Swiss Paraplegic Centre, Guido A. Zäch Strasse 1, Nottwil CH-6207, Switzerland.
Swiss Paraplegic Centre, Guido A. Zäch Strasse 1, Nottwil CH-6207, Switzerland.
EBioMedicine. 2021 Dec;74:103737. doi: 10.1016/j.ebiom.2021.103737. Epub 2021 Dec 9.
Damage to lower motor neuron causes denervation and degeneration of the muscles affected. Experimental and clinical studies of muscle denervation in lower extremities demonstrated that direct electrical stimulation (ES) of muscle can prevent denervation atrophy and restore contractility. The aim of this study was to identify possible myogenic effect of ES on denervated forearm and hand muscles in persons with spinal cord injury (SCI) and tetraplegia.
This prospective interventional study with repeated measurement design included 22 patients aged 48·6 (± 15·7), 0·25 (0·1/46) years after spinal cord lesion, AIS A-D. In each patient, two electrophysiologically-confirmed denervated muscles in the hand and forearm were analyzed - one extrinsic (Extensor Carpi Ulnaris - ECU) and one intrinsic (1st Dorsal Interosseus - IOD1). Muscles were stimulated for 33 min, five times per week over a 12-weeks period. Using ultrasonography (USG), muscle thickness (MT) and pennation angle (PA) of these muscles were determined at start and end of the stimulation period.
MT of IOD1 increased from 6·3 mm (± 3·2 mm) to 9·2 mm (± 2·4 mm) (p = 0·004) and the PA from 5·5° (± 3·0°) to 11° (± 2·2°) (p = 0·001). The corresponding values for the ECU were 5·5 mm (± 2·5 mm) to 7·0 mm (± 2·2 mm) (p = 0·039) and 5·5° (± 3·4°) to 9·4° (± 3·8°) (p = 0·005), respectively. The correlation of MT between baseline and completion was r = 0·58 (p = 0·037) for the ECU and r = 0·63 (p = 0·008) for the IOD1.
12 weeks of direct muscle stimulation increases the MT and PA of the denervated intrinsic and extrinsic hand muscles studied.
Swiss Paraplegic Centre, Switzerland.
下运动神经元损伤会导致受影响肌肉的去神经和变性。下肢肌肉去神经的实验和临床研究表明，肌肉的直接电刺激（ES）可以防止去神经萎缩并恢复收缩力。本研究的目的是确定电刺激对脊髓损伤（SCI）和四肢瘫痪患者前臂和手部去神经肌肉的可能成肌作用。
这项前瞻性干预研究采用重复测量设计，纳入了 22 名年龄为 48.6（±15.7）岁、脊髓损伤后 0.25（0.1/46）年、AIS A-D 的患者。在每位患者中，对手和前臂中两个经电生理确认的去神经肌肉进行了分析——一个外在（尺侧腕伸肌 - ECU）和一个内在（第一背侧间骨肌 - IOD1）。肌肉每周刺激 5 次，每次 33 分钟，共 12 周。使用超声（USG），在刺激开始和结束时分别确定这些肌肉的肌肉厚度（MT）和羽状角（PA）。
IOD1 的 MT 从 6.3mm（±3.2mm）增加到 9.2mm（±2.4mm）（p=0.004），PA 从 5.5°（±3.0°）增加到 11°（±2.2°）（p=0.001）。ECU 的相应值分别为 5.5mm（±2.5mm）到 7.0mm（±2.2mm）（p=0.039）和 5.5°（±3.4°）到 9.4°（±3.8°）（p=0.005）。ECU 的 MT 基线与完成之间的相关性为 r=0.58（p=0.037），IOD1 的相关性为 r=0.63（p=0.008）。
12 周的直接肌肉刺激增加了研究中去神经的内在和外在手部肌肉的 MT 和 PA。
瑞士截瘫中心，瑞士。
