2003 Director's Summary Synopsis

DETERMINING THE BENEFITS OF LOWER EXTREMITY EXERCISE
Mark S. Nash, Ph.D. • Edelle Field-Fote, Ph.D. • Patrick L. Jacobs, Ph.D.

Because of the physical impairments resulting from SCI, the exercise options for a person to maintain fitness are often limited to passive activities or arm exercises. Miami Project researchers continue to analyze the potential benefits of various types of exercise. Previous studies have shown that endurance arm exercises can enhance fitness and health. Of concern, however, is that these arm exercises can also cause upper extremity injury and pain.

Evaluating an active exercise, Dr. Patrick Jacobs compared the effects of lower extremity functional electrical stimulation (FES)-assisted walking to arm crank exercise in volunteers with complete paraplegia. The results show that the fitness benefits of FES ambulation and arm crank exercise are similar. Since the risk for injury to the upper extremity is less with FES walking, this type of exercise is a potential alternative to arm crank exercise. With further research, FES walking may prove to be less fatiguing and allow more exercise to be done.

Evaluating the effects of passive exercise is also an important research question especially concerning people with cervical injuries who have a limited capacity for arm exercise. To understand whether passive exercise has positive benefits, Drs. Mark Nash and Field-Fote have collaborated on studies to evaluate the use of robotic-assisted treadmill walking in a body weight support (BWS) system. In this case study of one research volunteer with complete cervical SCI, they observed changes in heart rate and respiratory function. While research with more people is needed to confirm beneficial results, the preliminary findings suggest that this type of passive exercise may offer exercise and fitness benefits.

Synopsis Publications

 Jacobs PL, Mahoney ET (2002) Peak exercise capacity of electrically induced ambulation in persons with paraplegia. Med Sci Sports Exerc 34:1551-1556.

 Nash MS, Jacobs PL, Johnson BM, Field-Fote E (2003) Metabolic and cardiac responses to robotic-assisted locomotion in motor-complete tetraplegia: A case report. J Spinal Cord Med 2004;27(1):78-82.