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Ganse B. Methods to accelerate fracture healing - a narrative review from a clinical perspective. Front Immunol 2024; 15:1384783. [PMID: 38911851 PMCID: PMC11190092 DOI: 10.3389/fimmu.2024.1384783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 05/14/2024] [Indexed: 06/25/2024] Open
Abstract
Bone regeneration is a complex pathophysiological process determined by molecular, cellular, and biomechanical factors, including immune cells and growth factors. Fracture healing usually takes several weeks to months, during which patients are frequently immobilized and unable to work. As immobilization is associated with negative health and socioeconomic effects, it would be desirable if fracture healing could be accelerated and the healing time shortened. However, interventions for this purpose are not yet part of current clinical treatment guidelines, and there has never been a comprehensive review specifically on this topic. Therefore, this narrative review provides an overview of the available clinical evidence on methods that accelerate fracture healing, with a focus on clinical applicability in healthy patients without bone disease. The most promising methods identified are the application of axial micromovement, electromagnetic stimulation with electromagnetic fields and direct electric currents, as well as the administration of growth factors and parathyroid hormone. Some interventions have been shown to reduce the healing time by up to 20 to 30%, potentially equivalent to several weeks. As a combination of methods could decrease the healing time even further than one method alone, especially if their mechanisms of action differ, clinical studies in human patients are needed to assess the individual and combined effects on healing progress. Studies are also necessary to determine the ideal settings for the interventions, i.e., optimal frequencies, intensities, and exposure times throughout the separate healing phases. More clinical research is also desirable to create an evidence base for clinical guidelines. To make it easier to conduct these investigations, the development of new methods that allow better quantification of fracture-healing progress and speed in human patients is needed.
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Affiliation(s)
- Bergita Ganse
- Innovative Implant Development (Fracture Healing), Clinics and Institutes of Surgery, Saarland University, Homburg, Germany
- Department of Trauma, Hand and Reconstructive Surgery, Clinics and Institutes of Surgery, Saarland University, Homburg, Germany
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2
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Takahashi A, Honda Y, Tanaka N, Miyake J, Maeda S, Kataoka H, Sakamoto J, Okita M. Skeletal Muscle Electrical Stimulation Prevents Progression of Disuse Muscle Atrophy via Forkhead Box O Dynamics Mediated by Phosphorylated Protein Kinase B and Peroxisome Proliferator-Activated Receptor gamma Coactivator-1alpha. Physiol Res 2024; 73:105-115. [PMID: 38466009 PMCID: PMC11019614 DOI: 10.33549/physiolres.935157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/12/2023] [Indexed: 04/26/2024] Open
Abstract
Although electrical muscle stimulation (EMS) of skeletal muscle effectively prevents muscle atrophy, its effect on the breakdown of muscle component proteins is unknown. In this study, we investigated the biological mechanisms by which EMS-induced muscle contraction inhibits disuse muscle atrophy progression. Experimental animals were divided into a control group and three experimental groups: immobilized (Im; immobilization treatment), low-frequency (LF; immobilization treatment and low-frequency muscle contraction exercise), and high-frequency (HF; immobilization treatment and high-frequency muscle contraction exercise). Following the experimental period, bilateral soleus muscles were collected and analyzed. Atrogin-1 and Muscle RING finger 1 (MuRF-1) mRNA expression levels were significantly higher for the experimental groups than for the control group but were significantly lower for the HF group than for the Im group. Peroxisome proliferator-activated receptor gamma coactivator-1alpha (PGC-1alpha) mRNA and protein expression levels in the HF group were significantly higher than those in the Im group, with no significant differences compared to the Con group. Both the Forkhead box O (FoxO)/phosphorylated FoxO and protein kinase B (AKT)/phosphorylated AKT ratios were significantly lower for the Im group than for the control group and significantly higher for the HF group than for the Im group. These results, the suppression of atrogin-1 and MuRF-1 expression for the HF group may be due to decreased nuclear expression of FoxO by AKT phosphorylation and suppression of FoxO transcriptional activity by PGC-1alpha. Furthermore, the number of muscle contractions might be important for effective EMS.
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Affiliation(s)
- A Takahashi
- Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan.
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Uçar N, Öner H, Kuş MA, Karaca H, Fırat T. The effect of neuromuscular electrical stimulation applied at different muscle lengths on muscle architecture and sarcomere morphology in rats. Anat Rec (Hoboken) 2024; 307:356-371. [PMID: 37194371 DOI: 10.1002/ar.25240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/04/2023] [Accepted: 04/26/2023] [Indexed: 05/18/2023]
Abstract
Neuromuscular electrical stimulation (NMES) is often used to increase muscle strength and functionality. Muscle architecture is important for the skeletal muscle functionality. The aim of this study was to investigate the effects of NMES applied at different muscle lengths on skeletal muscle architecture. Twenty-four rats were randomly assigned to four groups (two NMES groups and two control groups). NMES was applied on the extensor digitorum longus muscle at long muscle length, which is the longest and stretched position of the muscle at 170° plantar flexion, and at medium muscle length, which is the length of the muscle at 90° plantar flexion. A control group was created for each NMES group. NMES was applied for 8 weeks, 10 min/day, 3 days/week. After 8 weeks, muscle samples were removed at the NMES intervention lengths and examined macroscopically, and microscopically using a transmission electron microscope and streo-microscope. Muscle damage, and architectural properties of the muscle including pennation angle, fibre length, muscle length, muscle mass, physiological cross-sectional area, fibre length/muscle length, sarcomere length, sarcomere number were then evaluated. There was an increase in fibre length and sarcomere number, and a decrease in pennation angle at both lengths. In the long muscle length group, muscle length was increased, but widespread muscle damage was observed. These results suggest that the intervention of NMES at long muscle length can increase the muscle length but also causes muscle damage. In addition, the greater longitudinal increase in muscle length may be a result of the continuous degeneration-regeneration cycle.
