SUMMARY The proposed research project examines the impact of early utilization of a novel neuromuscular electrical stimulation (NMES) program on skeletal muscle metabolism and overall metabolic health in individuals with sub-acute, complete spinal cord injuries (SCI). Background: Individuals with SCI live longer than before and live to an age where metabolic disorders become highly prevalent. Due to loss of mobility and severe skeletal muscle atrophy, obesity, glucose intolerance, and peripheral insulin resistance develop soon after the onset of SCI. These abnormalities are thought to contribute to the increased diabetes disease risk and accelerated aging process in the SCI population. As a result of these trends, overall burden of complications, economic impact and reduced quality of life are increasing. Until there are effective treatments for SCI, it is imperative to develop effective interventions to mitigate metabolic disorders that develop in individuals with SCI. There is a lack of experienced clinicians and researchers who have expertise on metabolic health and SCI. Additionally, there is a lack of adequate early interventions to prevent or reduce the degree of metabolic dysfunction that follows injury. Implications: The growing population and increased age of individuals with SCI calls for novel and interdisciplinary rehabilitation approaches to care in order to reduce the economic burden and enhance the quality of life. Next Steps: Interdisciplinary rehabilitation researchers are needed to lead the investigations necessary to address the aforementioned problems and challenges. As a candidate for this training and research proposal, I am uniquely trained and motivated to commit my career to addressing the challenges associated with the current trends. My prior research and clinical training ideally position me for an independent research career. During my doctoral and post-doctoral training, I was actively engaged in research on the development of exercise and nutrition interventions to improve musculoskeletal and metabolic health in individuals with SCI. I bring to this research a diverse training background in physical therapy and rehabilitation, human physiology, and skeletal muscle biology as indicated by my publication record. My postdoctoral experience fostered my abilities to direct truly translational research by extending clinical research experiences to mechanistic studies in skeletal muscle and molecular biology. The specific focus of my work that I will build upon involved understanding the effects of NMES on activity of intracellular signaling pathways for glucose utilization and muscle growth. I conducted all aspects of SCI projects – from subject recruitment, to clinical studies, to molecular and histological assays in the laboratory. My postdoctoral experiments revealed novel findings, some of which are detailed in the Research Strategy, providing strong support for the hypotheses of my proposal. The early results of thes...