Muscle and bone plasticity after spinal cord injury: review of adaptations to disuse and to electrical muscle stimulation

Shauna Dudley-Javoroski; Richard K Shields

doi:10.1682/JRRD.2007.02.0031

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Muscle and bone plasticity after spinal cord injury: review of adaptations to disuse and to electrical muscle stimulation

Journal article

Open access

Peer reviewed

Muscle and bone plasticity after spinal cord injury: review of adaptations to disuse and to electrical muscle stimulation

Shauna Dudley-Javoroski and Richard K Shields

Journal of rehabilitation research and development, Vol.45(2), pp.283-296

2008

DOI: 10.1682/JRRD.2007.02.0031

PMCID: PMC2744487

PMID: 18566946

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Abstract

The paralyzed musculoskeletal system retains a remarkable degree of plasticity after spinal cord injury (SCI). In response to reduced activity, muscle atrophies and shifts toward a fast-fatigable phenotype arising from numerous changes in histochemistry and metabolic enzymes. The loss of routine gravitational and muscular loads removes a critical stimulus for maintenance of bone mineral density (BMD), precipitating neurogenic osteoporosis in paralyzed limbs. The primary adaptations of bone to reduced use are demineralization of epiphyses and thinning of the diaphyseal cortical wall. Electrical stimulation of paralyzed muscle markedly reduces deleterious post-SCI adaptations. Recent studies demonstrate that physiological levels of electrically induced muscular loading hold promise for preventing post-SCI BMD decline. Rehabilitation specialists will be challenged to develop strategies to prevent or reverse musculoskeletal deterioration in anticipation of a future cure for SCI. Quantifying the precise dose of stress needed to efficiently induce a therapeutic effect on bone will be paramount to the advancement of rehabilitation strategies.

Bone Density

Humans

Adaptation, Physiological - physiology

Muscle, Skeletal - innervation

Electric Stimulation Therapy

Exercise Therapy

Biomechanical Phenomena

Bone and Bones - physiopathology

Animals

Neuronal Plasticity - physiology

Muscle, Skeletal - physiopathology

Spinal Cord Injuries - rehabilitation

Spinal Cord Injuries - physiopathology

Details

Title: Subtitle: Muscle and bone plasticity after spinal cord injury: review of adaptations to disuse and to electrical muscle stimulation
Creators: Shauna Dudley-Javoroski - Graduate Program in Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, IA 52242-1190, USA
Richard K Shields
Resource Type: Journal article
Publication Details: Journal of rehabilitation research and development, Vol.45(2), pp.283-296
DOI: 10.1682/JRRD.2007.02.0031
PMID: 18566946
PMCID: PMC2744487
NLM abbreviation: J Rehabil Res Dev
ISSN: 0748-7711
eISSN: 1938-1352
Publisher: United States
Grant note: R01 NR010285 / NINR NIH HHS R01 NR-010285-05 / NINR NIH HHS R01 NR010285-05 / NINR NIH HHS
Language: English
Date published: 2008
Academic Unit: Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
Record Identifier: 9984046825202771

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