Mixed
Neuromuscular electrical stimulation-based resistance training (NMES-RT) is the most robust and consistent intervention for increasing skeletal muscle mass in the paralyzed limbs of persons with chronic, motor complete spinal cord injury.
For individuals with chronic, complete spinal cord injury aiming to increase muscle mass, NMES-based resistance training (specifically the Dudley Protocol) is the most effective current strategy. This involves performing 3-4 sets of 10 electrically stimulated knee extensions twice weekly with progressive resistance. While other methods like FES cycling or pharmacological treatments exist, NMES-RT yields the largest and most consistent muscle growth, particularly in the quadriceps.
Resistance training (RT) using NMES on the quadriceps produced the largest and most consistent increases in SMM of all intervention modalities.
Why this rating
The review notes an 'overall high risk of bias' and 'high degree of heterogeneity' across the included studies, despite the consistency of the NMES-RT findings.
Source
Protocols aiming to increase muscle mass in persons with motor complete spinal cord injury: a systematic review
Jordan M. Fenton et al. · Disability and Rehabilitation · 2022
DOI 10.1080/09638288.2022.2063420
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