Wasim Momal A, Alazzam Ahmad M, Gorgey Ashraf S
Spinal Cord Injury and Disorders Center, Richmond VA Medical Center, Richmond, VA 23249, USA.
Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23298, USA.
J Clin Med. 2025 Jun 4;14(11):3972. doi: 10.3390/jcm14113972.
Pilot randomized clinical trial. : To examine the effect of electrically evoked muscle hypertrophy on indices of spasticity, as measured by Biodex after spinal cord injury (SCI). : Medical research center. : Thirteen males with chronic SCI were randomized into sixteen weeks of either surface neuromuscular resistance training (NMES-RT) + testosterone treatment (TT) (n = 7) or a TT-only group (n = 6). A Biodex isokinetic dynamometer was used to measure knee extensor and flexor muscle spasticity at the beginning (baseline; BL) and at the end (post-intervention; PI) of 16 weeks. The passive tension of the right knee extensor and flexor muscle groups were evaluated at angles of 5°, 30°, 60°, 90°, 180°, and 270° per second (sec). Dual energy X-ray absorptiometry and magnetic resonance imaging were used to measure leg lean mass and thigh muscle cross-sectional areas (CSAs). : Robust muscle hypertrophy was noted in leg lean mass [11%, = 0.023] as well as whole thigh [17%, = 0.001] and knee extensor muscle [28%, = 0.001] CSAs in the NMES-RT+TT compared to the TT-only group. There was no difference in extensor or flexor spasticity between the NMES-RT+TT or TT-only groups at different angular velocities following 16 weeks of intervention. Collapsing the extensor passive torques indicated an (24-28%) increase ( < 0.004) in response to angular velocities at BL and following PI measurements [180 deg/sec (23%; = 0.03) and 270 deg/sec (32%; = 0.009)] compared to 5 deg/sec. The extensor slope showed a non-significant ( > 0.05) decrease of 15-28% across all angular velocities. The catch-AB slopes were non-significantly lower in the TT-only group compared to the NMES-RT+TT at higher speeds [90 deg/sec and 270 deg/sec] and attained a trend towards lower passive torque at 180 deg/sec [180 deg/sec: 15.5%, = 0.05]. : Evoking skeletal muscle hypertrophy did not increase spasticity indices at different angular velocities following sixteen weeks of NMES-RT+TT or TT in persons with chronic SCI. Augmenting muscle hypertrophy is likely to attenuate the hyper reflexive slope of the extensor spasticity. The findings may suggest that evoking muscle hypertrophy following NMES-RT does not increase indices of spasticity after SCI. The clinical implications are highly important in managing spasticity after SCI.
旨在研究脊髓损伤（SCI）后，通过Biodex测量电诱发肌肉肥大对痉挛指标的影响。地点：医学研究中心。方法：13名慢性SCI男性被随机分为两组，一组接受为期16周的表面神经肌肉阻力训练（NMES-RT）加睾酮治疗（TT）（n = 7），另一组仅接受TT治疗（n = 6）。在16周开始时（基线；BL）和结束时（干预后；PI），使用Biodex等速测力计测量膝关节伸肌和屈肌的痉挛情况。在每秒5°、30°、60°、90°、180°和270°的角度下评估右膝伸肌和屈肌组的被动张力。使用双能X线吸收法和磁共振成像测量腿部瘦体重和大腿肌肉横截面积（CSA）。结果：与仅接受TT治疗的组相比，接受NMES-RT+TT治疗的组在腿部瘦体重[11%，P = 0.023]、整个大腿[17%，P = 0.001]和膝关节伸肌肌肉[28%，P = 0.001]的CSA方面出现了显著的肌肉肥大。在干预16周后，NMES-RT+TT组和仅接受TT治疗的组在不同角速度下的伸肌或屈肌痉挛情况没有差异。合并伸肌被动扭矩表明，与5°/秒相比，在BL和PI测量后的角速度下，响应增加了（24 - 28%）（P < 0.004）[180°/秒（23%；P = 0.03）和270°/秒（32%；P = 0.009）]。伸肌斜率在所有角速度下均出现了15 - 28%的非显著下降（P > 0.05）。在较高速度[90°/秒和270°/秒]下，仅接受TT治疗的组的捕捉-AB斜率与NMES-RT+TT组相比无显著降低，在180°/秒时呈现出较低被动扭矩的趋势[180°/秒：15.5%，P = 0.05]。结论：在慢性SCI患者中，经过16周的NMES-RT+TT或TT治疗后，诱发骨骼肌肥大并未增加不同角速度下的痉挛指标。增加肌肉肥大可能会减弱伸肌痉挛的过度反射斜率。研究结果可能表明，NMES-RT后诱发肌肉肥大不会增加SCI后的痉挛指标。这些发现对于SCI后痉挛的管理具有重要的临床意义。
