Short-term maximal-intensity resistance training increases volitional function and strength in chronic incomplete spinal cord injury: a pilot study.

Background and Purpose: Recent research shows that individuals with an incomplete spinal cord injury (SCI) have a reserve of forcegenerating capability that is observable during repeated intermittent maximal volitional effort contractions. Previous studies suggest that increased neural drive contributes to the enhanced short-term forcegenerating capabilities. Whether this reserve can be harnessed with repeated training is unclear. The purpose of this pilot study was to investigate the effects of 4 weeks of maximal-intensity resistance training, compared with conventional progressive resistance training, on lower extremity function and strength in chronic incomplete SCI. Methods: Using a randomized crossover design, 5 individuals with chronic(>1yearpostinjury)SCIAmericanSpinalInjuryAssociation Impairment Scale classification C or D were tested before and after 4 weeks of both maximal-intensity training and progressive resistance training paradigms. Outcomes measures included the 6-Minute Walk Test, the Berg Balance Scale, and peak isometric torque for strength of lower extremity muscles. Results: Maximal-intensity resistance training was associated with an average increase of 12.19 ± 8.29 m on the 6-Minute Walk Test, 4 ± 1.9pointsontheBergBalanceScale,4 ± 4.5pointsonthelower extremity motor score), while no changes on the above scores were seen with conventional training. Furthermore, significant increases in peak volitional isometric torques (mean increase = 20 ± 8N m) were observed following maximal-intensity resistance training when