title: Electrical stimulation during gait promotes increase of muscle cross-sectional area in quadriplegics: a preliminary study.
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 cm(2) to 57.3 +/- 10.3 cm(2)), but not in the control group (from 43.6 +/- 7.6 cm(2) to 41.8 +/- 8.4 cm(2)). After another 6 months of gait without NMES in the control group, the CSA did not change (from 41.8 +/- 8.4 cm(2) to 41.7 +/- 7.9 cm(2)). The increase in quadriceps CSA after gait training in patients with chronic complete quadriplegia appears associated with NMES.
authors.affiliation: 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. dabreu@fmrp.usp.br
authors.forename: Daniela Cristina Carvalho
authors.initials: DC
authors.lastname: de Abreu
authors.forename: Alberto
authors.initials: A
authors.lastname: Cliquet
authors.forename: Jane Maryan
authors.initials: JM
authors.lastname: Rondina
authors.forename: Fernando
authors.initials: F
authors.lastname: Cendes
mesh_terms: D000328:Adult; D004599:Electric Stimulation Therapy / Q000379:methods*; D005081:Exercise Therapy; D005684:Gait; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009133:Muscular Atrophy / Q000534:rehabilitation*; D052097:Quadriceps Muscle / Q000473:pathology*; D011782:Quadriplegia / Q000473:pathology* / Q000628:therapy
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