CHEST Guidelines-Noninvasive-Ventilation-During-Functional-Electric

Noninvasive-Ventilation-During-Functional-Electric

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The article discusses the role of noninvasive ventilation (NIV) during functional electrical stimulation (FES) rowing in individuals with high-level spinal cord injury (SCI). SCI often leads to muscle paralysis and decreased physical capacity, which can result in reduced aerobic exercise capability and increased cardiometabolic risks. While FES combined with upper body exercise can enhance muscular participation and exercise intensity, it is limited by the reduced peak ventilation in SCI patients, particularly those with high-level injuries.<br /><br />The study by Vivodtzev et al. examined the acute effects of NIV during FES rowing exercises in people with SCI, using a crossover, double-blind, randomized trial. Results showed that NIV improved breathing patterns but did not significantly enhance peak alveolar ventilation (VApeak), peak oxygen consumption (VO2peak), or oxygen uptake efficiency slope (OUES). Time since injury was noted to influence OUES changes with NIV, showing improvement predominantly in patients within six years post-injury. A subset of patients meeting specific VO2peak criteria did demonstrate improvements in OUES with NIV intervention.<br /><br />The study suggests that while NIV can positively affect ventilatory efficiency, further research is necessary to understand its potential long-term benefits and mechanisms when combined with FES training. Future research may focus on patient characteristics most likely to benefit, the effects of different exercise intensities, particularly high-intensity interval training (HIIT), and the potential long-term influence of NIV on exercise capacity and cardiometabolic risk reduction.<br /><br />Overall, NIV could potentially be an add-on to enhance the benefits of exercise rehabilitation in SCI patients, but its effectiveness needs to be explored further through extended studies on patient variability, exercise intensity, and long-term outcomes.

Keywords

noninvasive ventilation

functional electrical stimulation

spinal cord injury

FES rowing

cardiometabolic risks

ventilatory efficiency

high-level SCI

exercise rehabilitation

oxygen consumption

high-intensity interval training