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Affiliation(s)
- Nehir Uçar
- Department of Therapy and Rehabilitation, Vocational School of Health Sciences, University of Burdur Mehmet Akif Ersoy, Burdur, Turkey
| | - Hakan Öner
- Department of Histology and Embryology, Faculty of Veterinary Medicine, University of Burdur Mehmet Akif Ersoy, Burdur, Turkey
| | - Murat Abdulgani Kuş
- Department of Emergency Aid and Disaster Management, University of Burdur Mehmet Akif Ersoy, Burdur, Turkey
| | - Harun Karaca
- Department of Histology and Embryology, Faculty of Veterinary Medicine, University of Burdur Mehmet Akif Ersoy, Burdur, Turkey
| | - Tüzün Fırat
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Soni P, Edwards H, Anupom T, Rahman M, Lesanpezeshki L, Blawzdziewicz J, Cope H, Gharahdaghi N, Scott D, Toh LS, Williams PM, Etheridge T, Szewczyk N, Willis CRG, Vanapalli SA. Spaceflight Induces Strength Decline in Caenorhabditis elegans. Cells 2023; 12:2470. [PMID: 37887314 PMCID: PMC10605753 DOI: 10.3390/cells12202470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/14/2023] [Accepted: 10/15/2023] [Indexed: 10/28/2023] Open
Abstract
Background: Understanding and countering the well-established negative health consequences of spaceflight remains a primary challenge preventing safe deep space exploration. Targeted/personalized therapeutics are at the forefront of space medicine strategies, and cross-species molecular signatures now define the 'typical' spaceflight response. However, a lack of direct genotype-phenotype associations currently limits the robustness and, therefore, the therapeutic utility of putative mechanisms underpinning pathological changes in flight. Methods: We employed the worm Caenorhabditis elegans as a validated model of space biology, combined with 'NemaFlex-S' microfluidic devices for assessing animal strength production as one of the most reproducible physiological responses to spaceflight. Wild-type and dys-1 (BZ33) strains (a Duchenne muscular dystrophy (DMD) model for comparing predisposed muscle weak animals) were cultured on the International Space Station in chemically defined media before loading second-generation gravid adults into NemaFlex-S devices to assess individual animal strength. These same cultures were then frozen on orbit before returning to Earth for next-generation sequencing transcriptomic analysis. Results: Neuromuscular strength was lower in flight versus ground controls (16.6% decline, p < 0.05), with dys-1 significantly more (23% less strength, p < 0.01) affected than wild types. The transcriptional gene ontology signatures characterizing both strains of weaker animals in flight strongly corroborate previous results across species, enriched for upregulated stress response pathways and downregulated mitochondrial and cytoskeletal processes. Functional gene cluster analysis extended this to implicate decreased neuronal function, including abnormal calcium handling and acetylcholine signaling, in space-induced strength declines under the predicted control of UNC-89 and DAF-19 transcription factors. Finally, gene modules specifically altered in dys-1 animals in flight again cluster to neuronal/neuromuscular pathways, suggesting strength loss in DMD comprises a strong neuronal component that predisposes these animals to exacerbated strength loss in space. Conclusions: Highly reproducible gene signatures are strongly associated with space-induced neuromuscular strength loss across species and neuronal changes in calcium/acetylcholine signaling require further study. These results promote targeted medical efforts towards and provide an in vivo model for safely sending animals and people into deep space in the near future.
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Affiliation(s)
- Purushottam Soni
- Department of Chemical Engineering, Texas Tech University, Lubbock, TX 79409, USA; (P.S.); (M.R.); (L.L.)
| | - Hunter Edwards
- Department of Biological Sciences, Texas Tech University, Lubbock, TX 79409, USA;
| | - Taslim Anupom
- Department of Electrical Engineering, Texas Tech University, Lubbock, TX 79409, USA;
| | - Mizanur Rahman
- Department of Chemical Engineering, Texas Tech University, Lubbock, TX 79409, USA; (P.S.); (M.R.); (L.L.)
| | - Leila Lesanpezeshki
- Department of Chemical Engineering, Texas Tech University, Lubbock, TX 79409, USA; (P.S.); (M.R.); (L.L.)
| | - Jerzy Blawzdziewicz
- Department of Mechanical Engineering, Texas Tech University, Lubbock, TX 79409, USA;
- Department of Physics and Astronomy, Texas Tech University, Lubbock, TX 79409, USA
| | - Henry Cope
- School of Medicine, University of Nottingham, Derby DE22 3DT, UK; (H.C.); (N.G.)
| | - Nima Gharahdaghi
- School of Medicine, University of Nottingham, Derby DE22 3DT, UK; (H.C.); (N.G.)
| | - Daniel Scott
- School of Life Sciences, University of Nottingham, Nottingham NG7 2UH, UK;
| | - Li Shean Toh
- School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, UK; (L.S.T.); (P.M.W.)
| | - Philip M. Williams
- School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, UK; (L.S.T.); (P.M.W.)
| | - Timothy Etheridge
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter EX1 2LU, UK;
| | - Nathaniel Szewczyk
- School of Medicine, University of Nottingham, Derby DE22 3DT, UK; (H.C.); (N.G.)
- Ohio Musculoskeletal and Neurological Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
| | - Craig R. G. Willis
- School of Chemistry and Biosciences, Faculty of Life Sciences, University of Bradford, Bradford BD7 1DP, UK;
| | - Siva A. Vanapalli
- Department of Chemical Engineering, Texas Tech University, Lubbock, TX 79409, USA; (P.S.); (M.R.); (L.L.)
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Maffiuletti NA, Dirks ML, Stevens-Lapsley J, McNeil CJ. Electrical stimulation for investigating and improving neuromuscular function in vivo: Historical perspective and major advances. J Biomech 2023; 152:111582. [PMID: 37088030 DOI: 10.1016/j.jbiomech.2023.111582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 04/25/2023]
Abstract
This historical review summarizes the major advances - particularly from the last 50 years - in transcutaneous motor-level electrical stimulation, which can be used either as a tool to investigate neuromuscular function and its determinants (electrical stimulation for testing; EST) or as a therapeutic/training modality to improve neuromuscular and physical function (neuromuscular electrical stimulation; NMES). We focus on some of the most important applications of electrical stimulation in research and clinical settings, such as the investigation of acute changes, chronic adaptations and pathological alterations of neuromuscular function with EST, as well as the enhancement, preservation and restoration of muscle strength and mass with NMES treatment programs in various populations. For both EST and NMES, several major advances converge around understanding and optimizing motor unit recruitment during electrically-evoked contractions, also taking into account the influence of stimulation site (e.g., muscle belly vs nerve trunk) and type (e.g., pulse duration, frequency, and intensity). This information is equally important both in the context of mechanistic research of neuromuscular function as well as for clinicians who believe that improvements in neuromuscular function are required to provide health-related benefits to their patients.
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Affiliation(s)
| | - Marlou L Dirks
- Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK; Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands
| | - Jennifer Stevens-Lapsley
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA; VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), VA Eastern Colorado Health Care System, Aurora, CO, USA
| | - Chris J McNeil
- Integrated Neuromuscular Physiology Laboratory, School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
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Zulbaran‐Rojas A, Lee M, Bara RO, Flores‐Camargo A, Spitz G, Finco MG, Bagheri AB, Modi D, Shaib F, Najafi B. Electrical stimulation to regain lower extremity muscle perfusion and endurance in patients with post-acute sequelae of SARS CoV-2: A randomized controlled trial. Physiol Rep 2023; 11:e15636. [PMID: 36905161 PMCID: PMC10006649 DOI: 10.14814/phy2.15636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 03/12/2023] Open
Abstract
Muscle deconditioning and impaired vascular function in the lower extremities (LE) are among the long-term symptoms experienced by COVID-19 patients with a history of severe illness. These symptoms are part of the post-acute sequelae of Sars-CoV-2 (PASC) and currently lack evidence-based treatment. To investigate the efficacy of lower extremity electrical stimulation (E-Stim) in addressing PASC-related muscle deconditioning, we conducted a double-blinded randomized controlled trial. Eighteen (n = 18) patients with LE muscle deconditioning were randomly assigned to either the intervention (IG) or the control (CG) group, resulting in 36 LE being assessed. Both groups received daily 1 h E-Stim on both gastrocnemius muscles for 4 weeks, with the device functional in the IG and nonfunctional in the CG. Changes in plantar oxyhemoglobin (OxyHb) and gastrocnemius muscle endurance (GNMe) in response to 4 weeks of daily 1 h E-Stim were assessed. At each study visit, outcomes were measured at onset (t0 ), 60 min (t60 ), and 10 min after E-Stim therapy (t70 ) by recording ΔOxyHb with near-infrared spectroscopy. ΔGNMe was measured with surface electromyography at two time intervals: 0-5 min (Intv1 ) and: 55-60 min (Intv2 ). Baseline OxyHb decreased in both groups at t60 (IG: p = 0.046; CG: p = 0.026) and t70 (IG = p = 0.021; CG: p = 0.060) from t0 . At 4 weeks, the IG's OxyHb increased from t60 to t70 (p < 0.001), while the CG's decreased (p = 0.003). The IG had higher ΔOxyHb values than the CG at t70 (p = 0.004). Baseline GNMe did not increase in either group from Intv1 to Intv2 . At 4 weeks, the IG's GNMe increased (p = 0.031), whereas the CG did not change. There was a significant association between ΔOxyHb and ΔGNMe (r = 0.628, p = 0.003) at 4 weeks in the IG. In conclusion, E-Stim can improve muscle perfusion and muscle endurance in individuals with PASC experiencing LE muscle deconditioning.
