Electrical stimulation paradigms on muscle quality and bone mineral density after spinal cord injury.

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Osteoporosis International Pub Date : 2025-06-01 Epub Date: 2025-04-22 DOI:10.1007/s00198-025-07482-5

Ashraf S Gorgey, Siddharth Venigalla, Jakob N Deitrich, William B Ballance, William Carter, Timothy Lavis, Robert A Adler

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引用次数: 0

Abstract

The goal of the work was to determine the effects of altering muscle quality (peak torque and muscle CSA) via NMES-RT on bone mineral density (BMD) following application of FES-lower extremity cycling. Components of muscle quality were altered and attenuated the decline in BMD after SCI.

Introduction: Spinal cord injury (SCI) negatively impacts muscle quality and bone health. Neuromuscular electrical stimulation-resistance training (NMES-RT) has been shown to enhance muscle quality. It is unclear whether adding NMES-RT to functional electrical stimulation (FES)-lower extremity cycling may further augment muscle quality and subsequently enhance bone mineral density (BMD).

Methods: Thirty-two participants were randomized into either 12 weeks of NMES-RT followed by 12 weeks of FES- lower extremity cycling (NMES-RT + FES; n = 16) or 12 weeks of passive movement training (PMT) followed by 12 weeks of FES-lower extremity cycling (PMT + FES; n = 16). Measurements were conducted at baseline (BL), post-interventions 1 and 2 (P1 and P2) separated evenly by 12 weeks. Left thigh muscle isometric and isokinetic torques were measured using an isokinetic dynamometer. Magnetic resonance imaging measured whole thigh and knee extensor (KE) muscle CSAs. Dual energy X-ray absorptiometry measured total and regional BMD.

Results: NMES-RT elicited a trend towards greater isometric torque at 80 Hz (P = 0.057) and isokinetic torque (60 deg/s; P = 0.009 and 180 deg/s; P = 0.003) compared to PMT. Muscle CSA was greater in left whole thigh (F (2,20) = 9.1; P = 0.007) and KE (F (2,20) = 15.5; P = 0.001) by 11.0 and 8.0 cm² respectively at P1 in the NMES-RT + FES compared to PMT + FES. In the NMES-RT + FES, ankle weights were positively associated with muscle CSA, isometric and isokinetic torques as well as muscle quality following P1. Compared to PMT + FES, NMES-RT + FES maintained BMD at the distal femur.

Conclusion: NMES-RT + FES enhanced muscle quality as measured by torque production and muscle CSA as result of increasing ankle weights. The addition of FES- lower extremity cycling to NMES-RT maintained but did not further augment muscle quality. Furthermore, NMES-RT + FES may help maintain BMD after SCI.

Clinical trial registration: Registered with clinicaltrials.gov: NCT02660073.

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电刺激模式对脊髓损伤后肌肉质量和骨密度的影响。

这项工作的目的是确定在应用fes -下肢循环后，通过NMES-RT改变肌肉质量（峰值扭矩和肌肉CSA）对骨矿物质密度（BMD）的影响。肌肉质量成分发生改变，减轻了脊髓损伤后骨密度的下降。脊髓损伤（SCI）对肌肉质量和骨骼健康有负面影响。神经肌肉电刺激-阻力训练（NMES-RT）已被证明可以提高肌肉质量。目前尚不清楚在功能性电刺激(FES)-下肢循环中加入NMES-RT是否可以进一步增强肌肉质量，从而提高骨矿物质密度（BMD）。方法：32名参与者随机分为12周的NMES-RT，随后是12周的FES-下肢循环(NMES-RT + FES；n = 16)或12周被动运动训练（PMT）后12周FES-下肢循环(PMT + FES；n = 16)。在基线（BL）、干预后1和2 （P1和P2）平均间隔12周进行测量。用等速测功机测量左大腿肌肉等速和等速扭矩。磁共振成像测量了整个大腿和膝关节伸肌（KE） csa。双能x射线吸收仪测量了总骨密度和局部骨密度。结果：NMES-RT诱导的等距扭矩在80 Hz （P = 0.057）和等距扭矩(60°/s；P = 0.009, 180度/秒；P = 0.003)。左全大腿肌肉CSA较大(F (2,20) = 9.1；P = 0.007), KE (F (2,20) = 15.5；P = 0.001)，与PMT + FES相比，NMES-RT + FES在P1时分别减少11.0和8.0 cm2。在NMES-RT + FES中，踝关节重量与肌肉CSA、等距和等速扭矩以及P1后的肌肉质量呈正相关。与PMT + FES相比，NMES-RT + FES维持股骨远端骨密度。结论：NMES-RT + FES增加了踝关节重量，通过扭矩产生和肌肉CSA来测量肌肉质量。在NMES-RT中加入FES-下肢循环维持但没有进一步增加肌肉质量。此外，NMES-RT + FES可能有助于维持脊髓损伤后的骨密度。临床试验注册：在clinicaltrials.gov注册：NCT02660073。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Osteoporosis International 医学-内分泌学与代谢

CiteScore

8.10

自引率

10.00%

发文量

224

审稿时长

3 months

期刊介绍： An international multi-disciplinary journal which is a joint initiative between the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA, Osteoporosis International provides a forum for the communication and exchange of current ideas concerning the diagnosis, prevention, treatment and management of osteoporosis and other metabolic bone diseases. It publishes: original papers - reporting progress and results in all areas of osteoporosis and its related fields; review articles - reflecting the present state of knowledge in special areas of summarizing limited themes in which discussion has led to clearly defined conclusions; educational articles - giving information on the progress of a topic of particular interest; case reports - of uncommon or interesting presentations of the condition. While focusing on clinical research, the Journal will also accept submissions on more basic aspects of research, where they are considered by the editors to be relevant to the human disease spectrum.