Enhancing muscle force and femur compressive loads via feedback-controlled stimulation of paralyzed quadriceps in humans.

Abstract:

OBJECTIVE:To compare paralyzed quadriceps force properties and femur compressive loads in an upright functional task during conventional constant-frequency stimulation and force feedback-modulated stimulation. DESIGN:Crossover trial. SETTING:Research laboratory. PARTICIPANTS:Subjects (N=13; 12 men, 1 woman) with motor-complete spinal cord injury. INTERVENTIONS:Subjects performed 2 bouts of 60 isometric quadriceps contractions while supported in a standing frame. On separate days, subjects received constant-frequency stimulation at 20Hz (CONST) or frequency-modulated stimulation triggered by a change in force (FDBCK). During FDBCK, a computer algorithm responded to each 10% reduction in force with a 20% increase in stimulation frequency. MAIN OUTCOME MEASURES:A biomechanical model was used to derive compressive loads on the femur, with a target starting dose of load equal to 1.5 times body weight. RESULTS:Peak quadriceps force and fatigue index were higher for FDBCK than CONST (P<.05). Within-train force decline was greater during FDBCK bouts, but mean force remained above CONST values (P<.05). As fatigue developed during repetitive stimulation, FDBCK was superior to CONST for maintenance of femur compressive loads (P<.05). CONCLUSIONS:Feedback-modulated stimulation in electrically activated stance is a viable method to maximize the physiologic performance of paralyzed quadriceps muscle. Compared with CONST, FDBCK yielded compressive loads that were closer to a targeted dose of stress with known osteogenic potential. Optimization of muscle force with FDBCK may be a useful tactic for future training-based antiosteoporosis protocols.

journal_name

Arch Phys Med Rehabil

authors

Dudley-Javoroski S,Littmann AE,Chang SH,McHenry CL,Shields RK

doi

10.1016/j.apmr.2010.10.031

subject

Has Abstract

pub_date

2011-02-01 00:00:00

pages

242-9

issue

2

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(10)00863-4

journal_volume

92

pub_type

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