期刊
JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT
卷 45, 期 2, 页码 283-296出版社
JOURNAL REHAB RES & DEV
DOI: 10.1682/JRRD.2007.02.0031
关键词
adaptation; bone; electrical stimulation; muscle; musculoskeletal deterioration; osteoporosis; plasticity; pQCT; rehabilitation; soleus; spinal cord injury
资金
- NATIONAL INSTITUTE OF NURSING RESEARCH [R01NR010285] Funding Source: NIH RePORTER
- NINR NIH HHS [R01 NR-010285-05, R01 NR010285-05, R01 NR010285] Funding Source: Medline
The paralyzed musculoskeletal system retains a remarkable degree of plasticity after spinal cord injury (SCI). In response to reduced activity, muscle atrophies and shifts toward a fast-fatigable phenotype arising from numerous changes in histochemistry and metabolic enzymes. The loss of routine gravitational and muscular loads removes a critical stimulus for maintenance of bone mineral density (BMD), precipitating neurogenic osteoporosis in paralyzed limbs. The primary adaptations of bone to reduced use are demineralization of epiphyses and thinning of the diaphyseal cortical wall. Electrical stimulation of paralyzed muscle markedly reduces deleterious post-SCI adaptations. Recent studies demonstrate that physiological levels of electrically induced muscular loading hold promise for preventing post-SCI BMD decline. Rehabilitation specialists will be challenged to develop strategies to prevent or reverse musculoskeletal deterioration in anticipation of a future cure for SCL Quantifying the precise dose of stress needed to efficiently induce a therapeutic effect on bone will be paramount to the advancement of rehabilitation strategies.
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