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ФУНКЦИОНАЛЬНАЯ ЭЛЕКТРОСТИМУЛЯЦИЯ ПОСТОЯННО ДЕНЕРВИРОВАННЫХ МЫШЦ, ОБНОВЛЕННАЯ В 2020 Г
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ФУНКЦИОНАЛЬНАЯ ЭЛЕКТРОСТИМУЛЯЦИЯ ПОСТОЯННО ДЕНЕРВИРОВАННЫХ МЫШЦ, ОБНОВЛЕННАЯ В 2020 Г
УДК 616.833-001.31-003.93
Карраро У 1
Керн Х 2
Альбертин Г 3
Мазейро С 4
Понд А 5
Гарджуло П 6
Авторы:
1.  Университет Падуи

2.  Институт по изучению последствий войн им. Людвига Больцмана

3.  Университет Падуи

4.  Университет Падуи

5.  Университет Южного Иллинойса

6.  Университет Рейкьявика

Тип:
Статья
DOI:
https://doi.org/10.38025/2078-1962-2020-97-3-130-136
Страницы:
с 130 по 136
Статус:
Опубликован
Получено:
27.06.2020
Одобрено:
27.06.2020
Опубликовано:
27.06.2020
Классификаторы:
УДК 616.833-001.31-003.93
Язык материала:
английский
Ключевые слова:
травмы спинного мозга, денервированные дегенерирующие мышцы, домашняя функциональная электрическая стимуляция, мышечная соактивация, цветная компьютерная томография, функциональное восстановление, кожа
Аннотация и ключевые слова
Аннотация (русский):
Повреждение спинного мозга вызывает мышечное истощение, которое особенно тяжело после полного и постоянного повреждения нижних моторных нейронов, которое возникает при полном синдроме Кауда Эквина. Даже в этом худшем случае мы показали, что постоянно денервированные мышцы Квадрицепса могут быть спасены с помощью поверхностной функциональной электрической стимуляции и специально разработанного домашнего реабилитационного режима. Наша цель - показать, что эффект распространяется как на мышцы-антагонисты, так и на кожу бедер. До и после 2 лет электрической стимуляции, масса и структура мышц Квадрицепса и Хэмстрингса были квантитированы с помощью измерения силы. Мышцы валового поперечного сечения оценивались с помощью цветной компьютерной томографии, биопсии мышц и кожи с помощью количественной гистологии и иммуногистохимии. В результате лечения: а) увеличение площади поперечного сечения стимулированных мышц; б) увеличение среднего диаметра мышечных волокон; в) улучшение ультраструктурной организации; и г) увеличение выходной силы во время электрической стимуляции. Восстановление мышечной силы Квадрицепса было достаточным для того, чтобы 25% участников программы могли проводить тренировки в положении «стоя» и «шаг на месте». Улучшения распространяются на подколенные мышцы и кожу. Действительно, амортизирующий эффект, обеспечиваемый восстановленными тканями, является основным клиническим преимуществом. Мы надеемся, что вскоре в Европе и России, с нашими рекомендациями или без них, начнутся исследования для оказания нуждающимся людям той помощи, которую они заслуживают.

