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Electrical Stimulation During Gait Promotes Increase of Muscle Cross-sectional Area in Quadriplegics: A Preliminary Study

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Clinical Orthopaedics and Related Research

Abstract

Increases in muscular cross-sectional area (CSA) occur in quadriplegics after training, but the effects of neuromuscular electrical stimulation (NMES) along with training are unknown. Thus, we addressed two questions: (1) Does NMES during treadmill gait training increase the quadriceps CSA in complete quadriplegics?; and (2) Is treadmill gait training alone enough to observe an increase in CSA? Fifteen quadriplegics were divided into gait (n = 8) and control (n = 7) groups. The gait group performed training with NMES for 6 months twice a week for 20 minutes each time. After 6 months of traditional therapy, the control group received the same gait training protocol but without NMES for an additional 6 months. Axial images of the thigh were acquired at the beginning of the study, at 6 months (for both groups), and at 12 months for the control group to determine the average quadriceps CSA. After 6 months, there was an increase of CSA in the gait group (from 49.8 ± 9.4 cm2 to 57.3 ± 10.3 cm2), but not in the control group (from 43.6 ± 7.6 cm2 to 41.8 ± 8.4 cm2). After another 6 months of gait without NMES in the control group, the CSA did not change (from 41.8 ± 8.4 cm2 to 41.7 ± 7.9 cm2). The increase in quadriceps CSA after gait training in patients with chronic complete quadriplegia appears associated with NMES.

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Acknowledgments

We thank the students and the subjects for their participation in the project and the FAPESP.

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Authors and Affiliations

  1. Biomechanics, Medicine and Rehabilitation of Locomotor System Department, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Av Bandeirantes, 3900, Ribeirão Preto, SP, Brazil

    Daniela Cristina Carvalho de Abreu PhD

  2. Orthopaedics Department, Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil

    Alberto Cliquet Jr. PhD

  3. Neuroimage Laboratory, Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil

    Jane Maryan Rondina & Fernando Cendes PhD

Authors
  1. Daniela Cristina Carvalho de Abreu PhD
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  2. Alberto Cliquet Jr. PhD
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  3. Jane Maryan Rondina
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  4. Fernando Cendes PhD
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Corresponding author

Correspondence to Daniela Cristina Carvalho de Abreu PhD.

Additional information

One or more of the authors (ACJ) has received funding from Grants 2005/53530-0, 2003/05856-9, and 1996/12198-2 from Fundação de Amparo à Pesquisa do Estado de São Paulo.

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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de Abreu, D.C.C., Cliquet, A., Rondina, J.M. et al. Electrical Stimulation During Gait Promotes Increase of Muscle Cross-sectional Area in Quadriplegics: A Preliminary Study. Clin Orthop Relat Res 467, 553–557 (2009). https://doi.org/10.1007/s11999-008-0496-9

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  • DOI: https://doi.org/10.1007/s11999-008-0496-9

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