Gorgey Ashraf S, Lester Robert M, Wade Rodney C, Khalil Refka E, Khan Rehan K, Anderson Melodie L, Castillo Teodoro
Spinal Cord Injury and Disorders Service, Department of Veterans Affairs, Hunter Holmes McGuire VAMC, Richmond, VA, USA.
Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA.
Spinal Cord Ser Cases. 2017 Jun 29;3:17039. doi: 10.1038/scsandc.2017.39. eCollection 2017.
The objective of the study was to investigate the feasibility and initial efficacy of telehealth communication in conjunction with surface neuromuscular electrical stimulation (NMES) resistance training (RT) to induce muscle hypertrophy.
This was a home-based setting of within-subject control design of trained vs controlled limbs. Five men with chronic (>1 year postinjury) motor-complete spinal cord injury (SCI) participated in a twice-weekly telehealth videoconference program using home-based NMES-RT for 8 weeks. Stimulation was applied to the knee extensor muscle group of the trained leg, while the untrained leg served as a control. Participants received real-time feedback to ensure a proper setup of electrodes and stimulator to monitor subject safety throughout the entire training session. Magnetic resonance imaging was used to measure cross-sectional areas (CSAs) and intramuscular fat (IMF) of the whole thigh and individual muscle groups. Average two-way travel time, distance traveled in miles and total cost of gas per mile were calculated.
Participants had 100% compliance. Trained whole and absolute knee extensor muscle CSA increased by 13% (=0.002) and 18% (=0.0002), with no changes in the controlled limb. Absolute knee flexor and adductor CSAs increased by 3% (=0.02) and 13% (=0.0001), respectively. Absolute whole thigh and knee extensor IMF CSAs decreased significantly in the trained limb by 14% (=0.01) and 36% (=0.0005), respectively, with no changes in controlled limb.
The pilot work documented that using telehealth communication is a safe, feasible and potentially cost-reducing approach for monitoring home-based NMES-RT in persons with chronic SCI. All trained muscles showed detectable muscle hypertrophy with concomitant decrease in ectopic adipose tissue.
本研究的目的是调查远程医疗通信结合表面神经肌肉电刺激（NMES）阻力训练（RT）诱导肌肉肥大的可行性和初步疗效。
这是一项在家庭环境中进行的受试者自身对照设计，比较训练肢体与对照肢体。五名患有慢性（受伤后>1年）运动完全性脊髓损伤（SCI）的男性参加了为期8周的每周两次的远程医疗视频会议项目，采用家庭式NMES-RT。刺激施加于训练腿的膝伸肌肌群，而未训练的腿作为对照。参与者接受实时反馈，以确保电极和刺激器设置正确，在整个训练过程中监测受试者安全。使用磁共振成像测量整个大腿和各个肌肉群的横截面积（CSA）和肌内脂肪（IMF）。计算平均双向行程时间、行驶英里数和每英里的总汽油成本。
参与者的依从性为100%。训练后的整个和绝对膝伸肌CSA分别增加了13%（P=0.002）和18%（P=0.0002），对照肢体无变化。绝对膝屈肌和内收肌CSA分别增加了3%（P=0.02）和13%（P=0.0001）。训练肢体的整个大腿和膝伸肌IMF CSA绝对值分别显著下降了14%（P=0.01）和36%（P=0.0005），对照肢体无变化。
这项试点工作证明，使用远程医疗通信是一种安全、可行且可能降低成本的方法，用于监测慢性SCI患者的家庭式NMES-RT。所有训练的肌肉均显示出可检测到的肌肉肥大，同时异位脂肪组织减少。
