Role of Activity in Defining Metabolic and Contractile Adaptations After SCI

Spinal cord injury (SCI) can lead to moderate to severe muscle paralysis, loss of lower-limb functionality and often results in a reduced physical activity. As a consequence, people with SCI demonstrate numerous metabolic and contractile transformations such as leg muscles atrophy, a transformation from slow, fatigueresistant fibers to fast, fatigable fibers, a decreased vascularization. Appropriate exercise and most especially exercise using functional electrical stimulation (FES) is now well-known to have beneficial effects on muscle characteristics, force output, exercise capacity, but also bone mineral density and cardiovascular parameters. For example, increases in muscle mass and strength, oxidative capacity and vascularization have been reported after several weeks of FES exercise (FES-strengthening, FES-cycling or FES-rowing) in people with SCI.