HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: 95/4/2380    most recent 01181.2005v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (19) Citing Articles via Google Scholar Google Scholar Articles by Shields, R. K. Articles by Dudley-Javoroski, S. Search for Related Content PubMed PubMed Citation Articles by Shields, R. K. Articles by Dudley-Javoroski, S.

Musculoskeletal Plasticity After Acute Spinal Cord Injury: Effects of Long-Term Neuromuscular Electrical Stimulation Training

Graduate Program in Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, Iowa

Submitted 8 November 2005; accepted in final form 7 January 2006

Maintaining the physiologic integrity of paralyzed limbs may be critical for those with spinal cord injury (SCI) to be viable candidates for a future cure. No long-term intervention has been tested to attempt to prevent the severe musculoskeletal deterioration that occurs after SCI. The purposes of this study were to determine whether a long-term neuromuscular electrical stimulation training program can preserve the physiological properties of the plantar flexor muscles (peak torque, fatigue index, torque-time integral, and contractile speed) as well as influence distal tibia trabecular bone mineral density (BMD). Subjects began unilateral plantar flexion electrical stimulation training within 6 wk after SCI while the untrained leg served as a control. Mean compliance for the 2-yr training program was 83%. Mean estimated compressive loads delivered to the tibia were 1–1.5 times body weight. The training protocol yielded significant trained versus untrained limb differences for torque (+24%), torque-time integral (+27%), fatigue index (+50%), torque rise time (+45%), and between-twitch fusion (+15%). These between-limb differences were even greater when measured at the end of a repetitive stimulation protocol (125 contractions). Peripheral quantitative computed tomography revealed 31% higher distal tibia trabecular BMD in trained limbs than in untrained limbs. The intervention used in this study was sufficient to limit many of the deleterious muscular and skeletal adaptations that normally occur after SCI. Importantly, this method of load delivery was feasible and may serve as the basis for an intervention to preserve the musculoskeletal properties of individuals with SCI.

This article has been cited by other articles:

				C. K. Thomas, C. K. Hager-Ross, and C. S. Klein Effects of baclofen on motor units paralysed by chronic cervical spinal cord injury Brain, November 10, 2009; (2009) awp285v1. [Abstract] [Full Text] [PDF]

				T. G. Hornby, M. D. Lewek, C. K. Thompson, and R. Heitz Repeated Maximal Volitional Effort Contractions in Human Spinal Cord Injury: Initial Torque Increases and Reduced Fatigue Neurorehabil Neural Repair, November 1, 2009; 23(9): 928 - 938. [Abstract] [PDF]

				J. Glinsky, L. Harvey, P. van Es, S. Chee, and S. C Gandevia The addition of electrical stimulation to progressive resistance training does not enhance the wrist strength of people with tetraplegia: a randomized controlled trial Clinical Rehabilitation, August 1, 2009; 23(8): 696 - 704. [Abstract] [PDF]

				A. F. DiMarco and K. E. Kowalski Effects of chronic electrical stimulation on paralyzed expiratory muscles J Appl Physiol, June 1, 2008; 104(6): 1634 - 1640. [Abstract] [Full Text] [PDF]

				S. Dudley-Javoroski, A. E. Littmann, M. Iguchi, and R. K. Shields Doublet stimulation protocol to minimize musculoskeletal stress during paralyzed quadriceps muscle testing J Appl Physiol, June 1, 2008; 104(6): 1574 - 1582. [Abstract] [Full Text] [PDF]

				P. Negredo, J.-L. L. Rivero, B. Gonzalez, A. Ramon-Cueto, and R. Manso Slow- and fast-twitch rat hind limb skeletal muscle phenotypes 8 months after spinal cord transection and olfactory ensheathing glia transplantation J. Physiol., May 15, 2008; 586(10): 2593 - 2610. [Abstract] [Full Text] [PDF]

				S. Dudley-Javoroski and R. K Shields Dose Estimation and Surveillance of Mechanical Loading Interventions for Bone Loss After Spinal Cord Injury Physical Therapy, March 1, 2008; 88(3): 387 - 396. [Abstract] [Full Text] [PDF]

				R. K. Shields and S. Dudley-Javoroski Musculoskeletal Adaptations in Chronic Spinal Cord Injury: Effects of Long-term Soleus Electrical Stimulation Training Neurorehabil Neural Repair, March 1, 2007; 21(2): 169 - 179. [Abstract] [PDF]

				R. L. W. Harris, C. T. Putman, M. Rank, L. Sanelli, and D. J. Bennett Spastic Tail Muscles Recover From Myofiber Atrophy and Myosin Heavy Chain Transformations in Chronic Spinal Rats J Neurophysiol, February 1, 2007; 97(2): 1040 - 1051. [Abstract] [Full Text] [PDF]

				R. K. Shields, S. Dudley-Javoroski, and K. R. Cole Feedback-controlled stimulation enhances human paralyzed muscle performance J Appl Physiol, November 1, 2006; 101(5): 1312 - 1319. [Abstract] [Full Text] [PDF]

				R. K. Shields, S. Dudley-Javoroski, and A. E. Littmann Postfatigue potentiation of the paralyzed soleus muscle: evidence for adaptation with long-term electrical stimulation training J Appl Physiol, August 1, 2006; 101(2): 556 - 565. [Abstract] [Full Text] [PDF]