Lauren Hopps, Abby R. Fleming, Tiffany Adams, Jordan Saliba, Lee J. Winchester. University of Alabama, Tuscaloosa, AL.

BACKGROUND: The application of blood flow restriction (BFR) during low intensity resistance training has been found to increase muscular strength to a similar extent as high-intensity resistance training. Electrical muscular stimulation in everyday wheelchair users has been found to reverse vascular damage and improve muscle strength resulting from injury or inactivity. Utilizing EMS during BFR in the lower extremities may increase muscle hypertrophy and strength, improve vascular health, and contribute to improved function. The purpose of this study was to compare acute physiological responses to EMS with and without BFR among individuals that primarily use wheelchairs for activities of daily life. METHODS: 10 participants who require daily wheelchair use are being recruited for this study. Individuals meeting the inclusion criteria are participating in 3 randomized experimental sessions: EMS, BFR, and EMS+BFR. Upon arrival, participant anthropometrics are collected and then the participants are seated on a standard hospital bed in an upright position. After 5 minutes of rest, fingerprick lactate and posterior tibial artery ultrasound analysis are assessed. One of 3 treatment conditions are applied for 20 minutes and upon treatment cessation, lactate and arterial analyses are repeated. Repeated measures ANOVA will be used to assess differences between means, with an alpha level of 0.05 set for statistical significance. RESULTS: Preliminary data (n=4) for blood lactate show higher blood lactate post treatment in EMS compared with other groups (EMS pre = 1.05 + 0.22 mmol, post = 4.0 + 1.78 mmol; BFR pre = 0.93 + 0.29 mmol, post = 1.23 + 0.29 mmol; EMS+BFR pre = 1.02 + 0.09 mmol, post = 1.36 + 0.14 mmol). Posterior tibial artery diameter via ultrasonography seems to be similar among all conditions (EMS pre = 0.24 + 0.40 cm, post = 0.25 + 0.05 cm; BFR pre= 0.22 + 0.009 cm, post= 0.21 + 0.007 cm; EMS and BFR pre= 0.21 + 0.003 cm, post= 0.21 + 0.01 cm). Tibial artery volume flow follows a general trend for reduced volume flow after treatment, with BFR and EMS+BFR having the greatest change (EMS pre= 26.58 + 9.28 cc/min, post= 23.80 + 12.15 cc/min; BFR pre= 18.24 + 5.05, post= 14.26 + 5.06 cc/min; EMS and BFR pre= 18.29 + 10.88 cc/min, post = 10.74 + 2.96 cc/min). However, these results are preliminary and have not been statistically analyzed due to a very small sample number.

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