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Affiliation(s)
- Alejandro Zulbaran‐Rojas
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of SurgeryBaylor College of MedicineHoustonTexasUSA
| | - Myeounggon Lee
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of SurgeryBaylor College of MedicineHoustonTexasUSA
| | - Rasha O. Bara
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of SurgeryBaylor College of MedicineHoustonTexasUSA
| | - Areli Flores‐Camargo
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of SurgeryBaylor College of MedicineHoustonTexasUSA
| | - Gil Spitz
- Baylor St Luke's Medical Center, Exercise PhysiologyLiver Transplant ProgramHoustonTexasUSA
| | - M. G. Finco
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of SurgeryBaylor College of MedicineHoustonTexasUSA
| | - Amir Behzad Bagheri
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of SurgeryBaylor College of MedicineHoustonTexasUSA
| | - Dipaben Modi
- Department of Pulmonary Critical CareBaylor College of MedicineHoustonTexasUSA
| | - Fidaa Shaib
- Department of Pulmonary Critical CareBaylor College of MedicineHoustonTexasUSA
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of SurgeryBaylor College of MedicineHoustonTexasUSA
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Ye X, Vala D, Walker H, Gaza V, Umali V, Brodoff P, Gockel N, Nakamura M. Effects of Unilateral Neuromuscular Electrical Stimulation with Illusionary Mirror Visual Feedback on the Contralateral Muscle: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3755. [PMID: 36834447 PMCID: PMC9962941 DOI: 10.3390/ijerph20043755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
We aim to examine the cross-education effects of unilateral muscle neuromuscular electrical stimulation (NMES) training combined with illusionary mirror visual feedback (MVF). Fifteen adults (NMES + MVF: 5; NMES: 5, Control: 5) completed this study. The experimental groups completed a 3-week NMES training on their dominant elbow flexor muscle. The NMES + MVF group had a mirror placed in the midsagittal plane between their upper arms, so a visual illusion was created in which their non-dominant arms appeared to be stimulated. Baseline and post-training measurements included both arms' isometric strength, voluntary activation level, and resting twitch. Cross-education effects were not observed from all dependent variables. For the unilateral muscle, both experimental groups showed greater strength increases when compared to the control (isometric strength % changes: NMES + MVF vs. NMES vs. Control = 6.31 ± 4.56% vs. 4.72 ± 8.97% vs. -4.04 ± 3.85%, p < 0.05). Throughout the training, even with the maximally tolerated NMES, the NMES + MVF group had greater perceived exertion and discomfort than the NMES. Additionally, the NMES-evoked force increased throughout the training for both groups. Our data does not support that NMES combined with or without MVF induces cross-education. However, the stimulated muscle becomes more responsive to the NMES and can become stronger following the training.
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Affiliation(s)
- Xin Ye
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Daniel Vala
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Hayden Walker
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Victor Gaza
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Vinz Umali
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Patrick Brodoff
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Nathan Gockel
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Masatoshi Nakamura
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata 950-3198, Japan
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Yang X, Li P, Lei J, Feng Y, Tang L, Guo J. Integrated Application of Low-Intensity Pulsed Ultrasound in Diagnosis and Treatment of Atrophied Skeletal Muscle Induced in Tail-Suspended Rats. Int J Mol Sci 2022; 23:10369. [PMID: 36142280 PMCID: PMC9498990 DOI: 10.3390/ijms231810369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 08/29/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022] Open
Abstract
Long-term exposure to microgravity leads to muscle atrophy, which is primarily characterized by a loss of muscle mass and strength and reduces one′s functional capability. A weightlessness-induced muscle atrophy model was established using the tail suspension test to evaluate the intervention or therapeutic effect of low-intensity pulsed ultrasound (LIPUS) on muscle atrophy. The rats were divided into five groups at random: the model group (B), the normal control group (NC), the sham-ultrasound control group (SUC), the LIPUS of 50 mW/cm2 radiation group (50 UR), and the LIPUS of 150 mW/cm2 radiation group (150 UR). Body weight, gastrocnemius weight, muscle force, and B-ultrasound images were used to evaluate muscle atrophy status. Results showed that the body weight, gastrocnemius weight, and image entropy of the tail suspension group were significantly lower than those of the control group (p < 0.01), confirming the presence of muscle atrophy. Although the results show that the muscle force and two weights of the rats stimulated by LIPUS are still much smaller than those of the NC group, they are significantly different from those of the pure tail suspension B group (p < 0.01). On day 14, the gastrocnemius forces of the rats exposed to 50 mW/cm2 and 150 mW/cm2 LIPUS were 150% and 165% of those in the B group. The gastrocnemius weights were both 135% of those in the B group. This suggests that ultrasound can, to a certain extent, prevent muscular atrophy.
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Affiliation(s)
- Xuebing Yang
- Shaanxi Key Laboratory of Ultrasonics, Shaanxi Normal University, Xi’an 710119, China
| | - Pan Li
- Shaanxi Key Laboratory of Ultrasonics, Shaanxi Normal University, Xi’an 710119, China
| | - Jiying Lei
- Shaanxi Key Laboratory of Ultrasonics, Shaanxi Normal University, Xi’an 710119, China
- Junior Middle Department, Shanxi Modern Bilingual School, Taiyuan 030031, China
| | - Yichen Feng
- Shaanxi Key Laboratory of Ultrasonics, Shaanxi Normal University, Xi’an 710119, China
| | - Liang Tang
- Institute of Sports Biology, Shaanxi Normal University, Xi’an 710119, China
| | - Jianzhong Guo
- Shaanxi Key Laboratory of Ultrasonics, Shaanxi Normal University, Xi’an 710119, China
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Ye X, Gockel N, Vala D, Devoe T, Brodoff P, Gaza V, Umali V, Walker H. Wide-Pulse High-Frequency Neuromuscular Electrical Stimulation Evokes Greater Relative Force in Women Than in Men: A Pilot Study. Sports (Basel) 2022; 10:sports10090134. [PMID: 36136389 PMCID: PMC9501951 DOI: 10.3390/sports10090134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to examine the potential sex differences in wide-pulse high-frequency neuromuscular electrical stimulation (WPHF NMES)-evoked force. Twenty-two subjects (10 women) completed this study. Prior to the stimulation, the visual analogue scale (VAS) for discomfort and the rating of perceived exertion (RPE) were measured, followed by the isometric strength of the dominant elbow flexor muscles. The subjects then completed ten, 10-s on 10-s off WPHF NMES (pulse width: 1 ms, frequency: 100 Hz) at maximum tolerable intensities. The subjects’ RPE was recorded after each set, and the VAS was measured following the last stimulation. The stimulation induced significant increase in discomfort for both sexes, with women having greater discomfort than men (men: 22.4 ± 14.9 mm, women: 39.7 ± 12.7 mm). The stimulation amplitude was significantly greater in men than in women (men: 16.2 ± 6.3 mA, women: 12.0 ± 4.5 mA). For the evoked force, only the relative NMES-evoked force was found greater in women than in men (men: 8.96 ± 6.51%, women: 17.08 ± 12.61%). In conclusion, even at the maximum tolerable intensity, WPHF NMES evoked larger relative elbow flexion force in women than in men, with women experiencing greater discomfort.
