Volume 31, Issue 5 (August 2020)
Studies in Medical Sciences 2020, 31(5): 372-380 |
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roohi M R, allahyari S. THE EFFECT OF FATIGUE OCCURRENCE IN QUADRICEPS MUSCLE OF SPINAL CORD INJURY PATIENTS WHO USE FUNCTIONAL NEURAL ELECTRICAL STIMULATION REHABILITATION DEVICES: AN OBSERVATIONAL STUDY. Studies in Medical Sciences 2020; 31 (5) :372-380
URL: http://umj.umsu.ac.ir/article-1-5098-en.html
URL: http://umj.umsu.ac.ir/article-1-5098-en.html
Department of Biomechanical Medical Engineering, Tehran Science and Research Branch, Islamic Azad University, Tehran, Iran (Corresponding Author) , mre.rouhi@gmail.com
Abstract: (1736 Views)
Background & Aims: In this study, the critical limit of muscle fatigue was evaluated for patients who use Functional Neural Electrical Stimulation (FNES) rehabilitation devices for walking. These patients do not have voluntary muscle control and have to be artificially stimulated to walk and their fatigue is not recognized in time because of the lack of sensation in their muscles. With the help of this system, it is done more safely and its usage can speed up the training process.
Materials & Methods: In this study, the time of approaching the critical point of fatigue for Quadriceps muscles in patients with spinal cord injury was investigated. Patients having the injury level between T4-T12 were randomly selected. A system was designed to stimulate the Quadriceps muscle and identify the results before reaching critical fatigue.
Results: By adjusting the electrical stimulation diagrams and the modified electromyogram diagram in the early cycles of quadriceps muscle stimulation, the muscle initially started with a higher slope, but after 5–8 cycles, this difference reached its minimum. This slope difference begins again when approaching the fatigue phase. The voltage required to stimulate the female patients was 180 volts and the male patients needed 225 volts to raise their shins by 60 degrees.
Conclusion: The results of the experiments after the MVIC of quadriceps reached 80% averaged over 290 cycles equivalent to 232 m. There was also a significant relationship between regular use of the device and delay in the onset of muscle fatigue (p <0.001). After repeated testing, all subjects experienced fatigue after a longer period (11% on average).
Materials & Methods: In this study, the time of approaching the critical point of fatigue for Quadriceps muscles in patients with spinal cord injury was investigated. Patients having the injury level between T4-T12 were randomly selected. A system was designed to stimulate the Quadriceps muscle and identify the results before reaching critical fatigue.
Results: By adjusting the electrical stimulation diagrams and the modified electromyogram diagram in the early cycles of quadriceps muscle stimulation, the muscle initially started with a higher slope, but after 5–8 cycles, this difference reached its minimum. This slope difference begins again when approaching the fatigue phase. The voltage required to stimulate the female patients was 180 volts and the male patients needed 225 volts to raise their shins by 60 degrees.
Conclusion: The results of the experiments after the MVIC of quadriceps reached 80% averaged over 290 cycles equivalent to 232 m. There was also a significant relationship between regular use of the device and delay in the onset of muscle fatigue (p <0.001). After repeated testing, all subjects experienced fatigue after a longer period (11% on average).
References
1. Kumar R, Lim J, Mekary RA, Rattani A, Dewan MC, Sharif SY, et al. Traumatic Spinal Injury: Global Epidemiology and Worldwide Volume. World Neurosurg 2018; 113: 345-63. [DOI:10.1016/j.wneu.2018.02.033] [PMID]
2. Varma A, Das A, Wallace G, Barry J, Vertegel A, Ray S, et al. Spinal Cord Injury: A Review of Current Therapy, Future Treatments, and Basic Science Frontiers. Neurochem Res 2013; 38(5): 895-905. [DOI:10.1007/s11064-013-0991-6] [PMID] [PMCID]
3. Johnson M. Transcutaneous electrical nerve stimulation: review of effectiveness. Nurs Stand 2014; 28)40(: 44-53. [DOI:10.7748/ns.28.40.44.e8565] [PMID]
4. Kralj A, Bajd T, Turk R. Enhancement of gait restoration in spinal injured patients by functional electrical stimulation. Clin Orthop Relat Res 1988; (233): 34-43. [DOI:10.1097/00003086-198808000-00006]
