School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, AUSTRALIA.
Centre for Sports and Exercise Science, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, AUSTRALIA.
Med Sci Sports Exerc. 2018 Sep;50(9):1733-1739. doi: 10.1249/MSS.0000000000001637.
Muscle force production is usually impaired in people with spinal cord injury (SCI). The use of high-intensity neuromuscular electrical stimulation (NMES) strength training can help promote metabolically active lean muscle mass and, thus, increase muscle mass and improve physical health and quality of life (QoL). Nonetheless, NMES is usually used at low-stimulation intensities, and there is limited evidence on the effects of high-intensity NMES strength training into improving muscle force and mass, symptoms of spasticity, or physical health and QoL in people with SCI.
Five individuals with chronic SCI completed five 10-repetition sets of high-intensity knee extension NMES strength training sessions for 12 wk in both quadriceps muscles. Quadriceps femoris (QF) knee extensor torque was measured on a dynamometer, and cross-sectional area (CSAQF) was measured with extended field-of-view ultrasonography. Venous blood samples were collected for blood lipid profiling and C-reactive protein analyses. The Spinal Cord Injury Spasticity Evaluation Tool was used to assess symptoms of spasticity, and the QoL index SCI version III was used for QoL measures.
QF tetanic knee extensor torque increased on average by 35% (2%-92%), and CSAQF increased by 47% (14%-145%). A significant increase in the HDL/LDL cholesterol ratio (P < 0.001) and a mean significant improvement of 4.8% ± 2.3% (absolute value = 0.26) in the Spinal Cord Injury Spasticity Evaluation Tool score was observed, whereas QoL showed a near-significant improvement in the health and functioning domain (15.0 ± 4.2 and 17.3 ± 5.1; P = 0.07).
High-intensity NMES strength training in people with SCI may improve muscle strength, mass, physical health, and QoL. However, replication of these results is necessary before clinical implementation.
肌肉力量产生在脊髓损伤（SCI）患者中通常受损。高强度神经肌肉电刺激（NMES）力量训练的使用可以帮助促进代谢活跃的瘦肌肉质量，从而增加肌肉质量，改善身体健康和生活质量（QoL）。尽管如此，NMES 通常在低刺激强度下使用，并且关于高强度 NMES 力量训练对改善肌肉力量和质量、痉挛症状或 SCI 患者的身体健康和 QoL 的影响的证据有限。
五名慢性 SCI 患者在 12 周内完成了五组 10 次重复的高强度膝关节伸展 NMES 力量训练，分别针对股四头肌的双侧肌肉进行训练。使用测力计测量股四头肌（QF）膝关节伸肌扭矩，使用扩展视野超声测量横截面积（CSAQF）。采集静脉血样进行血脂谱和 C 反应蛋白分析。使用脊髓损伤痉挛评估工具评估痉挛症状，使用 SCI 版本 III 生活质量指数评估生活质量。
QF 强直膝关节伸肌扭矩平均增加 35%（2%-92%），CSAQF 增加 47%（14%-145%）。观察到 HDL/LDL 胆固醇比值显著增加（P < 0.001），脊髓损伤痉挛评估工具评分平均显著改善 4.8%±2.3%（绝对值=0.26），而生活质量在健康和功能领域显示出接近显著的改善（15.0±4.2 和 17.3±5.1；P=0.07）。
SCI 患者的高强度 NMES 力量训练可能会改善肌肉力量、质量、身体健康和生活质量。然而，在临床实施之前，有必要复制这些结果。