Ключевые слова:
травмы спинного мозга, денервированные дегенерирующие мышцы, домашняя функциональная электрическая стимуляция, мышечная соактивация, цветная компьютерная томография, функциональное восстановление, кожа
Текст
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Introduction Early aging and Aging muscle atrophy Skeletal muscle atrophy is the loss of muscle size and strength, which occurs with prolonged malnutrition, bed rest, neural and skeletal muscle injuries, diseases such as chronic cardiovascular and respiratory failures, diabetes, sepsis, cancer, and occurs inexorably during late aging, even in obese persons [1]. It is a sad truth that human muscle tissues will naturally decline decade after decade past the age of 30 years [2]. There are innumerable neuromuscular disorders and systemic diseases, which induce muscle atrophy, impairing the mobility of both old and young patients. Ill people, and even the extreme elderly, may counteract muscle deterioration by working to maintain the majority of their skeletal muscles in the best possible shape [3]. However, because of the debilitation that often accompanies disease and advanced age, ill and elderly people generally spend very little to no time in daily physical activity. This decreased muscle use contributes to even further muscle loss. This consequent disuse muscle atrophy further limits patient independence and can culminate in confining people to wheelchairs, beds, and to prolonged hospitalizations. Thus, immobility-related muscle atrophy is associated with functional limitations, thromboembolism, and increasingly high medical costs [4]. Muscle atrophy countermeasures All chronic and progressive muscle impairments need permanent management. An effective, low-cost option is to educate people-in-need about how to perform physical activity, whether it is volitional [5] or electrical stimulation-induced exercise for cases in which the persons are not willing or are unable to move as needed [6]. Indeed, cardiovascular and ventilation rehabilitation protocols for surgical patients are well established and a major component of these is designed to reverse muscle atrophy and weakness [8,9]. Although the balance between cost (time/capital investment/interference with daily living) and long-term benefits is still debated [10,11], many practitioners and institutions recognize the value of electrical stimulation in their daily clinical practice[12-15]. During 2018, there was a new wave of papers in excellent journals (e.g., New England Journal of Medicine and Nature) about "Direct Spinal Cord Stimulation in Spinal Cord Injury", which promises to revolutionize the management of thoracic-level Spinal Cord Injury (SCI) patients as far as their mobility is concerned [16-17]. There is no question that these approaches deserve to be duplicated as soon as possible by independent trials with more numerous participants. However, there is a small group (at least in aging European countries) of SCI patients who will never be enrolled in these new trials. These patients suffer from conus and cauda equina complete injury, a rare SCI syndrome in which there is basically a complete separation of the lower motor neurons of the spinal cord from skeletal muscles [7]. In these patients, there are no longer intact peripheral nerves to carry messages from an intrathecal or external electrically stimulated spinal cord to the leg muscles. Indeed, these patients suffer much more than typical muscle atrophy, eventually eventually experiencing the replacement of muscle tissue with fibrous and adipose tissue as their denervated muscles degenerate. denervated degenerated muscles. Nonetheless, in previous studies we have shown that, in SCI patients suffering with permanent and complete conus and cauda equina syndrome, denervated leg muscles were rescued by 2-years of home-based Functional Electrical Stimulation, when a specific-purpose developed electrical stimulator (now commercially available: “Stimulette den2x” of the Schuhfried Medizintechnik GmbH, Vienna, Austria) provided the needed high currents to large surface electrodes covering the Quadriceps muscles [7,18,19]. Interestingly, we recently further demonstrated in these patients that skin, when exposed to 2 years of surface electrical stimulation, exhibits an improvement in epidermal thickness [20-22]. Here we add that the afore-described electrical fields also produced clinically relevant recovery in atrophic Hamstring muscles which were not in direct contact with the very large electrodes which are part of the Vienna Protocol of home-based Functional Electrical Stimulation for denervated degenerated muscles, validated by the EU Program: RISE [Use of electrical stimulation to restore standing in paraplegics with long-term denervated degenerated muscles (QLG5-CT-2001-02191)]. We see that a supposed drawback, the co-activation of non-targeted muscles, is indeed responsible for a major positive clinical result. In short, our data show that permanently denervated Quadriceps muscles can be rescued by a purpose designed home-based functional electrical stimulation regime. Here our aim is to emphasize that the effects have multiple clinical results, extending positive effects to non-targeted antagonist muscles and to the skin. Patients, home-based Functional Electrical Stimulation of denervated degenerated muscles, force, mass and extent of degeneration-recovery of thigh muscles Patients suffering with a complete Conus and Cauda Equina lesion (up to 9.0 years of complete and permanent peripheral denervation) were enrolled in the RISE Program following the inclusion and exclusion criteria previously reported, together with their demographic details [18]. They were volunteers suffering with a Conus and Cauda Equina lesion who received detailed information and signed an appropriate informed consent document [23]. Clinical and functional assessments, as well as follow-up procedures and muscle biopsies, were performed at the Wilhelminenspital, Vienna (Austria). Quadriceps muscle biopsies were harvested before and after 2 years of home-based Functional Electrical Stimulation and analyzed by light and electron microscopy (respectively, in Padova and Chieti Universities, Italy). Complete denervation of right and left quadriceps muscles was assessed before and after 2 years of home-based Functional Electrical Stimulation by test electrical stimulation, needle electromyography, and both transcranial and lumbosacral