Musculoskeletal plasticity after acute spinal cord injury: effects of long-term neuromuscular electrical stimulation training

Richard K Shields; Shauna Dudley-Javoroski

doi:10.1152/jn.01181.2005

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Musculoskeletal plasticity after acute spinal cord injury: effects of long-term neuromuscular electrical stimulation training

Journal article

Open access

Peer reviewed

Musculoskeletal plasticity after acute spinal cord injury: effects of long-term neuromuscular electrical stimulation training

Richard K Shields and Shauna Dudley-Javoroski

Journal of neurophysiology, Vol.95(4), pp.2380-2390

04/2006

DOI: 10.1152/jn.01181.2005

PMCID: PMC3298883

PMID: 16407424

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https://www.ncbi.nlm.nih.gov/pmc/articles/3298883View

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Abstract

Maintaining the physiologic integrity of paralyzed limbs may be critical for those with spinal cord injury (SCI) to be viable candidates for a future cure. No long-term intervention has been tested to attempt to prevent the severe musculoskeletal deterioration that occurs after SCI. The purposes of this study were to determine whether a long-term neuromuscular electrical stimulation training program can preserve the physiological properties of the plantar flexor muscles (peak torque, fatigue index, torque-time integral, and contractile speed) as well as influence distal tibia trabecular bone mineral density (BMD). Subjects began unilateral plantar flexion electrical stimulation training within 6 wk after SCI while the untrained leg served as a control. Mean compliance for the 2-yr training program was 83%. Mean estimated compressive loads delivered to the tibia were approximately 1-1.5 times body weight. The training protocol yielded significant trained versus untrained limb differences for torque (+24%), torque-time integral (+27%), fatigue index (+50%), torque rise time (+45%), and between-twitch fusion (+15%). These between-limb differences were even greater when measured at the end of a repetitive stimulation protocol (125 contractions). Peripheral quantitative computed tomography revealed 31% higher distal tibia trabecular BMD in trained limbs than in untrained limbs. The intervention used in this study was sufficient to limit many of the deleterious muscular and skeletal adaptations that normally occur after SCI. Importantly, this method of load delivery was feasible and may serve as the basis for an intervention to preserve the musculoskeletal properties of individuals with SCI.

Bone Density

Tibia - physiology

Humans

Male

Muscle, Skeletal - innervation

Tibial Nerve - physiology

Biomechanical Phenomena

Muscle Contraction

Neuronal Plasticity - physiology

Electric Stimulation Therapy - methods

Time Factors

Muscle, Skeletal - physiopathology

Adult

Spinal Cord Injuries - physiopathology

Musculoskeletal System - innervation

Spinal Cord Injuries - therapy

Muscle Fatigue

Neuromuscular Junction - physiology

Details

Title: Subtitle: Musculoskeletal plasticity after acute spinal cord injury: effects of long-term neuromuscular electrical stimulation training
Creators: Richard K Shields - Graduate Program in Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, IA 52242-1190, USA. richard-shields@uiowa.edu
Shauna Dudley-Javoroski
Resource Type: Journal article
Publication Details: Journal of neurophysiology, Vol.95(4), pp.2380-2390
DOI: 10.1152/jn.01181.2005
PMID: 16407424
PMCID: PMC3298883
NLM abbreviation: J Neurophysiol
ISSN: 0022-3077
eISSN: 1522-1598
Publisher: United States
Grant note: R01 HD039445 / NICHD NIH HHS R01-HD 39445 / NICHD NIH HHS R01 HD039445-04 / NICHD NIH HHS
Language: English
Date published: 04/2006
Academic Unit: Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
Record Identifier: 9984046910902771

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