Dynamic Echomyography Shows That FES in Peripheral Denervation does not Hamper Muscle Reinnervation

Zanato, Riccardo; Stramare, Roberto; Boato, N.; Zampieri, Sandra; Kern, Helmut; Marcante, Andrea; Masiero, Stefano; Carraro, Ugo

doi:10.1515/bmt-2013-4034

Cited by 17 publications

(12 citation statements)

References 3 publications

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“…[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] The benefits of this technology are being expanded into other areas, and FES has been recently utilized for injury rehabilitation and performance enhancement in horses. [24][25][26][27] The ability of FES to obtain precise, controlled functional movement, when compared to other electrotherapy approaches, is intriguing.…”

Section: Functional Electrical Stimulation (Fes) Has Beenmentioning

confidence: 99%

Functional electrical stimulation as a safe and effective treatment for equine epaxial muscle spasms: Clinical evaluations and histochemical morphometry of mitochondria in muscle biopsies

Ravara¹,

Gobbo

Carraro

et al. 2015

Eur J Transl Myol

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Section: Functional Electrical Stimulation (Fes) Has Beenmentioning

confidence: 99%

Functional electrical stimulation as a safe and effective treatment for equine epaxial muscle spasms: Clinical evaluations and histochemical morphometry of mitochondria in muscle biopsies

Ravara¹,

Gobbo

Carraro

et al. 2015

Eur J Transl Myol

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“…Further, in Padua he is extending the EU RISE results to partially reinnervating muscle, developing dedicated monitoring strategies. 39 , 44 , 45 To objectivize results of these researches, he is proud to have revitalized the clinical use of ultrasound muscle approaches, adding dynamic analyses of contractile properties in clinical evaluation of denervated and reinnervating muscles. Further, he suggested to Paolo Gargiulo and Helmut Kern to add false color to “Monitoring of muscle and bone recovery in spinal cord injury using three-dimensional imaging and segmentation techniques”, to allow doctors and their patients to read much easy-to-interpret Computer Tomography analyses of their deteriorating or recovering muscles.…”

Section: Ugo Carraro: Pioneering Studiesmentioning

confidence: 99%

Home-based Functional Electrical Stimulation for long-term denervated human muscle: History, basics, results and perspectives of the Vienna Rehabilitation Strategy

Kern

Carraro²

2014

Eur J Transl Myol

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We will here discuss the following points related to Home-based Functional Electrical Stimulation (h-b FES) as treatment for patients with permanently denervated muscles in their legs: 1. Upper (UMN) and lower motor neuron (LMN) damage to the lower spinal cord; 2. Muscle atrophy/hypertrophy versus processes of degeneration, regeneration, and recovery; 3. Recovery of twitch- and tetanic-contractility by h-b FES; 4. Clinical effects of h-b FES using the protocol of the “Vienna School”; 5. Limitations and perspectives. Arguments in favor of using the Vienna protocol include: 1. Increased muscle size in both legs; 2. Improved tetanic force production after 3-5 months of percutaneous stimulation using long stimulus pulses (> 100 msec) of high amplitude (> 80 mAmp), tolerated only in patients with no pain sensibility; 3. Histological and electron microscopic evidence that two years of h-b FES return muscle fibers to a state typical of two weeks denervated muscles with respect to atrophy, disrupted myofibrillar structure, and disorganized Excitation-Contraction Coupling (E-CC) structures; 4. The excitability never recovers to that typical of normal or reinnervated muscles where pulses less than 1 msec in duration and 25 mAmp in intensity excite axons and thereby muscle fibres. It is important to motivate these patients for chronic stimulation throughout life, preferably standing up against the load of the body weight rather than sitting. Only younger and low weight patients can expect to be able to stand-up and do some steps more or less independently. Some patients like to maintain the h-b FES training for decades. Limitations of the procedure are obvious, in part related to the use of multiple, large surface electrodes and the amount of time patients are willing to use for such muscle training.

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“…Taken together, these results are clear evidence that combining fibrillation analyses with dynamic echomyography to monitor the denervation phase and to follow the rate of atrophy along with the effectiveness of the electrostimulation can help to develop a therapy that is finely tuned to specific patient’s needs. 120 , 130 …”

Section: Usefulness Of Fibrillations For Monitoring Therapeutic Intermentioning

confidence: 99%

History, mechanisms and clinical value of fibrillation analyses in muscle denervation and reinnervation by Single Fiber Electromyography and Dynamic Echomyography

et al. 2014

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This work reviews history, current clinical relevance and future of fibrillation, a functional marker of skeletal muscle denervated fibers. Fibrillations, i.e., spontaneous contraction, in denervated muscle were first described during the nineteenth century. It is known that alterations in membrane potential are responsible for the phenomenon and that they are related to changes in electrophysiological factors, cellular metabolism, cell turnover and gene expression. They are known to inhibit muscle atrophy to some degree and are used to diagnose neural injury and reinnervation that are occurring in patients. Electromyography (EMG) is useful in determining progress, prognosis and efficacy of therapeutic interventions and their eventual change. For patients with peripheral nerve injury, and thus without the option of volitional contractions, electrical muscle stimulation may be helpful in preserving the contractility and extensibility of denervated muscle tissue and in retarding/counteracting muscle atrophy. It is obvious from the paucity of recent literature that research in this area has declined over the years. This is likely a consequence of the decrease in funding available for research and the fact that the fibrillations do not appear to cause serious health issues. Nonetheless, further exploration of them as diagnostic tools in long-term denervation is merited, in particular if Single Fiber EMG (SFEMG) is combined with Dynamic Echomyography (DyEM), an Ultra Sound muscle approach we recently designed and developed to explore denervated and reinnervating muscles.

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Dynamic Echomyography Shows That FES in Peripheral Denervation does not Hamper Muscle Reinnervation

Cited by 17 publications

References 3 publications

Functional electrical stimulation as a safe and effective treatment for equine epaxial muscle spasms: Clinical evaluations and histochemical morphometry of mitochondria in muscle biopsies

Functional electrical stimulation as a safe and effective treatment for equine epaxial muscle spasms: Clinical evaluations and histochemical morphometry of mitochondria in muscle biopsies

Home-based Functional Electrical Stimulation for long-term denervated human muscle: History, basics, results and perspectives of the Vienna Rehabilitation Strategy

History, mechanisms and clinical value of fibrillation analyses in muscle denervation and reinnervation by Single Fiber Electromyography and Dynamic Echomyography

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