Neuromuscular rehabilitation by treadmill running or electrical stimulation after peripheral nerve injury and repair

Abstract

Numerous studies have been devoted to the regeneration of the motor pathway toward a denervated muscle after nerve injury. However, the regeneration of sensory muscle endings after repair by self-anastomosis are little studied. In previous electrophysiological studies, our laboratory showed that the functional characteristics of tibialis anterior muscle afferents are differentially affected after injury and repair of the peroneal nerve with and without chronic electrostimulation. The present study focuses on the axonal regeneration of mechano- (fibers I and II) and metabosensitive (fibers III and IV) muscle afferents by evaluating the recovery of their response to different test agents after nerve injury and repair by self-anastomosis during 10 wk of treadmill running (LSR). Data were compared with control animals (C), animals with nerve lesion and suture (LS), and animals with lesion, suture, and chronic muscle rehabilitation by electrostimulation (LSE) with a biphasic current modulated in pulse duration and frequency, eliciting a pattern mimicking the activity delivered by the nerve to the muscle. Compared with the C group, results indicated that 1) muscle weight was smaller in LS and LSR groups, 2) the fatigue index was greater in the LS group and smaller in the LSE group, 3) metabosensibility remained altered in the LS and LSE groups, and 4) mechanosensitivity presented a large increase of the activation pattern in the LS and LSE groups. Our data indicated that chronic muscle electrostimulation partially favors the recovery of muscle properties (i.e., muscle weight and twitch response were close to the C group) and that rehabilitation by treadmill running also efficiently induced a better functional muscle afferent recovery (i.e., the discharge pattern was similar to the C group). The effectiveness of the chronic electromyostimulation and the treadmill exercise on afferent recovery is discussed with regard to parameters listed above.

Treadmill training promotes axon regeneration in injured peripheral nerves

“…Exercise, and in particular treadmill training, has been advocated for this purpose for patients with spinal cord injuries for some time (Edgerton, et al, 2004), but only recently has attention been devoted to its potential for treating peripheral nerve injuries. Marqueste et al (2004) found that treadmill training after common fibular nerve transection and repair results in better mechano-and metabosensitive afferent recovery in rats (Marqueste, et al, 2004). A more recent report showed a positive effect of treadmill training on axon regeneration in rats after sciatic nerve crush (Seo, et al, 2006).…”

“…Intensity was manipulated by altering treadmill speed. Continuous training has been used more extensively in animal exercise studies and has been applied in previous studies of exercise after peripheral nerve injury (Marqueste, et al, 2004, Seo, et al, 2006. However, the preferred approach to patterned running for rodents is brief intervals of high-intensity running interspersed with periods of rest (De Bono, et al, 2006).…”

“…Pre-injury exercise may "prime" adult dorsal root ganglion neurons for increased axon regeneration. In another recent study, treadmill training was found to enhance sensory functional recovery, as measured from nerve recordings (Marqueste, et al, 2004). However, there is little direct evidence of an effect of post-injury exercise on axon regeneration in injured peripheral nerves.…”

Efeito da associação da laserterapia com a natação no reparo morfológico do nervo isquiático e na recuperação funcional de ratos submetidos à axonotmese

“…Several authors have shown beneficial results by using exercise, namely through greater budding and extension of the axons 12 , increased number of myelinated nerve fibers, 13,14 and improved functional recovery of the injured member [15][16][17] . There have been extensive discussions in the scientific community 18 regarding recommendations as per the type of exercise as well as its duration and intensity.…”

Exercício imediato versus tardio na regeneração do nervo isquiático de ratos após axoniotmese: análise histomorfométrica e funcional

“…For this, low-frequency phased electrical stimulation 5 , chronic low-frequency electrostimulation 6 and physical exercise [7][8][9][10][11][12] have been used. Kinesiotherapy is prominent among physical therapy methods for rehabilitation following peripheral nerve injury.…”