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Supplement Number 1
Volume 42 Number 3, May/June 2005
Pages 43 — 54

Abstract - Muscle biopsies show that FES of denervated muscles reverses human muscle degeneration from permanent spinal motoneuron lesion

Helmut Kern, MD;1 Katia Rossini, DBiol;2 Ugo Carraro, MD;2* Winfried Mayr, PhD;3 Michael Vogelauer, MD;1 Ursula Hoellwarth, MD;1 Christian Hofer, DEng1

1Ludwig Boltzmann Institute of Electrostimulation and Physical Rehabilitation, Department of Physical Medicine, Wilhelminenspital. A-1171 Vienna, Austria; 2C.N.R. Institute of Neuroscience, Laboratory of Applied Myology of the Department of Biomedical Science and of the Interuniversity Institute of Myology, University of Padua Medical School, I-35121 Padua, Italy; 3Center of Biomedical Engineering and Physics, Medical University of Vienna, A-1090 Vienna, Austria
Abstract — This paper presents biopsy analyses in support of the clinical evidence of muscle recovery induced by a new system of life-long functional-electrical-stimulation (FES) training in permanent spinal-motoneuron-denervated human muscle. Not earlier than 1 year after subjects experienced complete conus cauda lesion, their thigh muscles were electrically stimulated at home for several years with large skin surface electrodes and an expressly designed stimulator that delivered much longer impulses than those presently available for clinical use. The poor excitability of long-term denervated muscles was first improved by several months of twitch-contraction training. Then, the muscles were tetanically stimulated against progressively increased loads. Needle biopsies of vastus lateralis from long-term denervated subjects showed severe myofiber atrophy or lipodystrophy beginning 2 years after spinal cord injury (SCI). Muscle biopsies from a group of 3.6- to 13.5-year denervated subjects, who underwent 2.4 to 9.3 years of FES, show that this progressive training almost reverted long-term muscle atrophy/degeneration.
Key words: FES, functional electrical stimulation, human, long-duration impulses, long-term denervation, muscle, muscle degeneration, muscle recovery, myofiber regeneration, permanent denervation, spinal cord injury, spinal motoneuron lesion.

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