Skiba Gabriel H, Andrade Sérgio F, Rodacki André F
Motor Behavior Studies Center/Physiology Education Post Graduation Program, Federal University of Paraná, Curitiba, Brazil.
Neurol Sci. 2022 Jan;43(1):603-613. doi: 10.1007/s10072-021-05307-x. Epub 2021 May 12.
Muscle atrophy is a great consequence of spinal cord injuries (SCI) due to immobility. SCI's detrimental effects on large muscle groups may lead to secondary effects such as glucose intolerance, increased risk of metabolic syndrome, and diabetes. Exercising with blood flow restriction (BFR) has been proposed as an effective method to induce hypertrophy using low training loads, with little or no muscle damage. This study investigated acute and chronic effects of low-intensity functional electrical stimulation (FES) combined with BFR on muscles affected by spinal cord injury. The acute effects of one bout of FES with (FES + BFR group) and without BFR (FES group) on muscle thickness (MT) and edema formation were compared. The chronic effects on MT and edema following 8 weeks of twice weekly training with and without BFR were also compared. The FES + BFR group showed MT and edema increases compared to the FES only group (p< 0.05). The FES + BFR showed a chronic MT increase after 4 weeks of training (p <0.05), with no further MT increases from the 4th to the 8th week (p>0.05). Following 3 weeks of detraining, MT decreased to baseline. No MT changes were observed in the FES (p>0.05). The FES + BF stimuli induced MT increases on the paralyzed skeletal muscles of SCI. The acute effects suggest that FES causes a greater metabolite accumulation and edema when combined with BFR. The early increases in MT can be attributed to edema, whereas after the 4th week, it is likely to be related to muscle hypertrophy. Register Clinical Trial Number on ReBeC: RBR-386rm8.
由于活动受限，肌肉萎缩是脊髓损伤（SCI）的一个严重后果。SCI对大肌肉群的有害影响可能会导致诸如葡萄糖不耐受、代谢综合征风险增加和糖尿病等继发性影响。有人提出，采用血流限制（BFR）进行锻炼是一种利用低训练负荷诱导肌肉肥大的有效方法，且几乎不会造成肌肉损伤。本研究调查了低强度功能性电刺激（FES）结合BFR对脊髓损伤所影响肌肉的急性和慢性影响。比较了一组有BFR（FES + BFR组）和无BFR（FES组）的FES对肌肉厚度（MT）和水肿形成的急性影响。还比较了在有和无BFR的情况下，每周两次、为期8周的训练后对MT和水肿的慢性影响。与仅FES组相比，FES + BFR组的MT和水肿增加（p<0.05）。FES + BFR组在训练4周后MT出现慢性增加（p <0.05），从第4周到第8周MT没有进一步增加（p>0.05）。在停训3周后，MT降至基线水平。FES组未观察到MT变化（p>0.05）。FES + BF刺激可使SCI瘫痪骨骼肌的MT增加。急性影响表明，FES与BFR联合使用时会导致更多代谢物积累和水肿。MT早期增加可归因于水肿，而在第4周后，可能与肌肉肥大有关。在ReBeC上注册临床试验编号：RBR - 386rm8。