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Affiliation(s)
- Xin Ye
- Correspondence: ; Tel.: +1-860-768-5787
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10
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Ganse B, Orth M, Roland M, Diebels S, Motzki P, Seelecke S, Kirsch SM, Welsch F, Andres A, Wickert K, Braun BJ, Pohlemann T. Concepts and clinical aspects of active implants for the treatment of bone fractures. Acta Biomater 2022; 146:1-9. [PMID: 35537678 DOI: 10.1016/j.actbio.2022.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/24/2022] [Accepted: 05/02/2022] [Indexed: 12/17/2022]
Abstract
Nonunion is a complication of long bone fractures that leads to disability, morbidity and high costs. Early detection is difficult and treatment through external stimulation and revision surgery is often a lengthy process. Therefore, alternative diagnostic and therapeutic options are currently being explored, including the use of external and internal sensors. Apart from monitoring fracture stiffness and displacement directly at the fracture site, it would be desirable if an implant could also vary its stiffness and apply an intervention to promote healing, if needed. This could be achieved either by a predetermined protocol, by remote control, or even by processing data and triggering the intervention itself (self-regulated 'intelligent' or 'smart' implant). So-called active or smart materials like shape memory alloys (SMA) have opened up opportunities to build active implants. For example, implants could stimulate fracture healing by active shortening and lengthening via SMA actuator wires; by emitting pulses, waves, or electromagnetic fields. However, it remains undefined which modes of application, forces, frequencies, force directions, time durations and periods, or other stimuli such implants should ideally deliver for the best result. The present paper reviews the literature on active implants and interventions for nonunion, discusses possible mechanisms of active implants and points out where further research and development are needed to build an active implant that applies the most ideal intervention. STATEMENT OF SIGNIFICANCE: Early detection of delays during fracture healing and timely intervention are difficult due to limitations of the current diagnostic strategies. New diagnostic options are under evaluation, including the use of external and internal sensors. In addition, it would be desirable if an implant could actively facilitate healing ('Intelligent' or 'smart' implant). Implants could stimulate fracture healing via active shortening and lengthening; by emitting pulses, waves, or electromagnetic fields. No such implants exist to date, but new composite materials and alloys have opened up opportunities to build such active implants, and several groups across the globe are currently working on their development. The present paper is the first review on this topic to date.
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Abitante TJ, Rutkove SB, Duda KR, Newman DJ. Effect of Athletic Training on Fatigue During Neuromuscular Electrical Stimulation. Front Sports Act Living 2022; 4:894395. [PMID: 35774382 PMCID: PMC9237484 DOI: 10.3389/fspor.2022.894395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/09/2022] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to explore the effect an individual's exercise training type will have on muscle fatigability during repetitive contractions induced by Neuromuscular Electrical Stimulation (NMES). Thirty-four subjects comprising of competitive athletes and controls were recruited into three cohorts: Endurance (runners/cyclists) n = 13; nine male, four female; 27 ± 8 years old, Explosive (Lifters/Sprinters) n = 11; nine male, two female; 30 ± 7 years old, and controls n = 10, six male, four female, 26 ± 4 years old. Subjects were placed in a custom-made leg extension rig, and received NMES against a fixed resistance (NMES-FR), to the Vastus Medialis muscle resulting in isometric leg extensions, at a duty cycle of 1 s on/3 s rest, for 20 min. The force of the isometric contractions was recorded using a Hogan MicroFet2 dynamometer, and three separate fatigue metrics were calculated to compare the different cohorts, sports within each cohort, and gender within each cohort. For every fatigue metric, the endurance group fatigued significantly less than both the explosive and control cohorts, with no difference observed between the explosive and the controls. Within each cohort, no significant difference was observed in any fatigue metric between sport or gender, but these comparisons lacked power. The results show that only high capacity endurance activity will have any effect on reducing one's fatigability during repetitive NMES. The implications of this conclusion can aid in the development of NMES regimens for use in healthy populations, such as athletic training or astronaut musculoskeletal countermeasures, as well as clinical applications when fatigue is to be minimized.
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Affiliation(s)
- Thomas J. Abitante
- Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, United States
- The Charles Stark Draper Laboratory, Inc., Cambridge, MA, United States
- *Correspondence: Thomas J. Abitante
| | - Seward B. Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
| | - Kevin R. Duda
- The Charles Stark Draper Laboratory, Inc., Cambridge, MA, United States
| | - Dava J. Newman
- MIT Media Lab, Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, MA, United States
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12
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Running Experimental Research of a Cable-Driven Astronaut on-Orbit Physical Exercise Equipment. MACHINES 2022. [DOI: 10.3390/machines10050377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Manned spaceflight has already become an important approach to space science exploration, while long-term exposure to the microgravity environment will lead to severe health problems for astronauts, including bone loss, muscle atrophy, and cardiovascular function decline. In order to mitigate or eliminate those negative influences, this paper presents a cable-driven exercise equipment that can be applied in a microgravity environment to render multi-functional on-orbit physical exercise modes for astronauts. First, the structure of cable module and the configuration of the equipment were proposed. Second, a two-level controller was provided, including the cable tension distribution algorithm and tension controller of the cable module. A safety protection strategy was proposed to ensure the safety of the astronaut. Furthermore, simulation and running experiment studies of the equipment were conducted, the results demonstrate that the load force of the equipment could achieve a high-level accuracy, and the exercise status of the astronaut could be monitored and protected in the meantime. Therefore, physical exercises could be carried out by the assistance of the equipment to keep astronauts in good shape on-orbit.