5. Nas K. Rehabilitation of spinal cord injuries. World J Orthop 2015; 6(1): 8.
https://doi.org/10.5312/wjo.v6.i1.1 [DOI:10.5312/wjo.v6.i1.8]
6. Suehiro K, Morikage N, Murakami M, Yamashita O, Ueda K, Samura M, et al. A Study of Leg Edema in Immobile Patients. Circulation 2014; 78(7): 1733-9. [DOI:10.1253/circj.CJ-13-1599] [PMID]
7. Grigorian A, Sugimoto M, Joe V, Schubl S, Lekawa M, Dolich M, et al. Pressure Ulcer in Trauma Patients: A Higher Spinal Cord Injury Level Leads to Higher Risk. J Am Coll Clin Wound Spec 2017; 9(1-3): 24-31.e1. [DOI:10.1016/j.jccw.2018.06.001] [PMID] [PMCID]
8. Mackiewicz-Milewska M, Jung S, Kroszczyński A, Mackiewicz-Nartowicz H, Serafin Z, Cisowska-Adamiak M, et al. Deep venous thrombosis in patients with chronic spinal cord injury. J Spinal Cord Med 2016; 39(4): 400-4. [DOI:10.1179/2045772315Y.0000000032] [PMID] [PMCID]
9. Do J, Kim D, Sung D. Incidence of Deep Vein Thrombosis after Spinal Cord Injury in Korean Patients at Acute Rehabilitation Unit. J Korean Med Sci 2013; 28(9): 1382. [DOI:10.3346/jkms.2013.28.9.1382] [PMID] [PMCID]
10. Alabed S, Belci M, Van Middendorp J, Al Halabi A, Meagher T. Thromboembolism in the Sub-Acute Phase of Spinal Cord Injury: A Systematic Review of the Literature. Asian Spine Journal 2016; 10(5): 972. [DOI:10.4184/asj.2016.10.5.972] [PMID] [PMCID]
11. Soleyman-Jahi S, Yousefian A, Maheronnaghsh R, Shokraneh F, Zadegan S, Soltani A, et al. Evidence-based prevention and treatment of osteoporosis after spinal cord injury: a systematic review. Eur Spine J 2018; 27(8): 1798-1814. [DOI:10.1007/s00586-017-5114-7] [PMID]
12. Khazaeipour Z, Taheri-Otaghsara S, Naghdi M. Depression Following Spinal Cord Injury: Its Relationship to Demographic and Socioeconomic Indicators. Top Spinal Cord Inj Rehabil 2015; 21(2): 149-55. [DOI:10.1310/sci2102-149] [PMID] [PMCID]
13. Berlowitz D, Wadsworth B, Ross J. Respiratory problems and management in people with spinal cord injury. Breathe 2016; 12(4): 328-40. [DOI:10.1183/20734735.012616] [PMID] [PMCID]
14. Dearwater S, Laporte R, Cauley J, Brenes, G. Assessment of physical activity in inactive populations. Med Sci Sports Exerc 1985; 17(6): 651-55. [DOI:10.1249/00005768-198512000-00005] [PMID]
15. Koyuncu E, Nakipoğlu Yüzer G, Yenigün D, Özgirgin N. The analysis of serum lipid levels in patients with spinal cord injury. J Spinal Cord Med 2017; 40(5): 567-572. [DOI:10.1080/10790268.2016.1228286] [PMID] [PMCID]
16. Graupe D, Bazo HA. Thoracic Level Complete Paraplegia;Walking Performance, Training and Medical Benefits with the PARASTEP FES System. Int J Phys Med Rehabil 2015; 3(298): 10-4172. [DOI:10.4172/2329-9096.1000298]
17. Nekookar V, Erfanian A. Optimization of Stimulation Patterns in Paraplegic Walker-Assisted Walking using Functional Electrical Stimulation. Iranian Journal of Biomedical Engineering 2011; (4)4: 327-36. [Google Scholar]
18. Graupe D, Kohn K. Functional Neuromuscular Stimulator for Short-Distance Ambulation by Certain Thoracic Level Spinal-Cord-Injured Paraplegics. Surg Neurol 1998; 50(3): 202-7. [DOI:10.1016/S0090-3019(98)00074-3] [PMID]
19. Klose K, Jacobs P, Broton J, Guest R, Needham-Shropshire B, Lebwohl N, et al. Evaluation of a training program for persons with SCI paraplegia using the Parastep®1 ambulation system: Part 1. Ambulation performance and anthropometric measures. Arch Phys Med Rehabil 1997, 78(8); 789-93. [DOI:10.1016/S0003-9993(97)90188-X] [PMID]
20. Oliveira A, Correa F, Valim M, Oliviera C, Correa J. Determination of muscle fatigue index for strength training in patients with Duchenne dystrophy. Fisioterapia em Movimento 2010; 23(3): 351-60. [DOI:10.1590/S0103-51502010000300002]
21. Wang J, Xiang Z, Gammad G, Thakor N, Yen S, Lee C. Development of flexible multi-channel muscle interfaces with advanced sensing function. Sensors and Actuators A: Physical 2016; 249: 269-75. [DOI:10.1016/j.sna.2016.07.034]
22. Whittle M, Levine D, Richards J. Gait Analysis. 5th ed. Elsevier Health Sciences; 2012. P.40-7.
23. Enoka R, Duchateau J. Muscle fatigue: what, why and how it influences muscle function. Journal of Phisiology 2008; 586(3): 11-23. [DOI:10.1113/jphysiol.2007.139477] [PMID] [PMCID]
24. Del Coso J, González-Millán C, Salinero JJ, Abián-Vicén J, Soriano L, Garde S, et al. Muscle Damage and Its Relationship with Muscle Fatigue During a Half-Iron Triathlon. PLoS One 2012; 7(8): e43280. [DOI:10.1371/journal.pone.0043280] [PMID] [PMCID]
25. Cook D, O'Connor P, Lange G, Steffener J. Functional neuroimaging correlates of mental fatigue induced by cognition among chronic fatigue syndromes patients and controls. Neuroimage 2007; 36: 108-22. [DOI:10.1016/j.neuroimage.2007.02.033] [PMID]
26. Green H. Mechanisms of muscle fatigue in intense exercise. J Sports Sci 1997; 15(3): 247-56. [DOI:10.1080/026404197367254] [PMID]
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