Mastropietro Alfonso, Peruzzo Denis, Taccogna Maria Giovanna, Sanna Nicole, Casali Nicola, Nossa Roberta, Biffi Emilia, Ambrosini Emilia, Pedrocchi Alessandra, Rizzo Giovanna
Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato, Consiglio Nazionale delle Ricerche, via Alfonso Corti, 12, Milan, 20133, Italy, 39 02 2369 993.
Neuroimaging Unit, Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy.
JMIR Rehabil Assist Technol. 2025 Jan 16;12:e64825. doi: 10.2196/64825.
Spinal cord injuries (SCIs) cause debilitating secondary conditions such as severe muscle deterioration, cardiovascular, and metabolic dysfunctions, significantly impacting patients' quality of life. Functional electrical stimulation (FES) combined with cycling exercise (FES-cycling) has shown promise in improving muscle function and health in individuals with SCI.
This pilot study aimed to investigate the potential role of multiparametric magnetic resonance imaging (MRI) to assess muscle health during and after an FES-cycling rehabilitation program.
Four male participants with chronic SCI underwent a 6-month FES-cycling training program, consisting of two 30-minute sessions per week. MRI scans were performed at baseline (T0), after 3 months (T1), at the end of the training (T2), and 1-month posttraining (T3). The MRI protocol included T1-weighted imaging for volume quantification, Dixon imaging for fat fraction, multi-echo spin echo for T2 relaxation times, and diffusion tensor imaging to assess diffusion parameters.
Muscle hypertrophy was observed, with an average increase in muscle volume of 22.3% at T1 and 36.7% at T2 compared with baseline. One month posttraining, muscle volume remained 23.2% higher than baseline. Fat fraction decreased from 11.1% at T0 to 9.1% at T2, with a rebound to 10.9% at T3. T2 relaxation times showed a reduction even though this was not consistent among participants. Diffusion tensor imaging parameters revealed subtle changes in muscle tissue microstructure, with a decrease in fractional anisotropy mainly associated to an increase of radial diffusivity.
Although preliminary, this study provides evidence that 6 months of low-intensity FES-bike training can increase muscle volume and decrease fat infiltration in individuals with SCI. The study demonstrates that the use of a multiparametric MRI provides comprehensive insights into both macroscopic and microscopic changes within muscle tissues, supporting its integration into clinical practice for assessing the efficacy of rehabilitation interventions.
脊髓损伤（SCI）会引发使人衰弱的继发性病症，如严重的肌肉退化、心血管和代谢功能障碍，对患者的生活质量产生重大影响。功能性电刺激（FES）结合骑行运动（FES-骑行）已显示出改善SCI患者肌肉功能和健康状况的潜力。
本试点研究旨在探讨多参数磁共振成像（MRI）在评估FES-骑行康复计划期间及之后肌肉健康状况方面的潜在作用。
四名患有慢性SCI的男性参与者接受了为期6个月的FES-骑行训练计划，每周进行两次，每次30分钟。在基线期（T0）、3个月后（T1）、训练结束时（T2）和训练后1个月（T3）进行MRI扫描。MRI方案包括用于体积定量的T1加权成像、用于脂肪分数的 Dixon成像、用于T2弛豫时间的多回波自旋回波成像以及用于评估扩散参数的扩散张量成像。
观察到肌肉肥大，与基线相比，T1时肌肉体积平均增加22.3%，T2时增加36.7%。训练后1个月，肌肉体积仍比基线高23.2%。脂肪分数从T0时的11.1%降至T2时的9.1%，T3时反弹至10.9%。尽管参与者之间不一致，但T2弛豫时间有所缩短。扩散张量成像参数显示肌肉组织微观结构有细微变化，各向异性分数降低主要与径向扩散率增加有关。
尽管本研究是初步的，但提供了证据表明，6个月的低强度FES-自行车训练可增加SCI患者的肌肉体积并减少脂肪浸润。该研究表明，使用多参数MRI可全面了解肌肉组织内的宏观和微观变化，支持将其纳入临床实践以评估康复干预的效果。
