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  4. Neuromuscular disorders in women and men with spinal cord injury are associated with changes in muscle and tendon architecture

Neuromuscular disorders in women and men with spinal cord injury are associated with changes in muscle and tendon architecture

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2022.2035619 · Published: July 1, 2023

Spinal Cord InjuryNeurologyRehabilitation

Simple Explanation

This study looks at how spinal cord injury (SCI) affects the muscles and tendons in the lower limbs, and how this relates to nerve function. The study found that people with SCI had smaller muscles with altered structure (lower thickness, pennation angle, and fascicle length) and increased echo intensity, indicating changes in muscle quality. Tendons were also affected. The study also found electrophysiological disorders in the muscles of SCI patients, suggesting nerve damage. These changes may explain why muscles don't respond well to electrical stimulation after SCI.

Study Duration
January 2019 to September 2019
Participants
15 individuals with SCI and 15 non-disabled individuals
Evidence Level
Cross-sectional study with a control group

Key Findings

  • 1
    Muscle thickness, pennation angle, and fascicle length were lower in SCI participants for most muscles studied (RF, VL, VM, TA).
  • 2
    Echogenicity and chronaxie were greater in SCI participants, indicating changes in muscle quality and nerve function.
  • 3
    SCI participants had a higher prevalence of neuromuscular electrophysiological disorders (NED) in the RF, VL, VM, and TA muscles.

Research Summary

This study investigated the association between neuromuscular function, motor function impairment, and muscle and tendon structures in individuals with SCI compared to a control group. The results showed that individuals with SCI had reduced muscle thickness, pennation angle, and fascicle length, and increased echogenicity, along with a higher prevalence of neuromuscular electrophysiological disorders. These findings suggest that neuromuscular disorders occur in association with muscle and tendon maladaptation in individuals with chronic SCI, which can help clinicians design more rational treatment strategies.

Practical Implications

Rehabilitation Strategies

The study's findings can help in designing more targeted rehabilitation programs for individuals with SCI, focusing on addressing muscle and tendon maladaptations.

NMES Protocols

Understanding the neuromuscular electrophysiological disorders (NED) can lead to optimized NMES protocols tailored to the specific needs of SCI patients.

Early Intervention

Early detection and intervention strategies can be developed to mitigate muscle atrophy and tendon remodeling in individuals with SCI.

Study Limitations

  • 1
    Fascicle length measurements were obtained from 2D images.
  • 2
    Muscle atrophy was not assessed with CSA and volume measurement.
  • 3
    Mechanical and material tendon properties were not evaluated.

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