{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:54:43Z","timestamp":1782849283233,"version":"3.54.5"},"reference-count":63,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,21]],"date-time":"2023-10-21T00:00:00Z","timestamp":1697846400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Eunice Kennedy Shriver National Institute of Child Health &amp; Human Development","award":["K01HD087463"],"award-info":[{"award-number":["K01HD087463"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Maintaining healthy myofiber type and metabolic function early after spinal cord injury (SCI) may prevent chronic metabolic disorders. This study compares the effects of a 2\u20135 week combined (aerobic + resistance) neuromuscular electrical stimulation (Comb-NMES) regimen versus a sham control treatment on muscle protein signaling for glucose uptake, myofiber type distribution, and metabolic function. Twenty participants (31 \u00b1 9 years of age) with an SCI (C4-L1, AIS level A\u2013C) within 14 days of the SCI were randomly assigned to control (N = 8) or Comb-NMES (N = 12). Sessions were given three times per week. Fasting blood samples and vastus lateralis muscle biopsies were collected 24\u201348 h before or after the last session. Western blots were performed to quantify proteins, immunohistochemical analyses determined muscle myofiber distribution, and enzymatic assays were performed to measure serum glucose, insulin, and lipids. Our main findings include a decrease in fasting glucose (p &lt; 0.05) and LDL-C (p &lt; 0.05) levels, an upregulation of CamKII and Hexokinase (p &lt; 0.05), and an increase in type I (+9%) and a decrease in type IIx (\u221236%) myofiber distribution in response to Comb-NMES. Our findings suggest that maintaining healthy myofiber type and metabolic function may be achieved via early utilization of Comb-NMES.<\/jats:p>","DOI":"10.3390\/ijerph20206958","type":"journal-article","created":{"date-parts":[[2023,10,21]],"date-time":"2023-10-21T12:59:48Z","timestamp":1697893188000},"page":"6958","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The Effect of Lower Limb Combined Neuromuscular Electrical Stimulation on Skeletal Muscle Signaling for Glucose Utilization, Myofiber Distribution, and Metabolic Function after Spinal Cord Injury"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7260-5486","authenticated-orcid":false,"given":"Amal","family":"Alharbi","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35233, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Womack","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Molecular Biology, Entomology and Plant Pathology, Mississippi State University, Starkville, MS 39762, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0300-5141","authenticated-orcid":false,"given":"Matthew","family":"Farrow","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ceren","family":"Yarar-Fisher","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, OH 43210, USA"},{"name":"Department of Neuroscience, Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/0026-0495(94)90126-0","article-title":"Disorders of carbohydrate and lipid metabolism in veterans with paraplegia or quadriplegia: A model of premature aging","volume":"43","author":"Bauman","year":"1994","journal-title":"Metabolism"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1080\/10790268.2001.11753584","article-title":"Invited review carbohydrate and lipid metabolism in chronic spinal Cord Injury","volume":"24","author":"Bauman","year":"2001","journal-title":"J. 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