Long Duration Activity and Metabolic Control After Spinal Cord Injury

Skeletal muscle is the largest endocrine organ in the body, playing an indispensable role in
glucose homeostasis. Spinal cord injury (SCI) prevents skeletal muscle from carrying out this
important function. Dysregulation of glucose metabolism precipitates high rates of metabolic
syndrome, diabetes, and other secondary health conditions (SHCs) of SCI. These SHCs exert a
negative influence on health-related quality of life (HRQOL). New discoveries support that a
low level of activity throughout the day offers a more effective metabolic stimulus than
brief, episodic exercise bouts. The proposed study will translate this emerging concept to
the population of individuals with SCI by using low-force, long-duration electrical muscle
stimulation to subsidize daily activity levels. Recently, we demonstrated that this type of
stimulation up-regulates key genes that foster an oxidative, insulin-sensitive phenotype in
paralyzed muscle. We will now test whether this type of activity can improve glucose
homeostasis and metabolic function in patients with chronic paralysis. We hypothesize that
improvements in metabolic function will be accompanied by a reduction in SHCs and a
concomitant improvement in self-reported HRQOL. The long-term goal of this research is to
develop a rehabilitation strategy to protect the musculoskeletal health, metabolic function,
and health-related quality of life of people living with complete SCI.