Effect of anaerobic and aerobic exercise promoted by computer regulated functional electrical stimulation (FES) on muscle size, strength and histology in paraplegic males

The influence of anaerobic and aerobic exercise, promoted by computer regulated functional electrical stimulation (FES) was evaluated in four paraplegic males. Quadriceps muscle bulk was monitored by serial computerised axial tomography (CT) scanning and histology by muscle biopsies from the vastus intermedins. Anaerobic exercise consisted of 60 degree straight leg raising against increasing weights (range 1.4-11.4 kg) over a period of ten weeks. Aerobic exercise consisted of pedalling a modified Monark bicycle ergometer at 50 rpm against a fixed load ranging from 0-3/8 kilopond (0-18.75 watts) over a period of eight months. In both exercise studies the same work was not achieved by each paraplegic. FES was regulated by a closed loop system which is not presently commercially available, the frequency of the sequential muscle stimulator was 40 Hz with a pulse width of 300 us. Quadriceps muscle area of both legs increased 62.7% (p<0.01) after anaerobic exercise; similar but less pronounced effects followed aerobic exercise. Histologically two distinct patterns were noted from the outset, one had normal fibre type distribution the remainder had marked Type 1 loss. Both exercise regimens failed to change these although the number of internal nuclei per 100 fibres steadily increased (from 7.0% to 13.8% to 26.0%) as did the % of fibres with internal nuclei (5.4% to 10.5% to 25.7%) throughout the exercise periods. The significance of these observations is not immediately apparent but may signify continuing damage which may be due to the eccentric rather than the concentric nature of FES promoted muscular contraction.

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The Effects of Quadriceps Kinesio Taping on Aerobic and Anaerobic Exercise Performance in Healthy Participants: A Randomized Controlled Study

International Journal of Athletic Therapy & Training ◽

10.1123/ijatt.2014-0137 ◽

2016 ◽

Vol 21 (2) ◽

pp. 32-38 ◽

Cited By ~ 4

Author(s):

Neslihan Duruturk ◽

Nihan Ozunlu Pekyavas ◽

Atakan Yρlmaz ◽

Metin Karatas

Keyword(s):

Aerobic Exercise ◽

Exercise Capacity ◽

Exercise Performance ◽

Athletic Performance ◽

Quadriceps Muscle ◽

Anaerobic Exercise ◽

Randomized Controlled ◽

Aerobic Exercise Capacity ◽

Aerobic And Anaerobic ◽

Healthy Participants

Objective:Aerobic and anaerobic exercise capacities are important components of athletic performance. The use of Kinesio Taping® (KT) as a supplementary treatment in athletic settings has increased in the recent years. KT can facilitate muscle contraction, which may be useful for improving performance. The purpose of this study was to determine whether the application of KT to the quadriceps muscle has any effect on anaerobic and aerobic performance in young healthy individuals.Design:Randomized, controlled, double-blind clinical study.Setting:Baskent University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation.Patients:Thirty-two healthy male participants were randomly assigned to either the KT group or a sham KT (SKT) group.Interventions:The KT muscle facilitation technique was applied to the quadriceps muscle bilaterally and measurements were taken 45 min later to ensure full adhesion.Main Outcome Measures:The Wingate cycle ergometer test was used to assess peak anaerobic power (peak AnP, in Watts) and exercise capacity (Watt/kg), while the 6-minute walk test (6MWT) was used to assess aerobic exercise capacity of the participants. Comparisons between groups were performed using the nonparametric Mann-Whitney U test, while those between baseline and posttaping used the nonparametric Wilcoxon test.Results:No significant difference was found between the two groups in the aerobic or anaerobic test parameters (p > .05). Within the groups, a significant improvement in time factors in peak AnP (929.7 2 ± 184.37 W to 1043.49 ± 224.42 W) was found only in the KT group (p = .028) and no other parameter was significantly different (p > .05).Conclusions:KT applied to the quadriceps muscle can positively improve anaerobic exercise performance and athletic performance capacity. However, KT did not affect aerobic capacity. Further research is needed to show that KT can improve and support anaerobic and aerobic exercise capacity in healthy participants or athletes.

