This study was aimed to evaluate the effects of gait training with neuromuscular electric stimulation (NMES) on skeletal and cardio-respiratory systems of full quadriplegic patients (C4-C8). Aerobic power (VO2), carbon dioxide production (VCO2), minute ventilation (VE), heart rate (HR), blood pressure (BP), energy consumption, bone markers analysis (osteocalcin, bone alkaline phosphatase, pyridinoline, and deoxypyridinoline) and bone densitometry (DEXA) of the femoral neck and total femur were performed at baseline and six months later. Eleven patients walked on ergometric wake, with NMES and discharge of 60 - 70% of body weight, during six months, twice a week, 20 minutes daily. Ten patients did not perform the gait. Within the gait group, 81.8% showed significant increases of formation markers, of which 72.7% also presented with reduced bone resorption. Within the control group, 20% showed increased bone formation. DEXA results were, in general, opposite to those of bone markers. Cardio-respiratory tests showed a significant increase for VO2 l/min (36%), VCO2 (42.97%), VE (30.48%), SBP mmHg (4.8%) and energy consumption kcal/min (37.68%). In the control group, only VO2 l/min showed a significant increase (26.29%). Gait training with NMES was more efficient in increasing bone formation rates and aerobic power in quadriplegic patients.
Quadriplegia; Gait; Electrical stimulation; Bone mineral density; Oxygen consumption; Metabolism; Respiration
