Endurance neuromuscular electrical stimulation training improves skeletal muscle oxidative capacity in individuals with motor‐complete spinal cord injury

Abstract

Introduction Spinal cord injury (SCI) results in skeletal muscle atrophy, increases in intramuscular fat, and reductions in skeletal muscle oxidative capacity. Endurance training elicited with neuromuscular electrical stimulation (NMES) may reverse these changes and lead to improvement in muscle metabolic health. Methods Fourteen participants with complete SCI performed 16 weeks of home-based endurance NMES training of knee extensors muscles. Skeletal muscle oxidative capacity, muscle composition, and blood metabolic and lipid profiles were assessed pre- and post-training. Results There was an increase in number of contractions performed throughout the duration of training. The average improvement in skeletal muscle oxidative capacity was 119%, ranging from −14% to 387% (P = 0.019). There were no changes in muscle composition or blood metabolic and lipid profiles. Discussion Endurance training improved skeletal muscle oxidative capacity, however endurance NMES of knee extensor muscles did not change blood metabolic and lipid profiles.

In Vivo Assessment of Mitochondrial Dysfunction in Clinical Populations Using Near-Infrared Spectroscopy

“…The more impactful application of NIRS, however, is the assessment of mitochondrial dysfunction in clinical populations. There has been increasing interests in the ability of NIRS to quickly and noninvasively measure muscle mitochondrial function in clinical populations that may be affected by declines in oxidative capacity (Erickson et al, 2013 , 2015 , 2016 ; Bossie et al, 2016 ). NIRS can evaluate mitochondrial function in various muscles affected by pathology without imposing the burden of muscle biopsies, performing rigorous exercise tests, or even removing patients from their treatment facility.…”

“…NIRS can evaluate mitochondrial function in various muscles affected by pathology without imposing the burden of muscle biopsies, performing rigorous exercise tests, or even removing patients from their treatment facility. In addition, NIRS also provides a method of evaluating the effectiveness of therapeutic interventions targeting muscle mitochondrial function (Erickson et al, 2016 ). Several recent studies have employed this methodology to evaluate mitochondrial function in various clinical populations, and the findings are providing novel insight into pathophysiology and rehabilitation interventions (McCully et al, 2011 ; Erickson et al, 2013 , 2015 , 2016 ; Ryan et al, 2013d , 2014b ; Bossie et al, 2016 ).…”

“…Notably, the post-training oxidative capacity of the paralyzed muscle was comparable to previously reported measures from able bodied persons (Erickson et al, 2013 ; Ryan et al, 2013d ). In a more recent study of fourteen persons with SCI performing a similar progressive electrical stimulation training protocol, oxidative capacity of the vastus lateralis as measured by NIRS increased ~2-fold on average (Erickson et al, 2016 ). These studies demonstrate the usefulness of NIRS as a method of evaluating the effects of therapeutic interventions that does not require invasive muscle biopsies or expense of MRS.…”

Passive Strategies for the Prevention of Muscle Wasting During Recovery from Sports Injuries

“…Dirks et al [16] found that NMES increased MPS and inhibited the activation of protein degradation pathways in subjects with knee immobilization for 5 days, thereby preventing muscle mass loss [16]. In addition, NMES increases muscular and functional resistance especially in clinical patients [81], as well as muscle oxidative capacity [19] and VO 2max [44,80]. In addition, similar to endurance training, NMES increases antioxidant capacity [26,27], therefore proving useful in reducing the redox imbalance elicited by disuse periods [57].…”

Femoral Artery Blood Flow and Microcirculatory Perfusion During Acute, Low-Level Functional Electrical Stimulation in Spinal Cord Injury

“…Using electrically stimulated leg exercise in individuals with SCI, Thijssen et al showed evidence of arterial remodeling in areas subject to electrically stimulated muscular contractions, while vascular adaptations were not apparent in the passive, non-stimulated areas of the leg 11 . In addition to conduit remodeling, studies have shown that functional electrical stimulation (FES) results in increased muscle mass 12 , higher muscular oxidative capacity 13 , enhanced capillary supply 4 and improved blood flow 2 . This highlights the potency of FES to mediate beneficial adaptations.…”