Electrical Stimulation During Gait Promotes Increase of Muscle Cross-sectional Area in Quadriplegics: A Preliminary Study
Electrical Stimulation During Gait Promotes Increase of Muscle Cross-sectional Area in Quadriplegics: A Preliminary Study
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DOI：
10.1007/s11999-008-0496-9
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发表时间：
2009-02-01
影响因子：
4.2
通讯作者：
Cendes, Fernando
中科院分区：
文献类型：
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作者：
Carvalho de Abreu, Daniela Cristina;Cliquet, Alberto, Jr.;Cendes, Fernando
四肢瘫痪者训练后肌肉横截面积（CSA）增加，但神经肌肉电刺激（NMES）沿着训练的效果尚不清楚。因此，我们提出了两个问题：（1）在跑步机步态训练中，NMES是否会增加完全性四肢瘫痪患者的股四头肌CSA？（2）单独进行踏车步态训练是否足以观察到CSA的增加？15例四肢瘫痪者分为步态组（n = 8）和对照组（n = 7）。步态组进行NMES训练6个月，每周2次，每次20 min。在传统治疗6个月后，对照组接受相同的步态训练方案，但不接受NMES。在研究开始时、6个月时（两组）和12个月时（对照组）采集大腿轴向图像，以确定平均股四头肌CSA。6个月后，步态组的CSA增加（从49.8 +/- A 9.4 cm（2）增加到57.3 +/- A 10.3 cm（2）），但对照组没有增加（从43.6 +/- A 7.6 cm（2）增加到41.8 +/- A 8.4 cm（2））。对照组在无NMES的情况下再进行6个月步态训练后，CSA没有变化（从41.8 +/- A 8.4 cm（2）变为41.7 +/- A 7.9 cm（2））。慢性完全性四肢瘫痪患者步态训练后股四头肌CSA的增加似乎与NMES相关。
Increases in muscular cross-sectional area (CSA) occur in quadriplegics after training, but the effects of neuromuscular electrical stimulation (NMES) along with training are unknown. Thus, we addressed two questions: (1) Does NMES during treadmill gait training increase the quadriceps CSA in complete quadriplegics?; and (2) Is treadmill gait training alone enough to observe an increase in CSA? Fifteen quadriplegics were divided into gait (n = 8) and control (n = 7) groups. The gait group performed training with NMES for 6 months twice a week for 20 minutes each time. After 6 months of traditional therapy, the control group received the same gait training protocol but without NMES for an additional 6 months. Axial images of the thigh were acquired at the beginning of the study, at 6 months (for both groups), and at 12 months for the control group to determine the average quadriceps CSA. After 6 months, there was an increase of CSA in the gait group (from 49.8 +/- A 9.4 cm(2) to 57.3 +/- A 10.3 cm(2)), but not in the control group (from 43.6 +/- A 7.6 cm(2) to 41.8 +/- A 8.4 cm(2)). After another 6 months of gait without NMES in the control group, the CSA did not change (from 41.8 +/- A 8.4 cm(2) to 41.7 +/- A 7.9 cm(2)). The increase in quadriceps CSA after gait training in patients with chronic complete quadriplegia appears associated with NMES.