title: Adaptive change in electrically stimulated muscle: a framework for the design of clinical protocols.
abstract: Adult mammalian skeletal muscles have a remarkable capacity for adapting to increased use. Although this behavior is familiar from the changes brought about by endurance exercise, it is seen to a much greater extent in the response to long-term neuromuscular stimulation. The associated phenomena include a markedly increased resistance to fatigue, and this is the key to several clinical applications. However, a more rational basis is needed for designing regimes of stimulation that are conducive to an optimal outcome. In this review I examine relevant factors, such as the amount, frequency, and duty cycle of stimulation, the influence of force generation, and the animal model. From these considerations a framework emerges for the design of protocols that yield an overall functional profile appropriate to the application. Three contrasting examples illustrate the issues that need to be addressed clinically.
authors.affiliation: Department of Human Anatomy and Cell Biology, School of Biomedical Sciences, University of Liverpool, The Sherrington Buildings, Ashton Street, Liverpool L69 3GE, UK. s.salmons@liverpool.ac.uk
authors.forename: Stanley
authors.initials: S
authors.lastname: Salmons
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D000818:Animals; D004558:Electric Stimulation; D004599:Electric Stimulation Therapy / Q000379:methods*; D015444:Exercise; D006168:Guinea Pigs; D006801:Humans; D009046:Motor Neurons / Q000502:physiology*; D018485:Muscle Fibers, Skeletal / Q000145:classification / Q000502:physiology; D018482:Muscle, Skeletal / Q000294:innervation / Q000502:physiology*; D010807:Physical Endurance