Biology of muscle atrophy and of its recovery by FES in aging and mobility impairments: roots and by-products

Eur J Transl Myol - Basic Appl Myol, 2015 · DOI: · Published: January 1, 2015

Aging Rehabilitation Musculoskeletal Medicine

Simple Explanation

This paper discusses muscle atrophy related to aging and spinal cord injuries, and investigates the potential of Functional Electrical Stimulation (FES) to counteract muscle degeneration. The study compares muscle biopsies from active and sedentary seniors, showing differences in muscle fiber distribution, suggesting that activity helps maintain motoneurons and muscle fibers. The research also explores the use of FES in denervated muscles, demonstrating that electrical stimulation can retain and even regain muscle mass if people are compliant with the therapy.

Study Duration

Not specified

Participants

Sedentary seniors, active seniors, horses, and paraplegic patients with spinal cord injury

Evidence Level

Not specified

Key Findings

1
Activity maintains the motoneurons and the muscle fibers, evidenced by the different muscle fiber distribution between sedentary and active seniors.
2
Home-based functional electrical stimulation (h-b FES) can stop and revert the degeneration of skeletal muscle tissue in permanently denervated muscles.
3
Mitochondrial distribution and density are significantly changed by functional electrical stimulation in horse muscle biopsies.

Research Summary

The review examines the biology of muscle atrophy, particularly in the context of aging and mobility impairments, and how Functional Electrical Stimulation (FES) can aid in muscle recovery. The study leverages observations from master athletes to understand the linear decline of muscle power with age, emphasizing the role of denervation and reinnervation events in muscle decay. It presents evidence that FES can reverse muscle degeneration in cases of permanent denervation, supported by 2D and 3D Muscle Color Computer Tomography data showing increased muscle content and improved tissue quality.

Practical Implications

Rehabilitation Strategies

FES should be considered for use in rehabilitation centers and nursing facilities for patients who are inactive, even for short periods.

Clinical Practice

The study highlights the need for specific and appropriate electrical stimulation protocols to achieve desired clinical effects in treating denervated muscles.

Therapeutic Development

The findings support the development and use of commercial devices designed for electrical stimulation of long-term permanently denervated muscles.

Study Limitations

1
The exact mechanisms of how FES affects mitochondrial function and muscle fiber behavior require further investigation.
2
The study acknowledges that psychological factors might influence the effectiveness of FES in humans, which are less relevant in animal models.
3
The long-term effects of FES discontinuation need further study, as muscle deterioration can occur again after FES treatment is stopped.

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