Morphometric and neurophysiological analysis of skeletal muscle in paraplegic patients with traumatic cord lesion

Lotta, S; Scelsi, R; Alfonsi, Enrico; Saitta, Andrea; Nicolotti, D; Epifani, P; Carraro, Ugo

doi:10.1038/sc.1991.35

Cited by 89 publications

(87 citation statements)

References 7 publications

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“…43,44,46,49 The subjects in the present study were 12.5+2.0 years (mean+SE), range 3 ± 24 years after injury at the start of the exercise. Corresponding to previous ®ndings in SCI humans a high percentage of MHC isoform IIB and very little MHC isoform I in muscle were seen in our subjects before initiation of training.…”

Section: Fibre Types Mhc Analysis On Homogenatesmentioning

confidence: 89%

“…48 Studies have indicated that a similar change takes place after SCI in humans. 43,44,46,49 In subjects studied within the ®rst month after damage of the spinal cord an almost normal distribution of ®bres was found, whereas very high percentages of type IIB ®bres and low percentages of type I ®bres have been demonstrated in SCI subjects 9 ± 10 and 17 months, respectively after injury. 43,49 It was suggested that the ®ndings might re¯ect a ®bre transformation from slow twitch type I to fast twitch type IIB in response to spasticity in the paralysed muscles.…”

Section: Fibre Types Mhc Analysis On Homogenatesmentioning

confidence: 98%

“…43,44,46,49 In subjects studied within the ®rst month after damage of the spinal cord an almost normal distribution of ®bres was found, whereas very high percentages of type IIB ®bres and low percentages of type I ®bres have been demonstrated in SCI subjects 9 ± 10 and 17 months, respectively after injury. 43,49 It was suggested that the ®ndings might re¯ect a ®bre transformation from slow twitch type I to fast twitch type IIB in response to spasticity in the paralysed muscles. 49 In studies of SCI individuals after longer periods in the injured state, the percentage of type I ®bres was smallest in the individuals with the longest duration of injury, with a dominance of type IIB ®bres in subjects more than 2 years after SCI.…”

Section: Fibre Types Mhc Analysis On Homogenatesmentioning

confidence: 98%

“…43,49 It was suggested that the ®ndings might re¯ect a ®bre transformation from slow twitch type I to fast twitch type IIB in response to spasticity in the paralysed muscles. 49 In studies of SCI individuals after longer periods in the injured state, the percentage of type I ®bres was smallest in the individuals with the longest duration of injury, with a dominance of type IIB ®bres in subjects more than 2 years after SCI. 44,46 The muscle ®bre type distribution in the muscles above the level of the spinal cord lesion (deltoid muscle in paraplegics) has been found to be normal even several years after injury.…”

Section: Fibre Types Mhc Analysis On Homogenatesmentioning

confidence: 99%

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Long term adaptation to electrically induced cycle training in severe spinal cord injured individuals

