Abstracts From the IFESS 2025 Conference

Historically, persons with SCI with lower motor neuron injury would not benefit from standard neuromuscular electrical stimulation (NMES).Unlike NMES, the use of long pulse width electrical stimulation (LPWS) protocol provides the use of long pulse duration that may extend from 35 to 300 ms.The European project, Research and Innovation Staff Exchange (RISE) successfully restored 24% of the trained knee extensor CSA following the application of functional electrical cycling (FES) with LPWS (120-150 ms) at an amplitude of 250 mA for 5 days per week.Denervated muscles in persons with SCI experience severe atrophy with transformation of muscular tissue into fibrous connective tissue and infiltration of intramuscular fat (IMF).Compared to persons with upper motor neuron SCI, skeletal muscle is 40%-60% smaller with excessive IMF that may exceed 15%.This is typically associated with a loss in bone mineral density of the distal femur and proximal tibia.We will discuss (1) effects of lower motor neuron injury on muscle size, cardiometabolic profile, and bone mineral density in persons with SCI.We will also discuss recent findings, (2) regarding utilizing LPWS electrical stimulation exercise to overcome the effects of denervation on the paralyzed muscles in persons with SCI.The presentation will highlight the preliminary finding from a concluded clinical trial about the effects of 12 months of LPWS in conjunction with testosterone treatment on muscle size, body composition, and other cardio-metabolic risk factors compared to standard NMES and testosterone treatment.The preliminary results highlight the need for more studies to determine the most effective stimulation protocol as far as the training frequency and the stimulation parameters necessary to develop muscle hypertrophy and attenuate cardio-metabolic risk factors in this subpopulation with SCI.