Neuromuscular Electrical Stimulation Induces Beneficial Adaptations in the Extracellular Matrix of Quadriceps Muscle After Anterior Cruciate Ligament Transection of Rats

Abstract

This study showed that ACL transection increases CT content and MMP-2 mRNA levels and induces rapid changes in basement membranes, causing net degradation of type IV collagen during the first 2 wks after ACL injury. Furthermore, clinical-like NMES minimized the accumulation of CT density, regulated the MMP-2 mRNA levels, and increased both type IV collagen mRNA and protein levels.

Pharmacological inhibition of myostatin protects against skeletal muscle atrophy and weakness after anterior cruciate ligament tear

“…In general, excessive ECM accumulation can interfere with lateral force transmission between muscle fibers, leading to increased susceptibility to eccentric injuries . While less is known about muscle fibrosis and ECM accumulation in patients with ACL tears, collagen accumulation was reported in the quadriceps muscles of rats with ACL tears . In addition to inducing protein degradation, myostatin signaling can also induce the expression of type I collagen and several genes that regulate ECM structure and function .…”

Contribution of Neuromuscular Factors to Quadriceps Asymmetry After Anterior Cruciate Ligament Reconstruction

“…To treat alterations in the involved limb, emerging evidence indicates that eccentric exercise after ACLR is particularly beneficial to promoting muscle volume, 53 selective recruitment of type II fibers, and volitional muscle activity. 10 In animal models, highintensity neuromuscular electrical stimulation reduced fibrotic tissue formation 54 and atrogene levels of muscle atrophy. 55 Promising data are also available that support whole-body-vibration training to promote improved neuromuscular control 56 and blood-flow-restriction therapy to increase fiber-type recruitment, 57 satellite cell proliferation, 58 muscle activation, 59 and muscle volume.…”

Combination of eccentric exercise and neuromuscular electrical stimulation to improve biomechanical limb symmetry after anterior cruciate ligament reconstruction

“…Thus, it seems plausible that the combination of NMES and eccentric exercise may have been more effective, as a variety of modalities that are able to target both the strength as well as the neural components of muscle may have been able to better augment movement, and promote utilization of the quadriceps muscle during activity (Herman et al, 2008). Interestingly in a rodent model, NMES interventions following ACL transection have recently been found to help mitigate muscle atrophy (Durigan et al, 2014a) and promote beneficial adaptations to the quadriceps extracellular matrix by reducing the formation of fibrotic tissue following ACL injury (Durigan et al, 2014b). Thus the underlying benefits of NMES may not yet be well understood.…”

“…This result is in agreement with the previous literature (Lewek et al, 2002; Oberländer et al, 2013; Snyder-Mackler et al, 1991) and indicates that interventions that are capable of improving quadriceps strength, such as the one employed in this current study, should positively improve dynamic movement in ACL reconstructed patients. Further, animal models seem to indicate that NMES may have some underlying neuromuscular benefits that promote muscle function (Durigan et al, 2014a; Durigan et al, 2014b), which in turn may lead to improved performance during dynamic tasks. Future work studying the ability of NMES to mitigate harmful alterations in muscle morphology in a clinical population seems justified to understand the full benefits of this type of therapeutic intervention.…”