et al. 1997

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Spinal cord injured (SCI) individuals most often contract their injury at a young age and are deemed to a life of more or less physical inactivity. In addition to the primary implications of the SCI, severe SCI individuals are stigmatized by conditions related to their physically inactive lifestyle. It is unknown if these inactivity related conditions are potentially reversible and the aim of the present study was, therefore, to examine the e ect of exercise on SCI individuals. Ten such individuals (six with tetraplegia and four with paraplegia; age 27 ± 45 years; time since injury 3 ± 23 years) were exercise trained for 1 year using an electrically induced computerized feedback controlled cycle ergometer. They trained for up to three times a week (mean 2.3 times), 30 min on each occasion. The gluteal, hamstring and quadriceps muscles were stimulated via electrodes placed on the skin over their motor points. During the ®rst training bouts, a substantial variation in performance was seen between the subjects. A majority of them were capable of performing 30 min of exercise in the ®rst bout; however, two individuals were only able to perform a few minutes of exercise. After training for 1 year all of the subjects were able to perform 30 min of continuous training and the work output had increased from 4+1 (mean+SE) to 17+2 Kilo Joules per training bout (P50.05). The maximal oxygen uptake during electrically induced exercise increased from 1.20+0.08 litres per minute measured after a few weeks habituation to the exercise to 1.43+0.09 litres per minute after training for 1 year (P50.05).Magnetic resonance cross sectional images of the thigh were performed to estimate muscle mass and an increase of 12% (mean, P50.05) was seen in response to 1 year of training. In biopsies taken before exercise various degrees of atrophy were observed in the individual muscle ®bres, a phenomenon that was partially normalized in all subjects after training.The ®bre type distribution in skeletal muscles is known to shift towards type IIB ®bres (fast twitch, fast fatiguable, glycolytic ®bres) within the ®rst 2 years after the spinal cord injury. The muscle in the present investigation contained of 63% myosin heavy chain (MHC) isoform IIB, 33% MHC isoform IIA (fast twitch, fatigue resistant) and less than 5% MHC isoform I (slow twitch) before training. A shift towards more fatigue resistant contractile proteins was found after 1 year of training. The percentage of MHC isoform IIA increased to 61% of all contractile protein and a corresponding decrease to 32% was seen in the fast fatiguable MHC isoform IIB, whereas MHC isoform I only comprised 7% of the total amount of MHC. This shift was accompanied by a doubling of the enzymatic activity of citrate synthase, as an indicator of mitochondrial oxidative capacity.It is concluded that inactivity-associated changes in exercise performance capacity and skeletal muscle occurring in SCI individuals after injury are reversible, even up to over 20 years after the injury. It follows that electricall...

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Section: Fibre Types Mhc Analysis On Homogenatesmentioning

confidence: 89%

Section: Fibre Types Mhc Analysis On Homogenatesmentioning

confidence: 98%

Section: Fibre Types Mhc Analysis On Homogenatesmentioning

confidence: 98%

Section: Fibre Types Mhc Analysis On Homogenatesmentioning

confidence: 99%

See 2 more Smart Citations

Long term adaptation to electrically induced cycle training in severe spinal cord injured individuals

et al. 1997

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“…Two studies from Scelsi and collaborators 3,4 are of particular relevance to the present study because they also contain data from SCI patients over signi®cantly earlier time periods post injury than the aforementioned studies. Scelsi et al 3 reported that biopsies from the rectus femoris of SCI patients 1 ± 17 months post injury showed what they described as progressive stages of change.…”

Section: Discussionmentioning

confidence: 99%

Skeletal muscle fibre type transformation following spinal cord injury

et al. 1997

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Following spinal cord injury (SCI), upper motor neuron paralysed muscles lose the normal type I (slow) and II (fast) ®bre mosaic pattern and become predominantly composed of type II (fast glycolytic) ®bres). The majority of the research demonstrating this ®bre type shift was based on pH sensitive myo®brillar ATPase staining techniques on muscle from longstanding paraplegics and quadriplegics. The purpose of this study was to describe muscle ®bre type changes over a wide time spectrum post SCI using immuno¯uorescent techniques which may be more sensitive to change. A total of 19 vastus lateralis muscle biopsy specimens were obtained from 12 SCI subjects representing time points of 0.5 ± 219 months post SCI. Fast and slow myosin heavy chain isoform distribution was determined on single muscle ®bres for each of the biopsy specimens. Early post SCI (51 month) myosin heavy chain (MCH) isoform composition remained relatively stable. A transitional period was seen between 1 and 20 months post SCI wherein there was a progressive drop in the proportion of slow MHC isoform ®bres and a rise in the proportion that co-expressed both the fast and slow MHC isoform. By approximately 70 months post SCI a new steady state had been reached characterized by almost exclusively fast MHC isoform expression. This research has demonstrated that post SCI muscle type II transformation occurs in stages and commences earlier than previously appreciated. Interventions aimed at preventing or minimizing the transformation would need to be instituted within weeks post SCI.

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Physical Medicine and Rehabilitation

Young¹

1997

JAMA

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Morphometric and neurophysiological analysis of skeletal muscle in paraplegic patients with traumatic cord lesion

Cited by 89 publications

References 7 publications

Long term adaptation to electrically induced cycle training in severe spinal cord injured individuals

Long term adaptation to electrically induced cycle training in severe spinal cord injured individuals

Skeletal muscle fibre type transformation following spinal cord injury

Physical Medicine and Rehabilitation

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