1
|
Bateman EA, Larocerie-Salgado J, Ross DC, Miller TA, Pripotnev S. Assessment, patient selection, and rehabilitation of nerve transfers. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1267433. [PMID: 38058570 PMCID: PMC10696649 DOI: 10.3389/fresc.2023.1267433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/07/2023] [Indexed: 12/08/2023]
Abstract
Peripheral nerve injuries are common and can have a devastating effect on physical, psychological, and socioeconomic wellbeing. Peripheral nerve transfers have become the standard of care for many types of peripheral nerve injury due to their superior outcomes relative to conventional techniques. As the indications for, and use of, nerve transfers expand, the importance of pre-operative assessment and post-operative optimization increases. There are two principal advantages of nerve transfers: (1) their ability to shorten the time to reinnervation of muscles undergoing denervation because of peripheral nerve injury; and (2) their specificity in ensuring proximal motor and sensory axons are directed towards appropriate motor and sensory targets. Compared to conventional nerve grafting, nerve transfers offer opportunities to reinnervate muscles affected by cervical spinal cord injury and to augment natural reinnervation potential for very proximal injuries. This article provides a narrative review of the current scientific knowledge and clinical understanding of nerve transfers including peripheral nerve injury assessment and pre- and post-operative electrodiagnostic testing, adjuvant therapies, and post-operative rehabilitation for optimizing nerve transfer outcomes.
Collapse
Affiliation(s)
- Emma A. Bateman
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Parkwood Institute, St Joseph’s Health Care London, London, ON, Canada
| | | | - Douglas C. Ross
- Roth McFarlane Hand & Upper Limb Centre, St Joseph’s Health Care London, London, ON, Canada
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Thomas A. Miller
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Parkwood Institute, St Joseph’s Health Care London, London, ON, Canada
| | - Stahs Pripotnev
- Roth McFarlane Hand & Upper Limb Centre, St Joseph’s Health Care London, London, ON, Canada
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| |
Collapse
|
2
|
Wu C, Zhang Q, Zheng X, Han Q, Fu C, Liu X, Wu T. Electrical stimulation prevents condyle and subchondral degeneration following the masseter atrophy. Oral Dis 2023. [PMID: 37927162 DOI: 10.1111/odi.14799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 10/12/2023] [Accepted: 10/23/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE There is a strong relationship between masticatory muscle atrophy and condyle degeneration. Although electrical stimulation (ES) is an effective treatment for muscle atrophy, its influence on the underlying condyle is unclear. This study aimed to investigate whether ES can prevent condyle degradation during the stage of masseter muscle atrophy. MATERIALS AND METHODS Six-week-old rats were randomly divided into the control, botulinum toxin (BTX), or BTX + ES group. BTX was injected into the bilateral masseters of rats to induce masseter atrophy. The left-side masseters without ES treatment were served as BTX group, and the right-side masseters received ES with different parameters (5 mA/10 Hz, 5 mA/50 Hz, 6 mA/10 Hz, 6 mA/50 Hz, 7 mA/10 Hz, and 7 mA/50 Hz) were served as BTX + ES groups. After 4 weeks, micro-CT and qualitative or quantitative analysis of osteogenesis, chondrogenesis, and angiogenesis-related genes in condyles were conducted. RESULTS ES, especially at 7 mA/50 Hz, significantly attenuated masseter atrophy, condyle degeneration, and subchondral bone loss. Moreover, the upregulation of related proteins, including collagen 1, osteocalcin, bone morphogenetic protein 2, collagen 2a, and vascular endothelial growth factor were observed. CONCLUSION ES partly rescued condylar degeneration and subchondral bone loss following masseter atrophy.
