{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T22:51:52Z","timestamp":1782514312639,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,12,4]],"date-time":"2020-12-04T00:00:00Z","timestamp":1607040000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003653","name":"Korea National Institute of Health","doi-asserted-by":"publisher","award":["R01HL117037"],"award-info":[{"award-number":["R01HL117037"]}],"id":[{"id":"10.13039\/501100003653","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The prevalence of cardiometabolic disease following spinal cord injury is known to be high. However, it is unknown whether engaging in high\u2010intensity exercise, which is advocated by recent guidelines, is beneficial or feasible for these individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the effects of high\u2010intensity, whole\u2010body exercise on the prevalence of cardiometabolic disease in individuals with spinal cord injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Combination of a randomized controlled trial and an open label intervention study of functional electrical stimulation legs plus arms rowing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Outpatient academic rehabilitation hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Forty individuals with spinal cord injury, with American Spinal Injury Association (ASIA) impairments scales A\u2010D and neurological levels of injury C1\u2010T12.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>Six months of high\u2010intensity, hybrid\u2010functional electrical stimulation rowing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Change in VO<jats:sub>2max<\/jats:sub>, serum lipids, and insulin resistance, prevalence of cardiometabolic disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Individuals averaged 42.1\u00a0\u00b1\u200922.0\u00a0minutes of hybrid\u2010functional electrical stimulation rowing a week over an average of 1.69 sessions per week over the 6\u00a0months of intervention. This amounted to an average of 170.9\u00a0\u00b1\u2009100\u2009km rowed, at a mean heart rate of 82.7% of individualized maximum. Only one of 40 individuals met current exercise guidelines for the full 6\u00a0months. VO<jats:sub>2max<\/jats:sub> increased significantly (<jats:italic>P<\/jats:italic>\u00a0&lt;\u2009.001), yet prevalence of cardiometabolic disease did not change significantly (decrease from 22.5% to 20%, <jats:italic>P<\/jats:italic>\u00a0=\u2009.70). Hemoglobin A1c did decrease significantly over this time (<jats:italic>P<\/jats:italic>\u00a0=\u2009.01), although serum lipids and fasting glucose\/insulin levels were unchanged. In exploratory subanalyses assessing individuals injured \u226412\u2009months, those with more chronic injuries decreased their triglyceride\u2010to\u2010high\u2010density lipoprotein (HDL) ratio (<jats:italic>P<\/jats:italic>\u00a0=\u2009.04), a marker of cardiac mortality. Stratifying by neurological level of injury, individuals with paraplegia had worsened low\u2010density lipoprotein (LDL) level (<jats:italic>P<\/jats:italic>\u00a0=\u2009.02) and total cholesterol\u2010to\u2010HDL ratio (<jats:italic>P<\/jats:italic>\u00a0=\u2009.04) over the 6\u2010month intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sustained high\u2010intensity exercise with hybrid functional electrical stimulation rowing does not decrease the prevalence of cardiometabolic disease after spinal cord injury.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.12507","type":"journal-article","created":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T19:09:55Z","timestamp":1602097795000},"page":"937-944","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Cardiometabolic Effects of High\u2010Intensity Hybrid Functional Electrical Stimulation Exercise after Spinal Cord Injury"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7121-8678","authenticated-orcid":false,"given":"Ryan","family":"Solinsky","sequence":"first","affiliation":[{"name":"Spaulding Rehabilitation Hospital  Boston MA"},{"name":"Department of Physical Medicine and Rehabilitation Harvard Medical School  Boston MA"},{"name":"Spaulding Research Institute  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Mercier","sequence":"additional","affiliation":[{"name":"Spaulding Rehabilitation Hospital  Boston MA"},{"name":"Department of Physical Medicine and Rehabilitation Harvard Medical School  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen","family":"Picard","sequence":"additional","affiliation":[{"name":"Spaulding Rehabilitation Hospital  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Andrew","family":"Taylor","sequence":"additional","affiliation":[{"name":"Spaulding Rehabilitation Hospital  Boston MA"},{"name":"Department of Physical Medicine and Rehabilitation Harvard Medical School  Boston MA"},{"name":"Spaulding Research Institute  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a1aa68"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0b013e31802f0247"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2016.07.002"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2007.02.031"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-200512000-00009"},{"key":"e_1_2_6_7_1","first-page":"122","article-title":"Stakeholder perceptions and clinical assessments of cardiometabolic disease after spinal cord injuries and disorders","volume":"25","author":"Solinsky R","year":"2019","journal-title":"Top Spinal Cord Inj Rehabil"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1042\/CS20070332"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092576"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.012257"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.772822"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1741826711400512"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2011.03.020"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41393-017-0017-3"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2014.04.001"},{"key":"e_1_2_6_16_1","volume-title":"American College of Sports Medicine Guidelines for Exercise Testing and Prescription","author":"Pescatello LS","year":"2014"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.12.2191"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1310\/sci2404-379"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2009.33"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.161.22.2685"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2009.446"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1139\/H10-091"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2014.12.005"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1249\/00005768-198406000-00012"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-199709000-00006"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.10.044"}],"container-title":["PM&amp;R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.12507","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pmrj.12507","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.12507","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T16:47:54Z","timestamp":1693241274000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pmrj.12507"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,4]]},"references-count":25,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1002\/pmrj.12507"],"URL":"https:\/\/doi.org\/10.1002\/pmrj.12507","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,4]]},"assertion":[{"value":"2020-06-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}