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Comparison of strategies and performance of functional electrical stimulation cycling in spinal cord injury pilots for competition in the first ever CYBATHLON

European Journal of Translational Myology ◽

10.4081/ejtm.2017.7219 ◽

2017 ◽

Vol 27 (4) ◽

Cited By ~ 4

Author(s):

Christine Azevedo Coste ◽

Vance Bergeron ◽

Rik Berkelmans ◽

Emerson Fachin Martins ◽

Ché Fornusek ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Muscular Contraction ◽

Cord Injury ◽

Clinical Environments ◽

And Performance ◽

Mechanical Devices ◽

Complete Spinal Cord Injury

Functional Electrical Stimulation (FES) can elicit muscular contraction and restore motor function in paralyzed limbs. FES is a rehabilitation technique applied to various sensorimotor deficiencies and in different functional situations, e.g. grasping, walking, standing, transfer, cycling and rowing. FES can be combined with mechanical devices. FES-assisted cycling is mainly used in clinical environments for training sessions on cycle ergometers, but it has also been adapted for mobile devices, usually tricycles. In October 2016, twelve teams participated in the CYBATHLON competition in the FES-cycling discipline for persons with motor-complete spinal cord injury. It was the first event of this kind and a wide variety of strategies, techniques and designs were employed by the different teams in the competition. The approaches of the teams are detailed in this special issue. We hope that the knowledge contained herein, together with recent positive results of FES for denervated degenerating muscles, will provide a solid basis to encourage improvements in FES equipment and open new opportunities for many patients in need of safe and effective FES management. We hope to see further developments and/or the benefit of new training strategies at future FES competitions, e.g. at the Cybathlon 2020 (www.cybathlon.ethz.ch).

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Home-Based Functional Electrical Stimulation of Human Permanent Denervated Muscles: A Narrative Review on Diagnostics, Managements, Results and Byproducts Revisited 2020

Diagnostics ◽

10.3390/diagnostics10080529 ◽

2020 ◽

Vol 10 (8) ◽

pp. 529 ◽

Cited By ~ 2

Author(s):

Helmut Kern ◽

Ugo Carraro

Keyword(s):

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Cauda Equina ◽

Quadriceps Muscle ◽

Ultrastructural Organization ◽

Force Output ◽

Case Scenario ◽

Worst Case ◽

Home Based ◽

Cord Injury

Spinal cord injury (SCI) produces muscle wasting that is especially severe after complete and permanent damage of lower motor neurons, as can occur in complete conus and cauda equina syndrome. Even in this worst-case scenario, mass and function of permanently denervated quadriceps muscle can be rescued by surface functional electrical stimulation using a purpose designed home-based rehabilitation strategy. Early diagnostics is a key factor in the long-term success of this management. Function of quadriceps muscle was quantitated by force measurements. Muscle gross cross-sections were evaluated by quantitative color computed tomography (CT) and muscle and skin biopsies by quantitative histology, electron microscopy, and immunohistochemistry. Two years of treatment that started earlier than 5 years from SCI produced: (a) an increase in cross-sectional area of stimulated muscles; (b) an increase in muscle fiber mean diameter; (c) improvements in ultrastructural organization; and (d) increased force output during electrical stimulation. Improvements are extended to hamstring muscles and skin. Indeed, the cushioning effect provided by recovered tissues is a major clinical benefit. It is our hope that new trials start soon, providing patients the benefits they need.

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COMPARATIVE STUDY OF NON-LINEAR CONTROLLERS FOR THE REGULATION OF THE PARAPLEGIC KNEE MOVEMENT USING FUNCTIONAL ELECTRICAL STIMULATION

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519418500197 ◽

2018 ◽

Vol 18 (05) ◽

pp. 1850019

Author(s):

SAFIA BENAHMED ◽

MOHAMED TADJINE ◽

OMAR KERMIA

Keyword(s):

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Quadriceps Muscle ◽

Considerable Improvement ◽

Knee Movement ◽

Linear Behavior ◽

Integral Action ◽

Non Linear ◽

Depth Study ◽

Linear Controllers

The non-idealities resulting from the excitation of the paraplegic quadriceps muscle by the functional electrical stimulation (FES) make the control problem challenging. Few works addressed the control of this highly non-linear behavior where the elaborated controllers are useless in the real world. To improve the controllers’ metrics available in the literature, we test others controllers which are the Double PID, the backstepping, the backstepping with an integral action and the super-twisting. For that, we first propose an in-depth study of the knee’s dynamic through which we explain the poorness of the paraplegic quadriceps response to the FES. As a result, we propose to control using derivative way instead of de-convolving approaches as proposed in the literature. Second, we implement the different controllers cited earlier. Finally, we compare the resulting metrics of each controller with those of literature and we conclude by identifying the best controller among the ones chosen in this study which presents a considerable improvement and advantages.