Collapse
Affiliation(s)
- Chuan Wu
- Department of Orthodontics, College & Hospital of Stomatology, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - Qunyan Zhang
- Department of Orthodontics, College & Hospital of Stomatology, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - Xiuyun Zheng
- Department of Orthodontics, College & Hospital of Stomatology, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - Quancheng Han
- Department of Orthodontics, College & Hospital of Stomatology, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - Chunfeng Fu
- Department of Orthodontics, College & Hospital of Stomatology, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - Xiaoyu Liu
- Department of Orthodontics, College & Hospital of Stomatology, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - Tingting Wu
- Department of Orthodontics, College & Hospital of Stomatology, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| |
Collapse
|
3
|
Hart DA. Regulation of Bone by Mechanical Loading, Sex Hormones, and Nerves: Integration of Such Regulatory Complexity and Implications for Bone Loss during Space Flight and Post-Menopausal Osteoporosis. Biomolecules 2023; 13:1136. [PMID: 37509172 PMCID: PMC10377148 DOI: 10.3390/biom13071136] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/04/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
During evolution, the development of bone was critical for many species to thrive and function in the boundary conditions of Earth. Furthermore, bone also became a storehouse for calcium that could be mobilized for reproductive purposes in mammals and other species. The critical nature of bone for both function and reproductive needs during evolution in the context of the boundary conditions of Earth has led to complex regulatory mechanisms that require integration for optimization of this tissue across the lifespan. Three important regulatory variables include mechanical loading, sex hormones, and innervation/neuroregulation. The importance of mechanical loading has been the target of much research as bone appears to subscribe to the "use it or lose it" paradigm. Furthermore, because of the importance of post-menopausal osteoporosis in the risk for fractures and loss of function, this aspect of bone regulation has also focused research on sex differences in bone regulation. The advent of space flight and exposure to microgravity has also led to renewed interest in this unique environment, which could not have been anticipated by evolution, to expose new insights into bone regulation. Finally, a body of evidence has also emerged indicating that the neuroregulation of bone is also central to maintaining function. However, there is still more that is needed to understand regarding how such variables are integrated across the lifespan to maintain function, particularly in a species that walks upright. This review will attempt to discuss these regulatory elements for bone integrity and propose how further study is needed to delineate the details to better understand how to improve treatments for those at risk for loss of bone integrity, such as in the post-menopausal state or during prolonged space flight.
Collapse
Affiliation(s)
- David A Hart
- Department of Surgery, Faculty of Kinesiology, and McCaig Institute for Bone & Joint Research, University of Calgary, Calgary, AB T2N 4N1, Canada
| |
Collapse
|
4
|
Shi H, Li F, Zhang F, Wei X, Liu C, Duan R. An electrical stimulation intervention protocol to prevent disuse atrophy and muscle strength decline: an experimental study in rat. J Neuroeng Rehabil 2023; 20:84. [PMID: 37386493 PMCID: PMC10311794 DOI: 10.1186/s12984-023-01208-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 06/19/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Skeletal muscle is negatively impacted by conditions such as spaceflight or prolonged bed rest, resulting in a dramatic decline in muscle mass, maximum contractile force, and muscular endurance. Electrical stimulation (ES) is an essential tool in neurophysiotherapy and an effective means of preventing skeletal muscle atrophy and dysfunction. Historically, ES treatment protocols have used either low or high frequency electrical stimulation (LFES/HFES). However, our study tests the use of a combination of different frequencies in a single electrical stimulation intervention in order to determine a more effective protocol for improving both skeletal muscle strength and endurance. METHODS An adult male SD rat model of muscle atrophy was established through 4 weeks of tail suspension (TS). To investigate the effects of different frequency combinations, the experimental animals were treated with low (20 Hz) or high (100 Hz) frequency before TS for 6 weeks, and during TS for 4weeks. The maximum contraction force and fatigue resistance of skeletal muscle were then assessed before the animals were sacrificed. The muscle mass, fiber cross-sectional area (CSA), fiber type and related protein expression were examined and analyzed to gain insights into the mechanisms by which the ES intervention protocol used in this study regulates muscle strength and endurance. RESULTS After 4 weeks of unloading, the soleus muscle mass and fiber CSA decreased by 39% and 58% respectively, while the number of glycolytic muscle fibers increased by 21%. The gastrocnemius muscle fibers showed a 51% decrease in CSA, with a 44% decrease in single contractility and a 39% decrease in fatigue resistance. The number of glycolytic muscle fibers in the gastrocnemius also increased by 29%. However, the application of HFES either prior to or during unloading showed an improvement in muscle mass, fiber CSA, and oxidative muscle fibers. In the pre-unloading group, the soleus muscle mass increased by 62%, while the number of oxidative muscle fibers increased by 18%. In the during unloading group, the soleus muscle mass increased by 29% and the number of oxidative muscle fibers increased by 15%. In the gastrocnemius, the pre-unloading group showed a 38% increase in single contractile force and a 19% increase in fatigue resistance, while in the during unloading group, a 21% increase in single contractile force and a 29% increase in fatigue resistance was observed, along with a 37% and 26% increase in the number of oxidative muscle fibers, respectively. The combination of HFES before unloading and LFES during unloading resulted in a significant elevation of the soleus mass by 49% and CSA by 90%, with a 40% increase in the number of oxidative muscle fibers in the gastrocnemius. This combination also resulted in a 66% increase in single contractility and a 38% increase in fatigue resistance. CONCLUSION Our results indicated that using HFES before unloading can reduce the harmful effects of muscle unloading on the soleus and gastrocnemius muscles. Furthermore, we found that combining HFES before unloading with LFES during unloading was more effective in preventing muscle atrophy in the soleus and preserving the contractile function of the gastrocnemius muscle.
