Employment of Neuromuscular Electrical Stimulation to Examine Muscle and Bone Qualities after Spinal Cord Injury

J. Clin. Med., 2022 · DOI: 10.3390/jcm11226681 · Published: November 11, 2022

Spinal Cord Injury Neurology Musculoskeletal Medicine

Simple Explanation

This study explores using neuromuscular electrical stimulation (NMES) to assess muscle and bone health in people with spinal cord injury (SCI). The goal was to determine if NMES amplitude could differentiate between those with greater versus lower musculoskeletal qualities. Seventeen participants with chronic SCI underwent three weeks of NMES-resistance training. They were divided into two groups based on current amplitude and leg extension repetitions: group A (greater musculoskeletal qualities) and group B (lower musculoskeletal qualities). The study found that NMES amplitude and repetitions of leg extension could differentiate between SCI survivors with varying musculoskeletal qualities, potentially highlighting the interaction between muscle and bone after SCI.

Study Duration

3 weeks

Participants

17 persons (2 women) with chronic SCI

Evidence Level

Not specified

Key Findings

1
Lower NMES current amplitude was associated with greater muscle cross-sectional area (CSA) and bone mineral density (BMD) in the distal femur and proximal tibia.
2
Participants with greater musculoskeletal qualities (group A) exhibited higher peak isometric torque, indicating stronger muscle function.
3
Higher spasticity and muscle spasm scores were observed in the group with greater musculoskeletal qualities, suggesting a potential protective role of spasticity in maintaining muscle and bone health.

Research Summary

The study investigated the use of surface neuromuscular electrical stimulation (NMES) amplitude to assess muscle and bone qualities in individuals with spinal cord injury (SCI). Results indicated that NMES amplitude and repetitions of leg extension could differentiate between SCI survivors with greater versus lower musculoskeletal qualities. The findings suggest a potential interplay between muscle and bone in persons with SCI, with spasticity and muscle spasms possibly contributing to the maintenance of muscle and bone health.

Practical Implications

Diagnostic Tool

NMES can be used as a simple and inexpensive diagnostic tool to indirectly assess musculoskeletal quality in persons with SCI.

Therapeutic Intervention

NMES-RT may represent a potential rehabilitation tool for evoking muscle hypertrophy, reducing IMF and enhancing bone quality in persons with SCI.

Guiding Clinical Trials

The use of NMES may provide a simple and safe technique for clinicians and researchers to guide their endeavors to limit the number of patients undergoing imaging techniques and to identify those who are at risks of developing neurogenic osteoporosis which may lead to condylar fractures in the future.

Study Limitations

1
Small sample size
2
Inclusion of only two women in the study
3
Limitations related to the specific NMES unit, electrodes, and anatomical location of the electrodes used

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