Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang-Gung University, Taipei, Taiwan.
Department of Plastic and Reconstructive Surgery, Hôpital Pasteur 2, CHU de Nice, Université Côte d'Azur, Nice, France.
J Reconstr Microsurg. 2023 Sep;39(7):508-516. doi: 10.1055/s-0043-1761207. Epub 2023 Jan 24.
Long nerve grafting often results in unsatisfactory functional outcomes. In this study we aim to investigate the effect of swimming exercise on nerve regeneration and functional outcomes after long nerve grafting.
A reversed long nerve graft was interposed between C6 and the musculocutaneous nerve in 40 rats. The rats were divided into four groups with 10 in each based on different postoperative swimming regimes for rehabilitation: group A, continuous exercise; group B, early exercise; group C, late exercise; and group D, no exercise (control group). A grooming test was assessed at 4, 8, 12, and 16 weeks postoperatively. Biceps muscle compound action potential (MCAP), muscle tetanic contraction force (MTCF), and muscle weights were assessed after 16 weeks. Histomorphometric analyses of the musculocutaneous nerves were performed to examine nerve regeneration.
The grooming test showed all groups except group D demonstrated a trend of progressive improvement over the whole course of 16 weeks. Biceps MCAP, MTCF, and muscle weights all showed significant better results in the exercise group in comparison to the group D at 16 weeks, which is especially true in groups A and B. Nerve analysis at 16 weeks, however, showed no significant differences between the exercise groups and the control group.
Swimming after long nerve grafting can significantly improve muscle functional behavior and volume. The effect is less evident on nerve regeneration. Continuous exercise and early exercise after surgery show more optimal outcomes than late or no exercise. Having a good habit with exercise in the early period is thought as the main reason. Further studies are needed to determine the optimal exercise regimen.
长神经移植常导致不满意的功能结果。本研究旨在探讨游泳运动对长神经移植后神经再生和功能结果的影响。
在 40 只大鼠中，将反向长神经移植物置于 C6 和肌皮神经之间。根据术后不同的游泳康复方案，将大鼠分为 4 组，每组 10 只：A 组，连续运动；B 组，早期运动；C 组，晚期运动；D 组，不运动（对照组）。术后 4、8、12 和 16 周评估梳理试验。16 周后评估二头肌复合动作电位（MCAP）、肌肉强直收缩力（MTCF）和肌肉重量。对肌皮神经进行组织形态计量学分析，以检查神经再生情况。
梳理试验显示，除 D 组外，所有组在 16 周的整个过程中均表现出逐渐改善的趋势。与 D 组相比，16 周时运动组的二头肌 MCAP、MTCF 和肌肉重量均显示出明显更好的结果，尤其是 A 组和 B 组。然而，16 周时神经分析显示运动组与对照组之间无显著差异。
长神经移植后游泳运动可显著改善肌肉功能行为和体积。对神经再生的影响不太明显。术后连续运动和早期运动的效果优于晚期运动或不运动。在早期养成运动的好习惯被认为是主要原因。需要进一步的研究来确定最佳的运动方案。
