Responses of diseased muscle to electrical and mechanical intervention

It is well established that the properties of muscle fibres are influenced by their neurons and that this is at least in part mediated by the pattern of activity. Application of this knowledge has led to the experimental trial of electrical stimulation in diseased muscle, both in the dystrophic mouse and in children with Duchenne muscular dystrophy. This has shown a beneficial effect of slow frequency stimulation. Another route through which muscle properties can be influenced is by changing the load by procedures such as tenotomy. This has been studied by complete tenotomy in normal animals and recently by selective partial procedures in human disease. Y. Rideau has shown that release of early shortening (contractures) of several muscles, a consistent feature in Duchenne muscular dystrophy, has a beneficial effect on muscle function. From personal observations on a number of Rideau's patients who have undergone this procedure the improvement in function seems disproportionate to what could be explained on simple biomechanical grounds alone and suggests some more fundamental change in the contractile properties of the muscle.