Collapse
Affiliation(s)
- Haiwang Shi
- Lab of Regenerative Medicine in Sports Science, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Fan Li
- Lab of Regenerative Medicine in Sports Science, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Fulong Zhang
- Lab of Regenerative Medicine in Sports Science, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Xiaobei Wei
- Lab of Regenerative Medicine in Sports Science, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Chengyi Liu
- Lab of Regenerative Medicine in Sports Science, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Rui Duan
- Lab of Regenerative Medicine in Sports Science, School of Physical Education and Sports Science, South China Normal University, Guangzhou, China.
| |
Collapse
|
5
|
Uno H, Kamiya S, Akimoto R, Hosoki K, Tadano S, Kouzaki K, Tamura Y, Kotani T, Isemura M, Nakazato K. Low-frequency electrical stimulation of bilateral hind legs by belt electrodes is effective for preventing denervation-induced atrophies in multiple skeletal muscle groups in rats. Sci Rep 2022; 12:21275. [PMID: 36481829 PMCID: PMC9732041 DOI: 10.1038/s41598-022-25359-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
Belt electrode skeletal muscle electrical stimulation (B-SES) can simultaneously contract multiple muscle groups. Although the beneficial effects of B-SES in clinical situations have been elucidated, its molecular mechanism remains unknown. In this study, we developed a novel rodent B-SES ankle stimulation system to test whether low-frequency stimulation prevents denervation-induced muscle atrophy. Electrical stimulations (7‒8 Hz, 30 min) with ankle belt electrodes were applied to Sprague-Dawley rats daily for one week. All animals were assigned to the control (CONT), denervation-induced atrophy (DEN), and DEN + electrical stimulation (ES) groups. The tibialis anterior (TA) and gastrocnemius (GAS) muscles were used to examine the effect of ES treatment. After seven daily sessions of continuous stimulation, muscle wet weight (n = 8-11), and muscle fiber cross-sectional area (CSA, n = 4-6) of TA and GAS muscles were lower in DEN and DEN + ES than in CON. However, it was significantly higher in DEN than DEN + ES, showing that ES partially prevented muscle atrophy. PGC-1α, COX-IV, and citrate synthase activities (n = 6) were significantly higher in DEN + ES than in DEN. The mRNA levels of muscle proteolytic molecules, Atrogin-1 and Murf1, were significantly higher in DEN than in CONT, while B-SES significantly suppressed their expression (p < 0.05). In conclusion, low-frequency electrical stimulation of the bilateral ankles using belt electrodes (but not the pad electrodes) is effective in preventing denervation-induced atrophy in multiple muscles, which has not been observed with pad electrodes. Maintaining the mitochondrial quantity and enzyme activity by low-frequency electrical stimulation is key to suppressing muscle protein degradation.
Collapse
Affiliation(s)
- Hiroyuki Uno
- HOMER ION Co., Ltd., Shinsen 17-2, Shibuya-ku, Tokyo, 150-0045 Japan ,grid.412200.50000 0001 2228 003XSchool of Health and Sport Science, Nippon Sport Science University, 7-1-1 Fukazawa, Setagaya-ku, Tokyo, 158-8508 Japan
| | - Shohei Kamiya
- HOMER ION Co., Ltd., Shinsen 17-2, Shibuya-ku, Tokyo, 150-0045 Japan
| | - Ryuji Akimoto
- HOMER ION Co., Ltd., Shinsen 17-2, Shibuya-ku, Tokyo, 150-0045 Japan
| | - Katsu Hosoki
- HOMER ION Co., Ltd., Shinsen 17-2, Shibuya-ku, Tokyo, 150-0045 Japan
| | - Shunta Tadano
- HOMER ION Co., Ltd., Shinsen 17-2, Shibuya-ku, Tokyo, 150-0045 Japan
| | - Karina Kouzaki
- grid.412200.50000 0001 2228 003XSchool of Health and Sport Science, Nippon Sport Science University, 7-1-1 Fukazawa, Setagaya-ku, Tokyo, 158-8508 Japan
| | - Yuki Tamura
- grid.412200.50000 0001 2228 003XSchool of Health and Sport Science, Nippon Sport Science University, 7-1-1 Fukazawa, Setagaya-ku, Tokyo, 158-8508 Japan
| | - Takaya Kotani
- grid.412200.50000 0001 2228 003XSchool of Health and Sport Science, Nippon Sport Science University, 7-1-1 Fukazawa, Setagaya-ku, Tokyo, 158-8508 Japan
| | - Mako Isemura
- HOMER ION Co., Ltd., Shinsen 17-2, Shibuya-ku, Tokyo, 150-0045 Japan ,grid.412200.50000 0001 2228 003XSchool of Health and Sport Science, Nippon Sport Science University, 7-1-1 Fukazawa, Setagaya-ku, Tokyo, 158-8508 Japan
| | - Koichi Nakazato
