Department of Physical Therapy, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia.
Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
Int J Mol Sci. 2024 Oct 16;25(20):11095. doi: 10.3390/ijms252011095.
In individuals with a spinal cord injury (SCI), rapid skeletal muscle atrophy and metabolic dysfunction pose profound rehabilitation challenges, often resulting in substantial loss of muscle mass and function. This study evaluates the effect of combined neuromuscular electrical stimulation (Comb-NMES) on skeletal muscle cross-sectional area (CSA) and inflammatory signaling within the acute phase of SCI. We applied a novel Comb-NMES regimen, integrating both high-frequency resistance and low-frequency aerobic protocols on the vastus lateralis muscle, to participants early post-SCI. Muscle biopsies were analyzed for CSA and inflammatory markers pre- and post-intervention. The results suggest a potential preservation of muscle CSA in the Comb-NMES group compared to a control group. Inflammatory signaling proteins such as TLR4 and Atrogin-1 were downregulated, whereas markers associated with muscle repair and growth were modulated beneficially in the Comb-NMES group. The study's findings suggest that early application of Comb-NMES post-SCI may attenuate inflammatory pathways linked to muscle atrophy and promote muscle repair. However, the small sample size and variability in injury characteristics emphasize the need for further research to corroborate these results across a more diverse and extensive SCI population.
在脊髓损伤（SCI）患者中，快速的骨骼肌萎缩和代谢功能障碍带来了深远的康复挑战，常常导致大量的肌肉质量和功能丧失。本研究评估了联合神经肌肉电刺激（Comb-NMES）在 SCI 急性期对骨骼肌横截面积（CSA）和炎症信号的影响。我们对 SCI 后早期的参与者应用了一种新的 Comb-NMES 方案，即在股外侧肌上同时应用高频电阻和低频有氧方案。在干预前后分析了 CSA 和炎症标志物的肌肉活检。结果表明，与对照组相比，Comb-NMES 组的肌肉 CSA 可能得到了保留。炎症信号蛋白，如 TLR4 和 Atrogin-1，被下调，而与肌肉修复和生长相关的标志物在 Comb-NMES 组中则被有益地调节。研究结果表明，SCI 后早期应用 Comb-NMES 可能会减轻与肌肉萎缩相关的炎症途径，并促进肌肉修复。然而，样本量小和损伤特征的变异性强调需要进一步的研究，以在更广泛的 SCI 人群中证实这些结果。