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13
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KiloHertz currents on aspects of muscle function: A scoping review. J Bodyw Mov Ther 2022; 32:110-119. [DOI: 10.1016/j.jbmt.2022.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 05/15/2022] [Indexed: 11/19/2022]
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14
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Nunes EA, Stokes T, McKendry J, Currier BS, Phillips SM. Disuse-induced skeletal muscle atrophy in disease and non-disease states in humans: mechanisms, prevention, and recovery strategies. Am J Physiol Cell Physiol 2022; 322:C1068-C1084. [PMID: 35476500 DOI: 10.1152/ajpcell.00425.2021] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Decreased skeletal muscle contractile activity (disuse) or unloading leads to muscle mass loss, also known as muscle atrophy. The balance between muscle protein synthesis (MPS) and muscle protein breakdown (MPB) is the primary determinant of skeletal muscle mass. A reduced mechanical load on skeletal muscle is one of the main external factors leading to muscle atrophy. However, endocrine and inflammatory factors can act synergistically in catabolic states, amplifying the atrophy process and accelerating its progression. Additionally, older individuals display aging-induced anabolic resistance, which can predispose this population to more pronounced effects when exposed to periods of reduced physical activity or mechanical unloading. Different cellular mechanisms contribute to the regulation of muscle protein balance during skeletal muscle atrophy. This review summarizes the effects of muscle disuse on muscle protein balance and the molecular mechanisms involved in muscle atrophy in the absence or presence of disease. Finally, a discussion of the current literature describing efficient strategies to prevent or improve the recovery from muscle atrophy is also presented.
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Affiliation(s)
- Everson A Nunes
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada.,Laboratory of Investigation of Chronic Diseases, Department of Physiological Sciences, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Tanner Stokes
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - James McKendry
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Brad S Currier
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Stuart M Phillips
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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15
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Kilroy EA, Ignacz AC, Brann KL, Schaffer CE, Varney D, Alrowaished SS, Silknitter KJ, Miner JN, Almaghasilah A, Spellen TL, Lewis AD, Tilbury K, King BL, Kelley JB, Henry CA. Beneficial impacts of neuromuscular electrical stimulation on muscle structure and function in the zebrafish model of Duchenne muscular dystrophy. eLife 2022; 11:62760. [PMID: 35324428 PMCID: PMC8947762 DOI: 10.7554/elife.62760] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/10/2022] [Indexed: 12/20/2022] Open
Abstract
Neuromuscular electrical stimulation (NMES) allows activation of muscle fibers in the absence of voluntary force generation. NMES could have the potential to promote muscle homeostasis in the context of muscle disease, but the impacts of NMES on diseased muscle are not well understood. We used the zebrafish Duchenne muscular dystrophy (dmd) mutant and a longitudinal design to elucidate the consequences of NMES on muscle health. We designed four neuromuscular stimulation paradigms loosely based on weightlifting regimens. Each paradigm differentially affected neuromuscular structure, function, and survival. Only endurance neuromuscular stimulation (eNMES) improved all outcome measures. We found that eNMES improves muscle and neuromuscular junction morphology, swimming, and survival. Heme oxygenase and integrin alpha7 are required for eNMES-mediated improvement. Our data indicate that neuromuscular stimulation can be beneficial, suggesting that the right type of activity may benefit patients with muscle disease.
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Affiliation(s)
- Elisabeth A Kilroy
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States
| | - Amanda C Ignacz
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States
| | - Kaylee L Brann
- School of Biology and Ecology, University of Maine, Orono, United States
| | - Claire E Schaffer
- School of Biology and Ecology, University of Maine, Orono, United States
| | - Devon Varney
- School of Biology and Ecology, University of Maine, Orono, United States
| | | | - Kodey J Silknitter
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States
| | - Jordan N Miner
- Department of Chemical and Biomedical Engineering, University of Maine, Orono, United States
| | - Ahmed Almaghasilah
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States
| | - Tashawna L Spellen
- School of Biology and Ecology, University of Maine, Orono, United States
| | - Alexandra D Lewis
- School of Biology and Ecology, University of Maine, Orono, United States
| | - Karissa Tilbury
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States.,Department of Chemical and Biomedical Engineering, University of Maine, Orono, United States
| | - Benjamin L King
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States.,Department of Molecular and Biomedical Sciences, University of Maine, Orono, United States
| | - Joshua B Kelley
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States.,Department of Molecular and Biomedical Sciences, University of Maine, Orono, United States
| | - Clarissa A Henry
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States.,School of Biology and Ecology, University of Maine, Orono, United States
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16
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Wellauer V, Item JF, Bizzini M, Maffiuletti NA. Home-Based Nonoperative-Side Quadriceps Neuromuscular Electrical Stimulation Prevents Muscle Weakness Following Anterior Cruciate Ligament Reconstruction. J Clin Med 2022; 11:jcm11020466. [PMID: 35054160 PMCID: PMC8781752 DOI: 10.3390/jcm11020466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 02/06/2023] Open
Abstract
We compared the effectiveness of a home-based neuromuscular electrical stimulation (NMES) program applied to the quadriceps of the nonoperative side against sham-NMES as a complement to standard rehabilitation on knee extensor neuromuscular function in patients following anterior cruciate ligament (ACL) reconstruction. Twenty-four patients completed the 6 week NMES (n = 12) and sham-NMES (n = 12) post-operative interventions and were tested at different time points for neuromuscular function and self-reported knee function. Isometric, concentric, and eccentric strength deficits (muscle weakness) increased significantly from pre-surgery to 24 weeks post-surgery in the sham-NMES group (p < 0.05), while no significant changes were observed in the NMES group. On the stimulated (nonoperative) side, quadriceps voluntary activation and muscle thickness were respectively maintained (p > 0.05) and increased (p < 0.001) as a result of the NMES intervention, contrary to sham-NMES. Self-reported knee function improved progressively during the post-operative phase (p < 0.05), with no difference between the two groups. Compared to a sham-NMES intervention, a 6 week home-based NMES program applied to the quadriceps of the nonoperative side early after ACL reconstruction prevented the occurrence of knee extensor muscle weakness 6 months after surgery. We conclude that nonoperative-side NMES may help counteract muscle weakness after ACL reconstruction.
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Affiliation(s)
- Vanessa Wellauer
- Human Performance Lab., Schulthess Clinic, 8008 Zurich, Switzerland; (V.W.); (J.F.I.); (M.B.)
- Performance Diagnostics, Schulthess Clinic, 8008 Zurich, Switzerland
| | - Julia F. Item
- Human Performance Lab., Schulthess Clinic, 8008 Zurich, Switzerland; (V.W.); (J.F.I.); (M.B.)
| | - Mario Bizzini
- Human Performance Lab., Schulthess Clinic, 8008 Zurich, Switzerland; (V.W.); (J.F.I.); (M.B.)
| | - Nicola A. Maffiuletti
- Human Performance Lab., Schulthess Clinic, 8008 Zurich, Switzerland; (V.W.); (J.F.I.); (M.B.)
