This proposed research is a revised competing continuation of a previous award. Our previous research showed that surface neuromuscular electrical stimulation (SNMES) can markedly increase muscle mass in individuals with complete spinal cord injury (SCI). We found pilot data that suggested that SNMES can also increase insulin action after complete SCI who are glucose tolerant. The general aim of this proposal is to extend our research to test whether exercise therapy can improve insulin action in complete SCI individuals who are either diabetic (DIA) or have impaired glucose tolerance (IGT).
The specific aims are: 1) Can 3 months of resistance or endurance exercise therapy be affective at "treating" IGT or DIA in complete, SCI individuals;and 2) What are the physiological adaptations (increased muscle mass, decreased fat mass, increased muscle endurance) are responsible for the improved insulin action following SNMES-induced exercise therapy. 100 subjects (84 to start the program, 78 expected to finish) with complete SCI (either paraplegic or quadriplegic) who are either IGT or DIA, 18 to 55 yrs of age, will be studied over the next 5 yrs. The resistance training will consist of knee extensions with ankle weights, two sessions of 40 lifts per week for 3 months. The weight used will be increased as needed. Endurance exercise therapy will use twitch stimulations for 30 minutes three times per week. A control group (no exercise) will be used for comparison. The following techniques will be used to assess the efficacy of the therapies;an oral glucose tolerance test for insulin action, magnetic resonance imaging for muscle size and lipid deposits, and SNMES for the fatigue tests. Rejection of the null hypothesis will show that those with a complete SCI can use either residence-based, self-administered resistance or endurance exercise therapy to treat IGT/DIA and reduce the risk of cardiovascular disease. In addition, physiological adaptations that best predict changes in insulin action will be determined. A blocked design will be used to separately evaluate IGT and DIA. This research will address methods to prevent diabetes which is an important health problem in SCI. This study will also use practical self-administered exercise protocols, and will test links between insulin action and modifiable physiological functions. Thus, this research has the potential to significantly benefit people with spinal cord injuries.
|Erickson, Melissa Lynn; Ryan, Terence E; Young, Hui-Ju et al. (2013) Near-infrared assessments of skeletal muscle oxidative capacity in persons with spinal cord injury. Eur J Appl Physiol 113:2275-83|
|Ryan, Terence E; Brizendine, Jared T; Backus, Deborah et al. (2013) Electrically induced resistance training in individuals with motor complete spinal cord injury. Arch Phys Med Rehabil 94:2166-73|
|Potter, Wm; Wang, L; McCully, Kk et al. (2013) Evaluation of a New (1)H/(31)P Dual-Tuned Birdcage Coil for (31)P Spectroscopy. Concepts Magn Reson Part B Magn Reson Eng 43:90-99|
|Ryan, Terence Edward; Southern, William Michael; Brizendine, Jared T et al. (2013) Activity-induced changes in skeletal muscle metabolism measured with optical spectroscopy. Med Sci Sports Exerc 45:2346-52|
|McCully, Kevin K; Mulcahy, Tara K; Ryan, Terence E et al. (2011) Skeletal muscle metabolism in individuals with spinal cord injury. J Appl Physiol 111:143-8|
|Gorgey, Ashraf S; Black, Christopher D; Elder, Christopher P et al. (2009) Effects of electrical stimulation parameters on fatigue in skeletal muscle. J Orthop Sports Phys Ther 39:684-92|
|Black, Christopher D; McCully, Kevin K (2008) Force per active area and muscle injury during electrically stimulated contractions. Med Sci Sports Exerc 40:1596-604|
|Black, Christopher D; McCully, Kevin K (2008) Muscle injury after repeated bouts of voluntary and electrically stimulated exercise. Med Sci Sports Exerc 40:1605-15|
|Gorgey, Ashraf S; Dudley, Gary A (2008) The role of pulse duration and stimulation duration in maximizing the normalized torque during neuromuscular electrical stimulation. J Orthop Sports Phys Ther 38:508-16|
|Black, Christopher D; Elder, Christopher P; Gorgey, Ashraf et al. (2008) High specific torque is related to lengthening contraction-induced skeletal muscle injury. J Appl Physiol 104:639-47|
Showing the most recent 10 out of 30 publications