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1、Histochemical changes in muscle of individuals with spinal cord injury following functional electrical stimulated exercise trainingPD Chilibeck*,1, J Jeon1,3C Weiss1,3, G Bell1and R Burnham2,31The Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada;2Faculty
2、 ofMedicine, University of Alberta, Edmonton, Alberta, Canada and3The Rick Hansen Centre, University of Alberta,Edmonton, Alberta, CanadaStudy Design:Longitudinal training. Objectives:To determine the e?ects of functional electrical stimulated (FES) leg cycle ergometer training on muscle histochemic
3、al characteristics in individuals with motor-complete spinal cord injury (SCI). Setting:University of Alberta, Edmonton, Alberta, Canada. Methods:Six individuals with motor-complete SCI (age 3150 years; 325 years post- injury) trained using FES leg cycle ergometry for 30 min, 3 days per week for 8 w
4、eeks. Biopsies of the vastus lateralis muscle were obtained pre- and post-training and analyzed forfibre composition, fibre size and capillarization. Results:The majority of muscle fibres were classified as type 2 pre- and post-training.Average fibre area increased 23% (P50.05) and capillary number
5、increased 39% (P50.05) with training. As a result of these proportional increases, capillarization expressed relative tofibre area was unchanged with training. Conclusions:FES leg cycle ergometer training results in proportional increases in fibre area and capillary number in individuals with SCI. S
6、ponsorship:Supported by the Glenrose Rehabilitation Hospital.Keywords: capillarization; vastus lateralis; paraplegia; cycle ergometerIntroductionFollowing spinal cord injury (SCI), paralysed muscleundergoes marked changes, including a shift in fibrecomposition to fast twitch fibre type,13muscle fibr
7、e atrophy,1,2,4and a reduction in capillary number.4,5 These changes may be associated with functionaldeficits at the whole body level, including a reduced aerobiccapacity,6prolongedexercisegas-exchange kinetics,7and reduced insulin-mediated glucose utiliza- tion.5 Functional electrical stimulated (
8、FES) cycle erg- ometer training has been used to improve some of thesewhole-bodyparameters,includingmaximal oxygen uptake,8,9gas-exchange kinetics,8and submax- imal exercise endurance time9,10in individuals with SCI.Inhealthyindividuals,di?erencesinthese measures of exercise peformance have been att
9、ributed to di?erences in muscle characteristics. For example, individuals with a higher proportion of slow-twitchfibres experience a smaller accumulation of metabolic by-productsinvolvedinthefatigueprocess,11,12 presumablyallowinggreaterexerciseendurance.Also, muscle capillarization is related to ma
10、ximal oxygen uptake13,14and recovery from exercise.15,16 Finally,increasesinmusclemassarerelatedto improvements in maximal oxygen uptake and sub- maximalexerciseperformanceinindividualswith initially low muscle mass (ie the elderly).17,18Given the importance of these muscle characteristics for deter
11、mining exercise capacity in healthy individuals, it was of interest to assess the e?ects of exercise training, with FES, on the characteristics of paralysed muscle in individuals with SCI. The purpose of this study was to assess changes inmuscle fibre type composition, muscle fibre area and capillar
12、ization, with FES cycle ergometer training in individualswithSCI.Wehypothesizedthatthis training would favourably induce changes in these muscle characteristics.MethodsSubjectsSix individuals (five males, one female; aged 3150 years) with motor-complete spinal cord injury (325 years post-injury invo
13、lving levels C5-T8) volunteered for this study. Informed consent was obtained and the*Correspondence:PDChilibeck,Ph.D.,CollegeofPhysical Education, University of Saskatchewan, 221 Cumberland Avenue N., Saskatoon, Saskatchewan, Canada S7N 1M3Spinal Cord (1999) 37, 264268 1999 International Medical So
14、ciety of ParaplegiaAll rights reserved 13624393/99 $12.00http:/www.stockton-press.co.uk/scproject was approved by ethics committees of the University of Alberta and the Glenrose Rehabilitation Hospital. Subjects underwent a medical examination priortoparticipation.Exclusioncriteriaincluded subjects
15、with pacemakers, uncontrolled arrhythmias, angina, congestive heart failure, current deep venous thrombosis or pulmonary emboli, severe automomicdysreflexia response to electrical stimulation, less than908 of flexion range of motion of the hips and knees, severe lower extremity spasticity, and curre
16、nt participa- tion in regular exercise.Exercise training Subjects trained using a computer controlled FES-leg cycle ergometer (ERGYS II; Therapeutic Alliance, Fairborn, OH, USA) for an accumulated duration of 30 mincycling,3daysperweek,for8weeks. Electrical stimulation was applied through surface electrodes (4.5610 cm) to the gluteal, hamstring, and quadriceps muscles in a controlled sequence to allow pedalling. Two active electrodes and one reference electrode were placed on each muscl
