Simon Miller

Influence of Electrical-Stimulation of the Tibialis Anterior Muscle in Paraplegic Subjects. 2: Morphological and Histochemical Properties

In adult paraplegic subjects one tibialis anterior muscle received daily electrical stimulation for 4 weeks at twice the motor threshold to determine changes of morphological and histochemical profiles (this paper) and of contractile properties (preceding paper).1 Bilateral biopsies, obtained 4 weeks before, and immediately after, electrical stimulation, were studied for fibre type proportions, fibre diameters, oxidative capacity, microvasculature and histopathology. Before stimulation the biopsies showed disuse with increased type 2 fibre proportions and decreased oxidative capacity (succinate dehydrogenase (SDH) activity). The effects of two stimulus patterns1 were compared. Following stimulation SDH activity increased significantly in all stimulated muscles. Inconsistent changes occurred in fibre type proportions, fibre diameters, capillary density and capillary/fibre ratios. Both stimulus patterns evoked similar results. In five/seven subjects subsarcolemmal vacuolation was observed. Electrical stimulation for 4 weeks at only twice motor threshold improves oxidative capacity, but different stimulus parameters are probably needed for significant fibre type conversion.

Influence of electrical stimulation of the tibialis anterior muscle in paraplegic subjects. 1. Contractile properties

In adult paraplegic subjects one tibialis anterior muscle received daily electrical stimulation for 4 weeks at twice motor threshold to determine changes of its contractile properties (this paper) and its morphological and histochemical profiles (following paper).1 Force, speed of contraction and fatigue resistance were assessed by percutaneous electrical stimulation of the muscle with torque measured about the ankle. Comparative contractile tests were performed on 51 normal adult subjects and new parameters for force measurement proposed, particularly where maximum voluntary contraction cannot be obtained. In paraplegic subjects before stimulation the tibialis anterior muscle showed evidence of disuse with decreased force, faster contraction and relaxation, and reduced fatigue resistance. The effects of two stimulus patterns were compared: 10 Hz, and 10 Hz with 100 Hz bursts. After stimulation contraction was slower, fatigue resistance increased and there was a tendency for force to increase. No differences occurred using the different stimulus patterns. Four weeks later fatigue resistance was partially maintained, while speed of contraction reverted to pre-stimulus levels.