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Functional electrical stimulation (FES): muscle histochemical analysis

J M Greve1, R Muszkat, B Schmidt

  • 1Department of Rehabilitation, Clinics Hospital, School of Medicine, University of São Paulo, Brazil.

Paraplegia
|December 1, 1993
PubMed
Summary

Functional electrical stimulation (FES) therapy improved muscle fiber composition in paraplegic patients. Specifically, FES significantly increased the number of type IIa muscle fibers in the quadriceps femoris, aiding functional recovery.

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Area of Science:

  • Neurology
  • Muscle Physiology
  • Rehabilitation Medicine

Background:

  • Functional electrical stimulation (FES) has been utilized since 1989 in Brazil for enhancing orthostasis and locomotion in paraplegic individuals.
  • Spinal cord injuries (SCIs) significantly impair motor function, necessitating innovative therapeutic approaches.

Purpose of the Study:

  • To investigate the histochemical alterations in the quadriceps femoris muscle resulting from FES application in paraplegic patients.
  • To assess the impact of FES on muscle fiber type distribution and size.

Main Methods:

  • Four patients with T4-T10 level Frankel A traumatic spinal cord lesions (12-24 months post-injury) were included.
  • A standardized FES protocol (20-30 Hz, 0.003s pulses, 5s on/10s off) was applied twice daily for 90 days.

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  • Quadriceps muscle biopsies were analyzed pre- and post-FES using the ATPase technique to evaluate fiber types (I, IIa, IIb) and their diameters.

    • Main Results:

    • FES treatment did not significantly alter the mean diameters of muscle fiber types I, IIa, or IIb.
    • A statistically significant increase in the number of type IIa muscle fibers was observed after FES intervention.
    • The mean total number of muscle fibers per sample was 256 +/- 12.3.

    Conclusions:

    • FES therapy can induce favorable changes in muscle fiber composition, specifically increasing type IIa fibers.
    • These histochemical adaptations suggest a potential mechanism for functional improvements observed with FES in paraplegic patients.
    • Further research is warranted to correlate these fiber type changes with functional outcomes in SCI rehabilitation.