Cardiorespiratory responses to arm cranking and electrical stimulation leg cycling in people with paraplegia

Purpose: The purpose of this study was to assess the cardiorespiratory responses during arm exercise with and without concurrent electrical stimulation-induced leg cycling in people with paraplegia. Methods: On separate days, 10 subjects with spinal cord injuries (T5-T12) performed either arm cranking (ACE), or simultaneous arm cranking + electrical stimulation-induced leg cycling (ACE+ES-LCE) graded exercise tests. Results: During submaximal, steady-state exercise, ACE+ES-LCE elicited significantly higher (V) over dot O-2,O- (by 0.25-0.28 L.min(-1)), stroke volume (by 13 mL), and (V) over dot E-BTPS (by 9.4 L.min(-1)) compared with ACE alone. In contrast, there were no significant differences of submaximal HR, cardiac output, or power output between the exercise modes. At maximal exercise. ACE+ES-LCE elicited significantly higher (V) over dot O-2 (by 0.23 L.min(-1)) compared with ACE alone, but there were no differences in power output, HR, or (V) over dot E-BTPS. Conclusions: These results demonstrate that during submaximal or maximal exercise there was a greater metabolic stress elicited during ACE+ES-LCE compared with during ACE alone. The higher stroke volume observed juring submaximal ACE+ES-LCE, in the absence of any difference in HR, implied a reduced venous pooling and higher cardiac volume loading during ACE+ES-LCE. These results suggest that training incorporating ACE+ES-LCE may be more effective in improving aerobic fitness in people with paraplegia than ACE alone.