Femoral artery blood flow and microcirculatory perfusion during acute, low-level functional electrical stimulation in spinal cord injury

Objective Functional electrical stimulation (FES) may help to reduce the risk of developing macro- and microvascular complications in people with SCI. Low-intensity FES has significant clinical potential since this can be applied continuously throughout the day. This study examines the acute effects of low intensity FES using wearable clothing garment on vascular blood flow and oxygen consumption in people with SCI. Design Cross-sectional observation study Methods Eight participants with a motor complete SCI received 4x3 minutes of unilateral FES to the gluteal and hamstring muscles. Skin and deep femoral artery blood flow and oxygen consumption were measured at baseline and during each bout of stimulation. Results Femoral artery blood flow increased by 18.1% with the application of FES (P=0.02). Moreover, femoral artery blood flow increased further during each subsequent block of FES (P=0.004). Skin perfusion did not change during an individual block of stimulation (P=0.66). Skin perfusion progressively increased with each subsequent bout (P0.05). Conclusion Low-intensity FES acutely increased blood flow during stimulation, with a progressive increase across subsequent FES bouts. These observations suggest continuous, low-intensity FES may represent a practical and effective strategy to improve perfusion and reduce the risk of vascular complications. Correspondence: Dick Thijssen, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Byrom Street, L3 3AF, Liverpool, United Kingdom. Email: d.thijssen@ljmu.ac.uk. Tel: +44 (0)151 904 6264 Fax: +44 (0)151 904 6284 Disclosures The authors declare that there is no conflict of interest. This study was supported by funds received from the Stoke Mandeville-Masson research awards. The funding source had no such involvement in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. This research has previously been presented at IFESS conference 2017. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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