Functional electrical stimulation (FES): muscle histochemical analysis

Greve, Júlia Maria D’Andréa; Muszkat, R; Schmidt, Brian J.; Chiovatto, J; Barros, Turíbio; Batisttella, Linamara Rizzo

doi:10.1038/sc.1993.119

Cited by 43 publications

(53 citation statements)

References 9 publications

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“…The 15% increase in quadriceps CSA confirms previous studies that showed muscle increase in chronic spinal cord-injured patients using NMES in other modalities of therapy [3,19]. Two studies suggest NMES does not reverse muscle atrophy in chronic spinal cord-injured patients [1,16] but can promote moderate increases after muscle contractions against some external load [20,21]. Scremin et al [23] observed an increase of 31% in the CSA of the rectus femoris after 98.1 ± 9.1 sessions of FES cycle-ergometer training with progressive resistance as shown on CT. Mohr et al reported an increase of 12% in CSA of the thigh after FES cycle-ergometer with progressive load for 12 months three times a week [19].…”

Section: Discussionsupporting

confidence: 82%

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Electrical Stimulation During Gait Promotes Increase of Muscle Cross-sectional Area in Quadriplegics: A Preliminary Study

Abreu

Cliquet

Rondina

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Increases in muscular cross-sectional area (CSA) occur in quadriplegics after training, but the effects of neuromuscular electrical stimulation (NMES) along with training are unknown. Thus, we addressed two questions: (1) Does NMES during treadmill gait training increase the quadriceps CSA in complete quadriplegics?; and (2) Is treadmill gait training alone enough to observe an increase in CSA? Fifteen quadriplegics were divided into gait (n = 8) and control (n = 7) groups. The gait group performed training with NMES for 6 months twice a week for 20 minutes each time. After 6 months of traditional therapy, the control group received the same gait training protocol but without NMES for an additional 6 months. Axial images of the thigh were acquired at the beginning of the study, at 6 months (for both groups), and at 12 months for the control group to determine the average quadriceps CSA. After 6 months, there was an increase of CSA in the gait group (from 49.8 ± 9.4 cm 2 to 57.3 ± 10.3 cm 2 ), but not in the control group (from 43.6 ± 7.6 cm 2 to 41.8 ± 8.4 cm 2 ). After another 6 months of gait without NMES in the control group, the CSA did not change (from 41.8 ± 8.4 cm 2 to 41.7 ± 7.9 cm 2 ). The increase in quadriceps CSA after gait training in patients with chronic complete quadriplegia appears associated with NMES.

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Section: Discussionsupporting

confidence: 82%

“…However, FES contractions without resistance appear not to prevent muscle atrophy or to increase muscle CSA in the early and chronic phases of spinal cord injury [1,16]. Thus, these studies suggest the muscle hypertrophy is directly associated with the force produced during electrical stimulation training.…”

Section: Introductionmentioning

confidence: 82%

Electrical Stimulation During Gait Promotes Increase of Muscle Cross-sectional Area in Quadriplegics: A Preliminary Study

Abreu

Cliquet

Rondina

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…After the training period the inter®brillar tissue had disappeared. The accumulation of inter®brillar tissue demonstrated in muscle a few years after SCI 47 may represent an early stage of the derangement fully developed in some of our subjects with a long (more than 10 years) duration of injury. The large variation in time after injury could, to a large extent, explain the striking di erence in the histological muscle structure between our subjects before the training and also the di erences between the present and the above mentioned studies, which included only subjects with more recent SCI.…”

Section: Thigh Girthmentioning

confidence: 77%

“…12,45,47 In the ®rst ®ve of the subjects included in the present study we have previously reported a transformation of MHC in single ®bres. 12 The transformation from isoform IIB to isoform IIA was a continuous process throughout the full time of training ( Figure 10).…”

Section: Fibre Types Mhc Analysis On Homogenatesmentioning

confidence: 84%

Long term adaptation to electrically induced cycle training in severe spinal cord injured individuals

et al. 1997

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Spinal cord injured (SCI) individuals most often contract their injury at a young age and are deemed to a life of more or less physical inactivity. In addition to the primary implications of the SCI, severe SCI individuals are stigmatized by conditions related to their physically inactive lifestyle. It is unknown if these inactivity related conditions are potentially reversible and the aim of the present study was, therefore, to examine the e ect of exercise on SCI individuals. Ten such individuals (six with tetraplegia and four with paraplegia; age 27 ± 45 years; time since injury 3 ± 23 years) were exercise trained for 1 year using an electrically induced computerized feedback controlled cycle ergometer. They trained for up to three times a week (mean 2.3 times), 30 min on each occasion. The gluteal, hamstring and quadriceps muscles were stimulated via electrodes placed on the skin over their motor points. During the ®rst training bouts, a substantial variation in performance was seen between the subjects. A majority of them were capable of performing 30 min of exercise in the ®rst bout; however, two individuals were only able to perform a few minutes of exercise. After training for 1 year all of the subjects were able to perform 30 min of continuous training and the work output had increased from 4+1 (mean+SE) to 17+2 Kilo Joules per training bout (P50.05). The maximal oxygen uptake during electrically induced exercise increased from 1.20+0.08 litres per minute measured after a few weeks habituation to the exercise to 1.43+0.09 litres per minute after training for 1 year (P50.05).Magnetic resonance cross sectional images of the thigh were performed to estimate muscle mass and an increase of 12% (mean, P50.05) was seen in response to 1 year of training. In biopsies taken before exercise various degrees of atrophy were observed in the individual muscle ®bres, a phenomenon that was partially normalized in all subjects after training.The ®bre type distribution in skeletal muscles is known to shift towards type IIB ®bres (fast twitch, fast fatiguable, glycolytic ®bres) within the ®rst 2 years after the spinal cord injury. The muscle in the present investigation contained of 63% myosin heavy chain (MHC) isoform IIB, 33% MHC isoform IIA (fast twitch, fatigue resistant) and less than 5% MHC isoform I (slow twitch) before training. A shift towards more fatigue resistant contractile proteins was found after 1 year of training. The percentage of MHC isoform IIA increased to 61% of all contractile protein and a corresponding decrease to 32% was seen in the fast fatiguable MHC isoform IIB, whereas MHC isoform I only comprised 7% of the total amount of MHC. This shift was accompanied by a doubling of the enzymatic activity of citrate synthase, as an indicator of mitochondrial oxidative capacity.It is concluded that inactivity-associated changes in exercise performance capacity and skeletal muscle occurring in SCI individuals after injury are reversible, even up to over 20 years after the injury. It follows that electricall...