- grid.412200.50000 0001 2228 003XSchool of Health and Sport Science, Nippon Sport Science University, 7-1-1 Fukazawa, Setagaya-ku, Tokyo, 158-8508 Japan
| |
Collapse
|
6
|
Larocerie-Salgado J, Chinchalkar S, Ross DC, Gillis J, Doherty CD, Miller TA. Rehabilitation Following Nerve Transfer Surgery. Tech Hand Up Extrem Surg 2022; 26:71-77. [PMID: 34619740 DOI: 10.1097/bth.0000000000000359] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Nerve transfer surgery is an important new addition to the treatment paradigm following nerve trauma. The following rehabilitation plan has been developed over the past 15 years, in an interdisciplinary, tertiary peripheral nerve program at the "Roth|McFarlane Hand and Upper Limb Centre." This center evaluates more than 400 patients with complex nerve injuries annually and has been routinely using nerve transfers since 2005. The described rehabilitation program includes input from patients, therapists, physiatrists, and surgeons and has evolved based on experience and updated science. The plan is comprised of phases which are practical, reproducible and will serve as a framework to allow other peripheral nerve programs to adapt and improve the "Roth|McFarlane Hand and Upper Limb Centre" paradigm to enhance patient outcomes.
Collapse
Affiliation(s)
- Juliana Larocerie-Salgado
- Roth| McFarlane Hand and Upper Limb Centre and the Peripheral Nerve Clinic, Western University, London, ON
| | - Shrikant Chinchalkar
- Roth| McFarlane Hand and Upper Limb Centre and the Peripheral Nerve Clinic, Western University, London, ON
| | - Douglas C Ross
- Roth| McFarlane Hand and Upper Limb Centre and the Peripheral Nerve Clinic, Western University, London, ON
| | - Joshua Gillis
- Roth| McFarlane Hand and Upper Limb Centre and the Peripheral Nerve Clinic, Western University, London, ON
| | - Christopher D Doherty
- Department of Surgery, Division of Plastic Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Thomas A Miller
- Roth| McFarlane Hand and Upper Limb Centre and the Peripheral Nerve Clinic, Western University, London, ON
| |
Collapse
|
7
|
Yi D, Lim H, Yim J. Effect of Microcurrent Stimulation on Pain, Shoulder Function, and Grip Strength in Early Post-Operative Phase after Rotator Cuff Repair. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57050491. [PMID: 34067980 PMCID: PMC8152281 DOI: 10.3390/medicina57050491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 01/27/2023]
Abstract
Background and Objectives: The purpose of this study was to investigate the effects of microcurrent stimulation on pain, shoulder function, and grip strength in patients with rotator cuff repair. Materials and Methods: This randomized single-blind controlled trial was conducted on inpatients of the rehabilitation department, and included 28 patients who underwent rotator cuff repair. Participants were randomly assigned to the experimental group (n = 14), treated with microcurrent stimulation, and the control group (n = 14), treated with false microcurrent stimulation. The microcurrent stimulation administered to the experimental group underwent general physical therapy and microcurrent stimulation three times a week for 4 weeks. Results: Changes in pain, range of motion in shoulder, simple shoulder test, and grip strength were assessed before and after the intervention. Both groups showed a significant decrease in pain and shoulder function (t = 27.412, 22.079, 19.079, and 18.561; p < 0.001), and grip strength showed a significant increase (t = −8.251 and −9.946; p < 0.001). The experimental group that underwent microcurrent stimulation exhibited a significant effect on pain, shoulder function, and grip strength compared with the control group that underwent false microcurrent stimulation (t = −2.17, −2.22, and 2.213; p = 0.039, 0.035, and 0.036). Conclusions: This study confirmed that microcurrent stimulation is effective for the treatment of rotator cuff repair patients.
Collapse
Affiliation(s)
- Donghyun Yi
- Department of Physical Therapy, Graduate School of Sahmyook University, Seoul 01795, Korea; (D.Y.); (H.L.)
| | - Hwanyong Lim
- Department of Physical Therapy, Graduate School of Sahmyook University, Seoul 01795, Korea; (D.Y.); (H.L.)
| | - Jongeun Yim
- Department of Physical Therapy, Sahmyook University, Seoul 01795, Korea
- Correspondence: ; Tel.: +82-2-3399-1635
| |
Collapse
|