Skeletal muscle undergoes profound changes in morphological, physiological, and biochemical character when subjected to prolonged periods of increased use. Although increased use may be brought about in a variety of ways, the results show consistent features. In particular, endurance exercise and chronic stimulation differ only in degree: the properties which change in response to exercise are also those which change at an early stage of stimulation; the properties which are resistant to change under exercise conditions change only after prolonged stimulation. There is therefore a hierarchy of stability in the properties of skeletal muscle which is revealed in its response to changing functional demands. The adaptive potential of muscle provides a logical framework for understanding neural influences on the emergence of fiber types during muscle development. It is also relevant to the study of pathological conditions which may involve a sustained departure from normal postural and locomotor patterns of activity.

The changes which follow cross reinnervation of mammalian fast and slow twitch muscles may reflect a capacity of skeletal muscle to respond adaptively to different functional requirements. This interpretation is supported by experiments in which long-term electrical stimulation was used both to reproduce and to oppose the effects of cross reinnervation.

SUMMARY1. The time course of contraction and relaxation in the isometric twitch of a rabbit soleus muscle becomes more rapid following tenotomy and spinal cord section. This increase in speed could be prevented by long-term electrical stimulation at frequencies of 5 or 10/sec. It was not prevented by stimulation at frequencies of 20 or 40/sec.2. Long-term electrical stimulation of fast rabbit and cat muscles at a frequency of 10/sec had a slowing effect on the time course of contraction and relaxation.3. It is concluded that the almost continuous low frequency discharge of motoneurones innervating postural muscles plays an important part in establishing and maintaining the slow time course of contraction of these muscles. The characteristically different speeds of contraction of fast and slow striated muscles can in this way be related to the different patterns of impulse activity which they normally receive.

We investigated the restorative potential of intensive electrical stimulation in a patient with long-standing quadriceps denervation. Stimulation started 18 months after injury. After 26 months, the thighs were visibly less wasted. Muscle cross-sectional areas, measured by computerized tomography, increased from 36.0 cm(2) to 57.9 cm(2) (right) and from 36.1 cm(2) to 52.4 cm(2) (left). Knee torque had become sufficient to maintain standing without upper extremity support. Biopsies revealed evidence of both growth and regeneration of myofibers. The results suggest that electrical stimulation may offer a route to the future development of mobility aids in patients with lower motor neuron lesions.