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“…16 Electrical stimulation has been shown to improve muscle ®ber structure and function. 15,17,18 In animal models, investigators have reported the deleterious e ect of denervation on postreceptor insulin action, 19 exercise-induced glucose uptake, 20 insulin receptor binding, 21,22 receptor phosphorylation, 21 and the glucose transporter protein (GLUT-4). 23 ± 25 In a recent study, 26 individuals with tetraplegia were found to have a marked reduction in whole body glucose transport that appeared to be due to a proportional reduction in muscle mass.…”

Section: Determinants Of Insulin Resistancementioning

confidence: 99%

Risk factors for atherogenesis and cardiovascular autonomic function in persons with spinal cord injury

et al. 1999

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Persons with spinal cord injury (SCI) have been recognized to have several metabolic changes that adversely impact their risk for cardiovascular disease. An increased prevalence of disorders of carbohydrate metabolism and dyslipidemia may be related predominantly to paralysis with immobilization and associated loss of lean body tissue and gain in relative adiposity. Studies have reported an increased risk of vascular disease in those with SCI. As such, an understanding of the constellation of carbohydrate and lipid changes that occur after SCI is relevant to the clinical practice of medicine in this population. Oral glucose tolerance testing and associated studiesImpaired glucose tolerance and diabetes mellitus are more prevalent in individuals with SCI than in those who are able-bodied. 1 ± 4 In most of the individuals with SCI and abnormal carbohydrate tolerance, resistance to insulin mediation of glucose uptake by peripheral tissues may be demonstrable. In the presence of insulin resistance, the normal homeostatic response to glucose challenge is increased pancreatic b-cell secretion of insulin. If the compensatory response of the pancreas is insu cient to control the serum glucose concentration, worsening of carbohydrate tolerance will ensue.Bauman et al 3 performed a 75 g oral glucose tolerance test in 100 male veterans with SCI and in 50 able-bodied veteran controls. According to criteria established by the World Health Organization, 5 22% of those with SCI were diabetic whereas only 6% of the control group were diabetic. Eighty-two per cent of the controls had normal oral glucose tolerance, compared with 38% of those with quadriplegia and 50% of those with paraplegia. Subjects with SCI had signi®cantly higher mean plasma glucose and insulin values at several points during the oral glucose tolerance test when compared with controls ( Figure 1). In subgroups, determinants of insulin sensitivity were measured: per cent lean body mass, per cent fat mass, and cardiopulmonary ®tness. Values for insulin sensitivity were linearly related with those of ®tness (VO 2 max) determined from a progressive incremental upper-body exercise stress test. Insulin sensitivity was suggestively correlated with lean body mass, and negatively correlated with body fat. Thus, in a relatively small subgroup of untrained subjects with paraplegia, the strongest determinant of insulin sensitivity was cardiopulmonary ®tness.In 201 non-veteran subjects with SCI, Bauman et al 2 studied the relationship of oral carbohydrate tolerance after a 75 g glucose load to several variables, including level and completeness of lesion, gender, ethnicity, age, duration of injury, and anthropometric measures. Of the total group, 27 (13%) had diabetes mellitus and 56 (29%) had impaired glucose tolerance. 2,6 The subjects with complete tetraplegia had sign®cantly worse carbohydrate tolerance (Figure 2) and were more frequently classi®ed with a disorder of carbohydrate tolerance than the other neurological de®cit subgroups. 2 There were no signi®cant gend...

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Functional electrical stimulation (FES): muscle histochemical analysis

Abstract: The mean total number of fibres in each sample was 256 ± 12.3. The results showed that the sizes of the three types of fibres were not modified with the use of FES; the number of type IIa fibres increased in a significant fashion, after using of FES.

Cited by 43 publications

References 9 publications

Electrical Stimulation During Gait Promotes Increase of Muscle Cross-sectional Area in Quadriplegics: A Preliminary Study

Electrical Stimulation During Gait Promotes Increase of Muscle Cross-sectional Area in Quadriplegics: A Preliminary Study

Long term adaptation to electrically induced cycle training in severe spinal cord injured individuals

Risk factors for atherogenesis and cardiovascular autonomic function in persons with spinal cord injury

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