Purpose. To determine the feasibility of increasing the cardiopulmonary exercise intensity during walking with gait-patterned functional electrical stimulation (GP-FES) among individuals with motor incomplete SCI. Methods. Two men with motor-incomplete SCI (Subjects A and B, age 45 and 50 years; Level of Injury: C4 and T10; AIS score: D and D, resp.) performed a three sequential four-minute continuous walking sessions [(1) regular gait (non-GP-FES-1); (2) gait with GP-FES (GP-FES); (3) regular gait (non-GP-FES-2)]. Oxygen consumption (Vo2) was measured continuously during trials. Results. Vo2 was higher during GP-FES (Subjects A and B; 14.5 and 19.1？mL/kg/min, resp.) as compared to regular gait (Non-GP-FES-1: Subjects A and B; 13.4 and 17.0:？mL/kg/min, resp.; non-GP-FES-2: Subjects A and B; 13.1 and 17.5:？mL/kg/min, resp.). Conclusion. The exercise intensity of GP-FES walking was higher than that of regular walking among individuals with motor incomplete SCI. Further investigations are required to determine the clinical relevance of the exercise. 1. Introduction Coronary artery disease (CAD) is the most significant complication and leading cause of mortality after spinal cord injury (SCI) [1–3]. It is most likely that the high CAD risk observed in people with SCI is related to their extreme physical inactivity [4]. Therefore, increasing physical activity may reduce CAD risk factors among people with SCI [5, 6]. Although, in order to maximize the physiological benefits of cardiopulmonary training, exercise at an appropriate intensity is essential [7–9], the motor and autonomic impairments related to SCI often limit exercise intensity. Several exercise interventions using functional electrical stimulation (FES), such as FES arm or leg cycle ergometry training and FES walking, have been applied to enhance physical capacity and reduce CAD risk among persons with SCI [10–12]. FES is a technology that can restore useful movements by electrically stimulating and thereby artificially contracting paralyzed or paretic muscles [13]. Applications of FES can be divided into three classes: ( 1 ) neuroprostheses for use as a permanent assistive device; ( 2 ) facilitation of exercise; ( 3 ) short term as a therapeutic intervention to improve voluntary function [14, 15]. This latter application has been termed “FES therapy” (FET) [14]. Numerous reports over the past 30 years have asserted positive therapeutic effects of FES-assisted walking, including enhanced walking ability, among individuals with incomplete SCI [16–18]. However, there is growing evidence that regular
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