Recovery from muscle weakness by exercise and FES: lessons from Masters, active or sedentary seniors and SCI patients


Many factors contribute to the decline of skeletal muscle that occurs as we age. This is a reality that we may combat, but not prevent because it is written into our genome. The series of records from World Master Athletes reveals that skeletal muscle power begins to decline at the age of 30 years and continues, almost linearly, to zero at the age of 110 years. Here we discuss evidence that denervation contributes to the atrophy and slowness of aged muscle. We compared muscle from lifelong active seniors to that of sedentary elderly people and found that the sportsmen have more muscle bulk and slow fiber type groupings, providing evidence that physical activity maintains slow motoneurons which reinnervate muscle fibers. Further, accelerated muscle atrophy/degeneration occurs with irreversible Conus and Cauda Equina syndrome, a spinal cord injury in which the human leg muscles may be permanently disconnected from the nervous system with complete loss of muscle fibers within 5–8 years. We used histological morphometry and Muscle Color Computed Tomography to evaluate muscle from these peculiar persons and reveal that contraction produced by home-based Functional Electrical Stimulation (h-bFES) recovers muscle size and function which is reversed if h-bFES is discontinued. FES also reverses muscle atrophy in sedentary seniors and modulates mitochondria in horse muscles. All together these observations indicate that FES modifies muscle fibers by increasing contractions per day. Thus, FES should be considered in critical care units, rehabilitation centers and nursing facilities when patients are unable or reluctant to exercise.

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This work was supported by the European Regional Development Fund—Cross Border Cooperation Programme Slovakia—Austria 2007–2013 (Interreg-IVa), project Mobilität im Alter, MOBIL, N_00033 (Partners: Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Austria, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria, and Faculty of Physical Education and Sports, Comenius University in Bratislava, Slovakia); Austrian national co-financing of the Austrian Federal Ministry of Science and Research; Ludwig Boltzmann Society (Vienna, Austria) and supported by EU Commission Shared Cost Project RISE (Contract No. QLG5-CT-2001-02191) co-financed by the Austrian Ministry of Science. Some of the research reported in this publication was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Number NIH NIAMS 1R03AR053706-01A2 to ALP. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Ugo Carraro thanks the IRCCS Fondazione Ospedale San Camillo, Venice, Italy for hospitality and scientific support.

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Correspondence to Simone Mosole.

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All participants in the senior sportsmen studies were healthy and declared not to have any specific physical/disease issues (for detailed inclusion and exclusion criteria, see NCT01679977). All of the senior sportsmen declared to have a lifelong (30 years) history of high-level training. We certify that all applicable rules concerning the ethical use of human volunteers were followed during the course of this research (approval of ethical committee, Vienna, Austria: EK-02-068-0702).

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual partecipants included in the study.

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Carraro, U., Kern, H., Gava, P. et al. Recovery from muscle weakness by exercise and FES: lessons from Masters, active or sedentary seniors and SCI patients. Aging Clin Exp Res 29, 579–590 (2017).

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  • Aging
  • Master Athletes
  • Muscle
  • Denervation and type grouping
  • FES recovery
  • Muscle Color Computed Tomography