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Quadriceps muscle deoxygenation during functional electrical stimulation in adults with spinal cord injury

Spinal Cord ◽

10.1038/sj.sc.3101079 ◽

2000 ◽

Vol 38 (10) ◽

pp. 630-638 ◽

Cited By ~ 31

Author(s):

Y Bhambhani ◽

C Tuchak ◽

R Burnham ◽

J Jeon ◽

R Maikala

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Quadriceps Muscle ◽

Muscle Deoxygenation ◽

Cord Injury

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Effects of functional electrical stimulation (FES) on evoked muscular output in paraplegic quadriceps muscle

Spinal Cord ◽

10.1038/sc.1992.100 ◽

1992 ◽

Vol 30 (7) ◽

pp. 467-473 ◽

Cited By ~ 30

Author(s):

E Rabischong ◽

F Ohanna

Keyword(s):

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Quadriceps Muscle

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Muscle Size and Strength Benefits of Functional Electrical Stimulation-Evoked Cycling Dosage in Spinal Cord Injury: A Narrative Review

Sains Malaysiana ◽

10.17576/jsm-2019-4803-13 ◽

2019 ◽

Vol 48 (3) ◽

pp. 607-612

Author(s):

Nurhaida Rosley ◽

Nur Azah Hamzaid ◽

Nazirah Hasnan ◽

Glen M Davis ◽

Haidzir Manaf

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Narrative Review ◽

Muscle Size ◽

Cord Injury

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Functional electrical stimulation of permanently denervated muscles, updated 2020

Journal of restorative medicine and rehabilitation ◽

10.38025/2078-1962-2020-97-3-130-136 ◽

2020 ◽

Vol 97 (3) ◽

pp. 130-136 ◽

Cited By ~ 1

Author(s):

U. Carraro ◽

H. Kern ◽

G. Albertin G. ◽

S. Masiero ◽

A. Pond ◽

...

Keyword(s):

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Cauda Equina ◽

Quadriceps Muscle ◽

Ultrastructural Organization ◽

Force Output ◽

Case Scenario ◽

Cross Sectional ◽

Worst Case ◽

Cord Injury

Spinal cord injury produces muscle wasting, which is especially severe after the complete and permanent damage of lower motor neurons that occurs in complete Cauda Equina Syndrome. Even in this worst-case scenario, we have shown that permanently denervated Quadriceps muscle can be rescued by surface Functional Electrical Stimulation and a purpose designed home-based rehabilitation regime. Here, our aim is to show that the effects are extended to both antagonist muscles and the skin of the thighs. Before and after 2 years of electrical stimulation, mass and structure of Quadriceps and Hamstrings muscles were quantitated by force measurements. Muscle gross cross section were evaluated using color computed tomography, muscle and skin biopsies by quantitative histology and immunohistochemistry. The treatment produced: a) an increase in cross-sectional area of stimulated muscles; b) an increase in muscle fiber mean diameter; c) improvements in ultrastructural organization; and d) increased force output during electrical stimulation. The recovery of Quadriceps muscle force was sufficient to allow 25% of the compliant subjects to perform stand-up and step-in place trainings. Improvements are extended to hamstring muscles and skin. Indeed, the cushioning effect provided by recovered tissues is a major clinical benefit. It is our hope that, with or without our advice, trials may start soon in Europe and Russia to provide persons-in-need the help they deserve.

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Myogenic and Central Neurogenic Factors in Fatigue in Multiple Sclerosis

Multiple Sclerosis Journal ◽

10.1177/135245859600100409 ◽

1996 ◽

Vol 1 (4) ◽

pp. 236-241 ◽

Cited By ~ 25

Author(s):

M Latash ◽

E Kalugina ◽

J Nicholas ◽

C Orpett ◽

D Stefoski ◽

...

Keyword(s):

Multiple Sclerosis ◽

Electrical Stimulation ◽

Muscular Contraction ◽

Quadriceps Muscle ◽

Voluntary Contraction ◽

Joint Torque ◽

Subjective Feeling ◽

Muscle Torque ◽

Myogenic Factors ◽

The Right

Short episodes of electrical stimulation were applied to the right quadriceps muscle of patients with multiple sclerosis (MS) and healthy subjects at different times during 60 sec sustained voluntary muscle contractions at 0 to 100% levels of maximal voluntarily generated joint torque. The amplitude of electrically induced increments of torque (ΔT) has been shown to depend upon both the level of muscular contraction and time from the beginning of the contraction. The dependence of ΔT upon the time from the beginning of contraction has been assumed to reflect muscle fatigue. Patients with MS demonstrated an apparent involvement of central neurogenic mechanisms in fatigue manifested as a drop in muscle torque during sustained contractions at 75 and 100% levels when electrical stimulation was able to induce considerable increments in muscle torque. These patients also demonstrated a dependence of ΔT upon the contraction level suggesting that they did not produce maximal voluntary contraction torque in the pre-trial. Fatigue in MS is due to central, neurogenic factors and does not seem to involve any myogenic factors such as might be related to secondary muscle changes due to the long-standing disorder. The subjective feeling of tiredness (‘fatigue’) may be related to a dissociation between central motor commands (‘effort’) and their mechanical consequences.

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