Critically ill patients in the intensive care unit (ICU) develop muscle atrophy and decreased physical function. Though neuromuscular electrical stimulation (NMES) therapy has been shown to be effective in preventing this, but its effect on older patients is unknown.To examine the course of critically ill older patients treated with NMES in the ICU and to define the impact of its use.A retrospective cohort study was conducted using older ICU patients (≥65 years) categorized into a control group (n = 20) and an NMES group (n = 22). For subgroup analysis, each group was further classified into pre-old age (65-74 years) and old age (≥75 years).The control group showed significant decrease in muscle thickness during ICU and hospital stay. The NMES group showed lower reduction in muscle thickness and showed decrease in muscle echo intensity during hospital stay, compared to the control group. NMES inhibited decrease in muscle thickness in the pre-old age group versus the old age group. The decreasing effect of NMES on echo intensity during hospital stay manifested only in the pre-old age group. We did not find much difference in physical functioning between the NMES and control groups.Lower limb muscle atrophy reduces in critically ill older patients (≥65 years) with NMES and is pronounced in patients aged < 75 years. The impact of NMES on the physical functioning of older patients in ICU needs to be further investigated.

Cervical myelopathy is caused by chronic segmental compression of the spinal cord because of degenerative changes of the spine. However, the exact mechanisms of chronic cervical cord compression are not fully understood. The purpose of this study was to validate a new animal model of chronic cervical cord compression capable of reproducing the clinical course without laminectomy in rats. A polyethylene line attached to a plastic plate was fastened with three turns around the vertebral body of C4 in 1-month-old rats. After surgery, the polyethylene line grows deeper into the dorsal wall of the spinal canal along with the growth of the spinal canal and vertebral body, producing a gradual compression of the spinal cord. The results show that this cervical canal stenosis (CCS) model in rats caused motor deficits and sensory disturbances 9 months after initiating CCS; however, no clinical manifestations took place until 6 months. The intramedullary high-intensity area on T2-weighted images was observed in 70% of the CCS model rats at 12 months after initiating CCS. In histological sections, the spinal cord was compressed along the entire circumference at 12 months after initiating CCS. The number of ventral neurons was decreased, and the white matter showed wallerian degeneration. This model might reproduce characteristic features of clinical chronic cervical cord compression, including progressive motor and sensory disturbances after a latency period and insidious neuronal loss, and represents chronic compression of the cervical spinal cord in humans.

2022-Muscle blood volume increases due to stretching; however, the minimum duration of stretching to sustainably increase the muscle blood volume after stretching has not yet been elucidated. This study examined whether the duration of static stretching influenced the muscle blood volume and oxygenation. Ten healthy male subjects participated in this controlled laboratory study. Static stretching of the gastrocnemius muscle was performed for 5 durations (20 seconds, and 1, 2, 5, and 10 minutes). Changes in both the total-Hb (DtHb), as an index of blood volume, and tissue oxygenation index (DTOI) from baseline were determined using near-infrared spectroscopy. Both the DtHb and DTOI decreased during stretching and increased after stretching. The minimum value of DtHb during stretching did not differ in each of the 5 durations, but minimum DTOI progressively decreased with longer durations of stretching. The peak value of DtHb after stretching increased with longer durations of stretching. The value of DtHb at 5 minutes after the end of stretching increased with more than 2 minutes of stretching compared with 20 seconds of stretching, although the value of DtHb did not significantly differ between the 2, 5, and 10 minutes' durations. These findings suggest that a longer duration of stretching elicits a decrease in muscle oxygenation during stretching, and an increase in both the muscle blood volume and oxygenation after stretching. The results indicated that the minimum duration of stretching to sustain an increase in the muscle blood volume after stretching is 2 minutes.

The purpose of this study was to clarify the effects of muscle strengthening of hip abductor and adductor muscles just after surgery on gait at discharge. [Subjects and Methods] Subjects were twelve patients who had open reduction and internal fixation (ORIF) for unstable unilateral fractures of the pelvis. Six patients started muscle strengthening exercises at two weeks after surgery (regular rehabilitation group, RR), and another six patients started muscle strengthening of hip abductor and adductor muscles at two or three days after surgery (early rehabilitation group, ER). All patients were assessed for free gait without a cane when they were discharged from hospital. Gait analysis was performed using the VICON 370 system with six cameras and four force plates. [Results] Walking speed, step length and cadence showed no significant differences between the two groups. The hip abductor moment of the ER group was significantly higher than that of the RR group. [Conclusion] Our results suggest that early muscle strengthening of hip abductor and adductor muscles might improve hip abductor moment at discharge.