Chiaramonte Rita, Pavone Vito, Testa Gianluca, Pesce Isabella, Scaturro Dalila, Musumeci Giuseppe, Mauro Giulia Letizia, Vecchio Michele
Section of Pharmacology, Department of Biomedical and Biotechnological Sciences, University of Catania, 95124 Catania, Italy.
Section of Orthopaedics and Traumatology, Department of General Surgery and Medical Surgical Specialties, University Hospital Policlinico "Rodolico-San Marco", University of Catania, 95123 Catania, Italy.
Diagnostics (Basel). 2023 Jan 18;13(3):364. doi: 10.3390/diagnostics13030364.
The various mechanisms involved in peripheral nerve regeneration, induced by exercise and electrical nerve stimulation, are still unclear.
The aim of this review was to summarize the influence of physical exercise and/or electrical stimulation on peripheral nerve repair and regeneration and the variation of impact of intervention depending on timing, as well as kind and dosage of the intervention. A literature survey was conducted on PubMed, Scopus, and Web of Science, between February 2021 to July 2021, with an update in September 2022.
The literature search identified 101,386 articles with the keywords: "peripheral nerve" OR "neuropathy" AND "sprouting" OR "neuroapraxia" OR "axonotmesis" OR "neurotmesis" OR "muscle denervation" OR "denervated muscle" AND "rehabilitation" OR "physical activity" OR "physical exercise" OR "activity" OR "electrical stimulation". A total of 60 publications were included. Eligible studies were focused on evaluating the process of nerve repair (biopsy, electromyographic parameters or biomarker outcomes) after electrical stimulation or physical exercise interventions on humans or animals with peripheral sensory or motor nerve injury.
This study shows that the literature, especially regarding preclinical research, is mainly in agreement that an early physical program with active exercise and/or electrical stimulation promotes axonal regenerative responses and prevents maladaptive response. This was evaluated by means of changes in electrophysiological recordings of CMAPs for latency amplitude, and the sciatic functional index (SFI). Furthermore, this type of activity can cause an increase in weight and in muscle fiber diameter. Nevertheless, some detrimental effects of exercising and electrical stimulation too early after nerve repair were recorded.
In most preclinical studies, peripheral neuropathy function was associated with improvements after physical exercise and electrical stimulation. For humans, too little research has been conducted on this topic to reach a complete conclusion. This research supports the need for future studies to test the validity of a possible rehabilitation treatment in humans in cases of peripheral neuropathy to help nerve sprouting.
运动和电神经刺激诱导的周围神经再生所涉及的各种机制仍不清楚。
本综述的目的是总结体育锻炼和/或电刺激对周围神经修复和再生的影响，以及干预的影响因时间、干预的种类和剂量而异的情况。于2021年2月至2021年7月在PubMed、Scopus和Web of Science上进行了文献检索，并于2022年9月进行了更新。
文献检索共识别出101386篇文章，关键词为：“周围神经”或“神经病变”以及“发芽”或“神经失用症”或“轴突断裂”或“神经断裂”或“肌肉去神经支配”或“失神经肌肉”以及“康复”或“体力活动”或“体育锻炼”或“活动”或“电刺激”。共纳入60篇出版物。符合条件的研究重点评估电刺激或体育锻炼干预对周围感觉或运动神经损伤的人类或动物进行神经修复过程（活检、肌电图参数或生物标志物结果）。
本研究表明，文献，尤其是关于临床前研究的文献，主要一致认为早期进行积极运动和/或电刺激的体育项目可促进轴突再生反应并防止适应不良反应。这通过复合肌肉动作电位（CMAP）潜伏期振幅的电生理记录变化和坐骨神经功能指数（SFI）进行评估。此外，这种活动可导致体重增加和肌肉纤维直径增大。然而，记录到神经修复后过早进行运动和电刺激会有一些有害影响。
在大多数临床前研究中，周围神经病变功能与体育锻炼和电刺激后的改善相关。对于人类而言，关于这一主题的研究太少，无法得出完整结论。本研究支持未来需要进行研究，以测试在周围神经病变病例中对人类进行可能的康复治疗以帮助神经发芽的有效性。