- Correspondence: ; Tel.: +41-(0)4-4385-7975
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17
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Hughes L, Hackney KJ, Patterson SD. Optimization of Exercise Countermeasures to Spaceflight Using Blood Flow Restriction. Aerosp Med Hum Perform 2022; 93:32-45. [PMID: 35063054 DOI: 10.3357/amhp.5855.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION: During spaceflight missions, astronauts work in an extreme environment with several hazards to physical health and performance. Exposure to microgravity results in remarkable deconditioning of several physiological systems, leading to impaired physical condition and human performance, posing a major risk to overall mission success and crew safety. Physical exercise is the cornerstone of strategies to mitigate physical deconditioning during spaceflight. Decades of research have enabled development of more optimal exercise strategies and equipment onboard the International Space Station. However, the effects of microgravity cannot be completely ameliorated with current exercise countermeasures. Moreover, future spaceflight missions deeper into space require a new generation of spacecraft, which will place yet more constraints on the use of exercise by limiting the amount, size, and weight of exercise equipment and the time available for exercise. Space agencies are exploring ways to optimize exercise countermeasures for spaceflight, specifically exercise strategies that are more efficient, require less equipment, and are less time-consuming. Blood flow restriction exercise is a low intensity exercise strategy that requires minimal equipment and can elicit positive training benefits across multiple physiological systems. This method of exercise training has potential as a strategy to optimize exercise countermeasures during spaceflight and reconditioning in terrestrial and partial gravity environments. The possible applications of blood flow restriction exercise during spaceflight are discussed herein.Hughes L, Hackney KJ, Patterson SD. Optimization of exercise countermeasures to spaceflight using blood flow restriction. Aerosp Med Hum Perform. 2021; 93(1):32-45.
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18
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Pérez Olivera AL, Solan MC, Karamanidis K, Mileva KN, James DC. A voluntary activation deficit in m. abductor hallucis exists in asymptomatic feet. J Biomech 2021; 130:110863. [PMID: 34844033 DOI: 10.1016/j.jbiomech.2021.110863] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 01/06/2023]
Abstract
M. abductor hallucis (AbH) is the strongest intrinsic foot muscle and its dysfunction underlies various foot disorders. Attempts to strengthen the muscle by voluntary exercises are constrained by its complex morphology and oblique mechanical action, which leads to an inability even in asymptomatic individuals to fully activate AbH. This study investigated the extent and magnitude of this inability whilst also providing preliminary evidence for the virtue of targeted sub-maximum neuromuscular electrical stimulation (NMES) as a countermeasure for an AbH activation deficit. The voluntary activation ratio (VAR) was assessed via the twitch interpolation technique in the left AbH of 13 healthy participants during maximum voluntary 1st metatarsophalangeal joint flexion-abduction contractions (MVC). Participants were grouped ("able" or "unable") based on their ability to fully activate AbH (VAR ≥ 0.9). 7 s-NMES trains (20 Hz) were then delivered to AbH with current intensity increasing from 150% to 300% motor threshold (MT) in 25% increments. Perceived comfort was recorded (10 cm-visual analogue scale; VAS). Only 3 participants were able to activate AbH to its full capacity (able, mean (range) VAR: 0.93 (0.91-0.95), n = 3; unable: 0.69 (0.36-0.83), n = 10). However, the maximum absolute forces produced during the graded sub-maximum direct-muscle NMES protocol were comparable between groups implying that the peripheral contractility of AbH is intact irrespective of the inability of individuals to voluntary activate AbH to its full capacity. These findings demonstrate that direct-muscle NMES overcomes the prevailing inability for high voluntary AbH activation and therefore offers the potential to strengthen the healthy foot and restore function in the pathological foot.
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Affiliation(s)
- Andrei L Pérez Olivera
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, UK.
| | - Matthew C Solan
- Department of Trauma and Orthopaedic Surgery, Royal Surrey County Hospital, Guildford, Surrey GU2 5XX, UK
| | - Kiros Karamanidis
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, UK
| | - Katya N Mileva
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, UK
| | - Darren C James
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, UK
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19
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Tajima H, Matsuse H, Hashida R, Nago T, Bekki M, Iwanaga S, Higashi E, Shiba N. Electrically stimulated eccentric contraction during non-weight bearing knee bending exercise in the supine position increases oxygen uptake: A randomized, controlled, exploratory crossover trial. PLoS One 2021; 16:e0259856. [PMID: 34793521 PMCID: PMC8601547 DOI: 10.1371/journal.pone.0259856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/24/2021] [Indexed: 12/02/2022] Open
Abstract
It is well known that prolonged bed rest induces muscle weakness, muscle atrophy, cardiovascular deconditioning, bone loss, a loss of functional capacity, and the development of insulin resistance. Neuromuscular electrical stimulation is anticipated to be an interventional strategy for disuse due to bed rest. A hybrid training system (HTS), synchronized neuromuscular electrical stimulation for voluntary exercise using an articular motion sensor, may increase the exercise load though bed rest. We assessed oxygen uptake or heart rate during knee bending exercise in the supine position on a bed both simultaneously combined with HTS and without HTS to evaluate exercise intensity on different days in ten healthy subjects (8 men and 2 women) by a randomized controlled crossover trial. The values of relative oxygen uptake during knee bending exercise with HTS were significantly greater than those during knee bending exercise without HTS (7.29 ± 0.91 ml/kg/min vs. 8.29 ± 1.06 ml/kg/min; p = 0.0115). That increment with HTS was a mean of 14.42 ± 13.99%. Metabolic equivalents during knee bending exercise with HTS and without HTS were 2.08 ± 0.26 and 2.39 ± 0.30, respectively. The values of heart rate during knee bending exercise with HTS were significantly greater than those during knee bending exercise without HTS (80.82 ± 9.19 bpm vs. 86.36 ± 5.50 bpm; p = 0.0153). HTS could increase exercise load during knee bending exercise which is easy to implement on a bed. HTS might be a useful technique as a countermeasure against the disuse due to bed rest, for example during acute care or the quarantine for infection prophylaxis.
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Affiliation(s)
- Hiroshi Tajima
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
| | - Hiroo Matsuse
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
- * E-mail:
| | - Ryuki Hashida
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
| | - Takeshi Nago
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
| | - Masafumi Bekki
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
| | - Sohei Iwanaga
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
| | - Eriko Higashi
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
| | - Naoto Shiba
- Rehabilitation Center, Kurume University, Kurume, Fukuoka, Japan
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20
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Genchi GG, Degl’Innocenti A, Martinelli C, Battaglini M, De Pasquale D, Prato M, Marras S, Pugliese G, Drago F, Mariani A, Balsamo M, Zolesi V, Ciofani G. Cerium Oxide Nanoparticle Administration to Skeletal Muscle Cells under Different Gravity and Radiation Conditions. ACS APPLIED MATERIALS & INTERFACES 2021; 13:40200-40213. [PMID: 34410709 PMCID: PMC8414486 DOI: 10.1021/acsami.1c14176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/05/2021] [Indexed: 05/28/2023]
Abstract
For their remarkable biomimetic properties implying strong modulation of the intracellular and extracellular redox state, cerium oxide nanoparticles (also termed "nanoceria") were hypothesized to exert a protective role against oxidative stress associated with the harsh environmental conditions of spaceflight, characterized by microgravity and highly energetic radiations. Nanoparticles were supplied to proliferating C2C12 mouse skeletal muscle cells under different gravity and radiation levels. Biological responses were thus investigated at a transcriptional level by RNA next-generation sequencing. Lists of differentially expressed genes (DEGs) were generated and intersected by taking into consideration relevant comparisons, which led to the observation of prevailing effects of the space environment over those induced by nanoceria. In space, upregulation of transcription was slightly preponderant over downregulation, implying involvement of intracellular compartments, with the majority of DEGs consistently over- or under-expressed whenever present. Cosmic radiations regulated a higher number of DEGs than microgravity and seemed to promote increased cellular catabolism. By taking into consideration space physical stressors alone, microgravity and cosmic radiations appeared to have opposite effects at transcriptional levels despite partial sharing of molecular pathways. Interestingly, gene ontology denoted some enrichment in terms related to vision, when only effects of radiations were assessed. The transcriptional regulation of mitochondrial uncoupling protein 2 in space-relevant samples suggests perturbation of the intracellular redox homeostasis, and leaves open opportunities for antioxidant treatment for oxidative stress reduction in harsh environments.
