ABSTRACT / PROJECT SUMMARY This postdoctoral F32 Kirschstein NRSA proposes unique research and includes a comprehensive training plan in the study of functional electrical stimulation row training (FESRT) as a rehabilitation technique in individuals with spinal cord injuries (SCI). Individuals with spinal cord injuries have a greater morbidity and mortality risk from cardiovascular disease (CVD) than able-bodied individuals. The increased risk could be due, in part, to increased fat mass or dysregulated adipokine production leading to an impaired glucoregulatory control as a result of muscle atrophy and increased sedentary activity. Functional electrical stimulation (FES) exercise is increasingly being used in the acute and long-term rehabilitation of individuals with spinal cord injuries. Our lab uses this technique to induce leg extension and flexion in combination with voluntary upper body movements allowing for whole body rowing (FESRT). This exercise, incorporated into a 6-month training regimen, has been shown to increase aerobic fitness, attenuate gains in fat and loss of paralyzed muscle mass, and control blood glucose; hence, decreasing risk for CVD. However, there is currently a lack of information concerning retention of exercise training adaptations in those with SCI. Therefore, we propose a retrospective study to analyze body composition, adipose tissue adipokine production, serum adipokine concentrations, and glucoregulatory control in a group of individuals with SCI (n=31) who participated in 6 months of FESRT and either continued training (n=15) or returned to standard of care (n=16) (AIM 1). Additionally, these beneficial adaptations to FESRT may be proportional to exercise training intensity. Pulmonary limitations in SCI likely limit the attainment of sustainably vigorous FESRT exercise intensities. Therefore, we plan on studying changes in body composition, adipose tissue adipokine production, serum adipokine concentrations, and glucoregulatory control in relation to exercise training intensity in a prospective study that incorporates mechanical (non-invasive ventilation) and pharmaceutical (serotonin receptor agonist) ergogenic aids to increase ventilatory capacity (AIM 2). The ultimate purpose of this research is to optimize exercise training protocols for a population that both needs and seeks a broad range of benefits that exercise can confer. This F32 postdoctoral fellowship research and training plan will help develop and optimize rehabilitation strategies in individuals with spinal cord injuries and prepare me to advance as an independent researcher.

PROJECT NARRATIVE This work takes two approaches to examine body composition changes, adipokine production, and glucoregulatory control in response to 6-months of Functional Electrical Stimulation Row Training (FESRT) in individuals with spinal cord injuries (SCI). The first approach is a comparison analysis of individuals who initially completed 6 months FESRT (HL177037) and either continued FESRT within our training program or who ceased exercising. The second will take advantage of a concurrent study exploring mechanical and pharmaceutical interventions to overcome pulmonary limitations to FESRT and will examine the association between exercise intensity and changes in body composition, adipokine production, serum adipokine concentrations, and glucoregulatory control.