Hybrid High-intensity Interval Training for Persons With Spinal Cord Injury. A Feasibility Study

"Feasibility of High-intensity Interval Training (HIIT) as Hybrid Exercise Using Functional Electrical Stimulation Leg-cycling (FEScycling) and Ski Ergometer (SkiErg) With the Arms for People With Chronic Spinal Cord Injury Paraplegia"

This study examines safety and feasibility of a study protocol using a combination of functional electrical legcycling with voluntary armwork (hybrid training) as either skiergometer or armcycling in high intensity intervals for persons with spinal cord injury paraplegia.

Cardiovascular disease is one of the most common causes of early death in people with spinal cord injury. Physical activity at high intensity is known to reduce the risk of cardiovascular disease in other patient groups.

During aerobic training, combining functional electrical stimulation (FES) with voluntary arm-work induces a higher oxygen uptake than FES cycling alone and high intensity interval training induces higher oxygen uptake than training at continuous intensity. The hypothesis is that combining hybrid training with high-intensity induces even higher oxygen uptake thereby reducing the risk of cardiovascular disease. This training modality has not been tested before, so before conducting a randomized controlled trial testing the effect of this training modality on oxygen uptake, the aim was to asses safety and feasibility of this protocol.

Inclusion Criteria:

• spinal cord injury paraplegia,
• complete and incomplete lesions,
• ability to be electrically stimulated,
• willing to train 3 times a week at high intensity

Exclusion Criteria:

• heart pacemaker or other heart problems contradicting high intensity aerobic training,
• pregnancy,
• unstable fractures,
• cancer,
• heterotopic ossification,
• myositis ossificans,
• severe osteoporosis,
• pressure ulcers,
• newly implanted metal,
• newly surgery,
• frequent episodes of autonomic hyperreflexia,
• very high or low blood pressure,
• dislocation or subluxation of joints
• high level of shoulder pain at study start.