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Affiliation(s)
- Giada Graziana Genchi
- Istituto
Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera (Pisa), Italy
| | - Andrea Degl’Innocenti
- Istituto
Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera (Pisa), Italy
| | - Chiara Martinelli
- Istituto
Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera (Pisa), Italy
| | - Matteo Battaglini
- Istituto
Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera (Pisa), Italy
| | - Daniele De Pasquale
- Istituto
Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera (Pisa), Italy
- Scuola
Superiore Sant’Anna, The BioRobotics
Institute, Viale Rinaldo
Piaggio 34, 56025 Pontedera (Pisa), Italy
| | - Mirko Prato
- Istituto
Italiano di Tecnologia, Materials Characterization, Via Morego 30, 16163 Genova, Italy
| | - Sergio Marras
- Istituto
Italiano di Tecnologia, Materials Characterization, Via Morego 30, 16163 Genova, Italy
| | - Giammarino Pugliese
- Istituto
Italiano di Tecnologia, Nanochemistry, Via Morego 30, 16163 Genova, Italy
| | - Filippo Drago
- Istituto
Italiano di Tecnologia, Nanochemistry, Via Morego 30, 16163 Genova, Italy
| | | | - Michele Balsamo
- Kayser
Italia S.r.l., Via di
Popogna 501, 57128 Livorno, Italy
| | - Valfredo Zolesi
- Kayser
Italia S.r.l., Via di
Popogna 501, 57128 Livorno, Italy
| | - Gianni Ciofani
- Istituto
Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera (Pisa), Italy
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21
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Chen YC, Davies RG, Hengist A, Carroll HA, Perkin OJ, Betts JA, Thompson D. Effects of neuromuscular electrical stimulation on energy expenditure and postprandial metabolism in healthy men. Appl Physiol Nutr Metab 2021; 47:1-7. [PMID: 34403626 DOI: 10.1139/apnm-2021-0361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
It is unclear whether neuromuscular electrical stimulation (NMES) has meaningful metabolic effects when users have the opportunity to self-select the intensity to one that can be comfortably tolerated. Nine healthy men aged 28 ± 9 y (mean ± SD) with a body mass index 22.3 ± 2.3 kg/m2 completed 3 trials involving a 2-h oral glucose tolerance test whilst, in a randomised counterbalanced order, (1) sitting motionless (SIT), (2) standing motionless (STAND); and (3) sitting motionless with NMES of quadriceps and calves at a self-selected tolerable intensity. The mean (95% confidence interval [CI]) total energy expenditure was greater in the NMES trial (221 [180-262] kcal/2 h) and STAND trial (178 [164-191] kcal/2 h) than during SIT (159 [150-167] kcal/2 h) (both, p < 0.05). This was primarily driven by an increase in carbohydrate oxidation in the NMES and STAND trials compared with the SIT trial (p < 0.05). Postprandial insulin iAUC was lower in both NMES and STAND compared with SIT (16.4 [7.7-25.1], 17 [7-27] and 22.6 [10.8-34.4] nmol·120 min/L, respectively; both, p < 0.05). Compared with sitting, both NMES and STAND increased energy expenditure and whole-body carbohydrate oxidation and reduced postprandial insulin concentrations in healthy men, with more pronounced effects seen with NMES. Self-selected NMES is a potential strategy for improving metabolic health. This trial is registered at ClinicalTrials.gov (ID: NCT04389736). Novelty: NMES at a comfortable intensity enhances energy expenditure and carbohydrate oxidation, and reduces postprandial insulinemia. Thus, self-selected NMES represents a potential strategy to improve metabolic health.
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Affiliation(s)
- Yung-Chih Chen
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
- Department for Health, University of Bath, Bath, United Kingdom
| | | | - Aaron Hengist
- Department for Health, University of Bath, Bath, United Kingdom
| | - Harriet A Carroll
- Department for Health, University of Bath, Bath, United Kingdom
- Clinical Research Centre, Cardiovascular Research-Hypertension, Lund University, Malmo, Sweden
| | - Oliver J Perkin
- Department for Health, University of Bath, Bath, United Kingdom
| | - James A Betts
- Department for Health, University of Bath, Bath, United Kingdom
| | - Dylan Thompson
- Department for Health, University of Bath, Bath, United Kingdom
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22
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Welch C, Majid Z, Greig C, Gladman J, Masud T, Jackson T. Interventions to ameliorate reductions in muscle quantity and function in hospitalised older adults: a systematic review towards acute sarcopenia treatment. Age Ageing 2021; 50:394-404. [PMID: 33098419 PMCID: PMC7936029 DOI: 10.1093/ageing/afaa209] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Assimilate evidence for interventions to ameliorate negative changes in physical performance, muscle strength and muscle quantity in hospitalised older adults. METHODS We searched for articles using MEDLINE, Embase, CINAHL and Cochrane library using terms for randomised controlled trials, older adults, hospitalisation and change in muscle quantity, strength or physical performance. Two independent reviewers extracted data and assessed risk of bias. We calculated standardised mean differences for changes in muscle function/quantity pre- and post-intervention. RESULTS We identified 9,805 articles; 9,614 were excluded on title/abstract; 147 full texts were excluded. We included 44 studies including 4,522 participants; mean age 79.1. Twenty-seven studies (n = 3,417) involved physical activity interventions; a variety were trialled. Eleven studies involved nutritional interventions (n = 676). One trial involved testosterone (n = 39), two involved Growth Hormone (n = 53), one involved nandrolone (n = 29), and another involved erythropoietin (n = 141). Three studies (n = 206) tested Neuromuscular Electrical Stimulation. Evidence for effectiveness/efficacy was limited. Strongest evidence was for multi-component physical activity interventions. However, all studies exhibited at least some concerns for overall risk of bias, and considering inconsistencies of effect sizes across studies, certainty around true effect sizes is limited. CONCLUSION There is currently insufficient evidence for effective interventions to ameliorate changes in muscle function/quantity in hospitalised older adults. Multiple interventions have been safely trialled in heterogeneous populations across different settings. Treatment may need to be stratified to individual need. Larger scale studies testing combinations of interventions are warranted. Research aimed at understanding pathophysiology of acute sarcopenia will enable careful risk stratification and targeted interventions.
