subtetanic contractions were elicited using a handheld NMES device. Lean body mass (LBM) and other body composition variables were measured using dual-energy X-ray absorptiometry. Spasticity was measured using the Spinal Cord Assessment Tool for Spastic Reflexes (SCATs) and visual analog scales. Verbal and written feedback was obtained to subjectively evaluate spasticity. LBM and spasticity measurements were taken before and after an 8 wk NMES training program in order to assess change. A statistically significant increase in lower-limb LBM, i.e., muscle tissue (p > 0.001), and a reduction in SCATs (p < 0.001) score, indicating reduced spasticity, was observed. Subjective responses were positive. Improvements in body composition and SCATs scores indicate that subtetanic NMES training elicits favorable responses and may have important clinical implications for an SCI population.

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