Research

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.

ModerateSupportsMEDIUM confidence
Resistance training (RT) using NMES on the quadriceps produced the largest and most consistent increases in SMM of all intervention modalities.
Jordan M. Fenton et al. · Disability and Rehabilitation · 2022

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

systematic_review · n=303Cited 10×
Read the paper
DOI resolved against Crossref · corpus check 2026-06-10

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