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Affiliation(s)
- Carly Welch
- Address correspondence to: Carly Welch, University of Birmingham Research Laboratories, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, B15 2GW, UK. Tel: +01213713243.
| | - Zeinab Majid
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
- University Hospitals Birmingham NHS Trust, Birmingham, UK
| | - Carolyn Greig
- Medical Research Council and Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Nottingham, UK
- University Hospitals Birmingham NHS Trust, Birmingham, UK
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - John Gladman
- Medical Research Council and Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Nottingham, UK
- National Institute for Health Research Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Tahir Masud
- Medical Research Council and Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Nottingham, UK
- National Institute for Health Research Nottingham Biomedical Research Centre: Musculoskeletal Disease theme, Nottingham, UK
- Healthcare of Older People, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Thomas Jackson
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
- Medical Research Council and Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham and University of Nottingham, Nottingham, UK
- University Hospitals Birmingham NHS Trust, Birmingham, UK
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23
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Rabello R, Fröhlich M, Maffiuletti NA, Vaz MA. Influence of Pulse Waveform and Frequency on Evoked Torque, Stimulation Efficiency, and Discomfort in Healthy Subjects. Am J Phys Med Rehabil 2021; 100:161-167. [PMID: 32701636 DOI: 10.1097/phm.0000000000001541] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of the study was to determine the influence of neuromuscular electrical stimulation pulse waveform and frequency on evoked torque, stimulation efficiency, and discomfort at two neuromuscular electrical stimulation levels. DESIGN This is a repeated measures study. The quadriceps muscle of 24 healthy men was stimulated at submaximal (neuromuscular electrical stimulationsub) and maximal (neuromuscular electrical stimulationmax) levels using two pulse waveforms (symmetrical, asymmetrical) and three pulse frequencies (60, 80, 100 Hz). Repeated measures analysis of variance and effect sizes were used to verify the effect of pulse waveform and pulse frequency on stimulation efficiency (evoked torque/current intensity) and discomfort and to assess the magnitude of the differences, respectively. RESULTS Stimulation efficiency was higher for symmetrical (neuromuscular electrical stimulationsub = 0.88 ± 0.21 Nm/mA; neuromuscular electrical stimulationmax = 1.27 ± 0.46 Nm/mA) compared with asymmetrical (neuromuscular electrical stimulationsub = 0.77 ± 0.21 Nm/mA; neuromuscular electrical stimulationmax = 1.02 ± 0.34 Nm/mA; P ≤ 0.001; effect size = 0.56-0.66) but did not significantly differ between frequencies (P = 0.17). At both neuromuscular electrical stimulation levels, there were no statistically significant differences in discomfort between pulse waveforms or frequencies. CONCLUSIONS The higher stimulation efficiency of symmetrical pulses suggests that this waveform would be preferred to asymmetrical pulses in clinical practice. Stimulation frequencies between 60 and 100 Hz can be used interchangeably because of similar efficiency and discomfort.
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Affiliation(s)
- Rodrigo Rabello
- From the Laboratório de Pesquisa do Exercício, Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil (RR, MF, MAV); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy (RR); and Human Performance Laboratory, Schulthess Clinic, Zurich, Switzerland (NAM)
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24
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Mirzoev TM. Skeletal Muscle Recovery from Disuse Atrophy: Protein Turnover Signaling and Strategies for Accelerating Muscle Regrowth. Int J Mol Sci 2020; 21:ijms21217940. [PMID: 33114683 PMCID: PMC7663166 DOI: 10.3390/ijms21217940] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/08/2020] [Accepted: 10/23/2020] [Indexed: 12/15/2022] Open
Abstract
Skeletal muscle fibers have a unique capacity to adjust their metabolism and phenotype in response to alternations in mechanical loading. Indeed, chronic mechanical loading leads to an increase in skeletal muscle mass, while prolonged mechanical unloading results in a significant decrease in muscle mass (muscle atrophy). The maintenance of skeletal muscle mass is dependent on the balance between rates of muscle protein synthesis and breakdown. While molecular mechanisms regulating protein synthesis during mechanical unloading have been relatively well studied, signaling events implicated in protein turnover during skeletal muscle recovery from unloading are poorly defined. A better understanding of the molecular events that underpin muscle mass recovery following disuse-induced atrophy is of significant importance for both clinical and space medicine. This review focuses on the molecular mechanisms that may be involved in the activation of protein synthesis and subsequent restoration of muscle mass after a period of mechanical unloading. In addition, the efficiency of strategies proposed to improve muscle protein gain during recovery is also discussed.
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Affiliation(s)
- Timur M Mirzoev
- Myology Laboratory, Institute of Biomedical Problems RAS, Moscow 123007, Russia
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25
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Riedler DC, Zsoldos RR, Robel M, Jobst ID, Licka TF. Movement Caused by Electrical Stimulation of the Lumbosacral Region in Standing Horses. J Equine Vet Sci 2020; 91:103116. [PMID: 32684261 DOI: 10.1016/j.jevs.2020.103116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/12/2020] [Accepted: 05/04/2020] [Indexed: 11/29/2022]
Abstract
Electrical stimulation is commonly used as a modality for physical therapy in human and veterinary medicine. However, studies measuring the movement generated by electrical stimulation in horses are rare. The present study therefore evaluates the range of movement provoked by a commercially available physical therapy unit (FES310) and contrasts it with the movement generated by manually induced pelvic inclination (back rounding). Ten horses were tested on three measurement days over one week. Electrical stimulation was applied via a back treatment pad (belonging to the FES310 system) containing six electrodes (three on either side of the spine) placed over the lumbosacral region. This system produced a pulsed, biphasic electrical stimulation in a rectangular waveform which was gradually increased to a maximum of 10 volts. Before and after electrical stimulation testing, manual pelvic inclination was achieved by pressure on two points lateral to the root of the tail. Muscle tone and lameness were evaluated before and after treatments. Skinfold thickness, body condition score, and body mass were measured to detect possible confounding factors. Using kinematics, the angle ranges during movement of ten three-dimensional angles of the trunk, the pelvis, and the hind limbs were further analyzed. Movement was produced with manual stimulation in every tested individual on all measurement days and with electrical stimulation on at least one measurement day. The electrical stimulation led to significantly (P < .05) smaller angle ranges which were 15 %-57 % of the median of the manually stimulated movement. Strong positive correlations between angle ranges of the electrically generated movement were found for the hind limbs implicating their involvement in the movement created. Correlations between skinfold thickness, body condition score, and body mass with the angle ranges were weak and not significant. Before and after electrical and manual stimulation, muscle tone and lameness were similar. In the present study, both electrical and manual stimulation were proven to produce significant trunk and hind limb movement. Within this study's electrical stimulation treatment protocol, the movement generated by electrical stimulation was significantly less than the movement caused by manual pelvic inclination. However, electrical stimulation could easily be applied over a longer period and in a higher frequency than it would be possible for manual pelvic inclination. This treatment shows potential for stabilization and or mobilization of the lumbosacral region, although its efficiency as a therapeutic tool and its effect on specific orthopedic problems and is to be evaluated in further research.
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Affiliation(s)
- Daniela C Riedler
- University Clinic for Horses, Department of Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Rebeka R Zsoldos
- School of Agriculture and Food Sciences, The University of Queensland, Gatton, Queensland, Australia
| | - Matthias Robel
- University Clinic for Horses, Department of Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Isabelle D Jobst
- University Clinic for Horses, Department of Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Theresia F Licka
- University Clinic for Horses, Department of Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria; Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, Scotland, United Kingdom.
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