magnetic stimulation [23]. Using a custom-designed stimulator and large surface electrodes designed and implemented in Vienna (Austria), we stimulated denervated atrophic leg muscles according to our published home-based Functional Electrical Stimulation strategy [7,18,23]. We determined both the mass and force of the stimulated Quadriceps muscles at each time point. Force was assessed by electrostimulation of the Quadriceps m. of patients seated on a custom-designed chair. The isometric knee extension torque was measured as movement from a 90knee placement by activating the Quadriceps m. with a standardized stimulation program and the same electrodes used for the home-based training. Using Quantitative Muscle Color Computed Tomography (QMC-CT), we determined the gross anatomy of the thigh muscles and the extent of their atrophy/degeneration [24-26]. QMC-CT uses CT numbers (i.e., Hounsfield Units) for tissue characterization. In the process of assessing muscle quality, soft tissues were discriminated as follows: subcutaneous fat, intramuscular fat, low-density muscle, normal muscle, and fibrous-dense connective tissue (Fig. 1). To evaluate the data further, pixels within the defined interval of Hounsfield Units values were selected and highlighted in colors (red for normal muscle tissue, yellow for intramuscular adipose tissue, green and blue for loose or fibrous connective tissue, respectively) while other tissues with Hounsfield Units values outside the threshold ranges remain black, including the extra-muscular adipose tissue [25]. Results of the EU Program: RISE The EU Program: RISE [Use of electrical stimulation to restore standing in paraplegics with long-term denervated degenerated muscles (QLG5-CT-2001-02191)] resulted in improvement of thigh muscles in 20 out of 25 patients who completed a 2-year home-based Functional Electrical Stimulation program. The results revealed: 1) a 35% increase (p < 0.001) in cross-sectional area of the Quadriceps muscles; 2) a 75% increase (p < 0.001) in mean diameter of Quadriceps muscle fibers; and 3) improvement of the ultrastructural organization of contractile material and of the Ca2+-handling system (T-tubules and triads; 27-29 and Table 1). Table 1. Results of the EU RISE Project for home-based functional electrical stimulation (h-bFES) of denervated degenerating muscles in complete lumbosacral spinal cord injury (SCI): Use of electrical stimulation to restore standing capability in paraplegics with long-term denervated degenerated muscles (QLG5-CT-2001-02191) • The condition of none of the 20 patients who performed 2-year h-bFES worsened • Quantitative muscle color CT shows that after two years of h-bFES, Hamstring muscles present an increased content of red, high-density tissue (normal-looking muscle tissue), even when starting h-bFES at 3 years after SCI • CT cross sectional area of the Hamstring muscle group improved, increasing from 26.9+/- 8.4 to 30.7+/-9.8 cm2, a significant 15% increase (p≤0.05) • Despite co-activation of the antagonists, the Quadriceps muscle presented a 1187% increase in h-bFES-induced knee torque output from 0.81.3 to 10.3 8.1 Nm (p<0 .001) • Over time 23 of the 25 patients performed knee extension from a sitting position • Electrostimulation-induced force allowed 25% of patients to perform h-bFES stand-up exercises • Many of the compliant patients achieved good results during the first year of h-bFES Furthermore, there was an extremely impressive 1187% increase (p < 0.001) in force output during electrical stimulation that was sufficient to allow 25% of the end-point patients to perform home-based Functional Electrical Stimulation assisted stand-up exercises. Results beyond the EU Program: RISE Coactivation of the Hamstring muscles Though not expected by bioengineers and physiatrists, who are more interested in selective electrical stimulation to control arm and leg functional movements, after the 2 years during which the compliant SCI patients performed home-based Functional Electrical Stimulation (5 days per week using large electrodes covering the Quadriceps muscles), the CT cross sectional area of the Hamstring muscles also improved, increasing from 26.9+/-8.4 to 30.7+/-9.8 cm2; this represents a significant 15% increase (p≤0.05). Thus, the Color CT analyses confirm that the home-based Functional Electrical Stimulation-induced muscle improvements, which were noted in CT of Quadriceps m., also occurred in Hamstrings (Figure 1 and Table 2). Table 2. Quadriceps muscles (Fig. 1 A,B and E,F) and Hamstrings ( Fig. 1 C,D and G,H). Colored Areas Total Colored Area % of Red % of Orange % of Blue (m2) % Muscle Quadriceps A, Pre h-bFES* 68 27 5 2041 Quadriceps B, Post h-bFES 93 5 2 2713 43 Hamstrings C, Pre h-bFES 68 27 5 2013 Hamstrings D, Post h-bFES 82 5 13 2600 29 Quadriceps E, Pre h-bFES 50 32 18 1452 Quadriceps F, Post h-bFES 94 4 2 3400 134 Hamstrings G, Pre h-bFES 8 43 49 1426 Hamstrings H, Post h-bFES 52 17 31 2029 42 Densitometry of the color CT scan presented in Figure 1. Total area and percent areas of normal density muscle tissue (red), loose degenerating muscle tissue (orange), and of loose and dense connective tissues (blue/green). *h-bFES: Home-based functional electrical stimulation Fig. 1. Both denervated Quadriceps and Hamstring muscle groups respond to home-based Functional Electrical Stimulation (h-bFES) years after injury. a. Quadriceps muscle at 1 year post spinal cord injury (SCI), No h-bFES. b. Muscle in panel “a” after 2 years of h-bFES. c. Hamstring muscle at 1 year post SCI, No h-bFES. d. Muscle in panel “c” after 2 years of h-bFES. e. Quadriceps muscle at 3 year post SCI, No h-bFES. f. Muscle in panel “e” after 2 years of h-bFES. g. Hamstring muscle at 3 year post SCI, No h-bFES. h. Muscle in panel “g” after 2 years of h-bFES. i. Total area of muscles a-h. j. Quantitative computed densitometric analyses of tomography, muscles a-h. Comparison of left panels of Figure 1 provides strong evidence for the deterioration of permanently denervated muscles at 1 to 3 years post SCI. However, it is worth noting that, even starting at 3 years post SCI, home-based Functional Electrical Stimulation of denervated degenerated muscles is able to recover the Hamstrings to an impressive extent. This is strong evidence that co-contraction of dorsal and ventral thigh muscles induced by the large electrodes is a powerful mechanism behind the success of the Vienna Strategy for recovery of denervated degenerated muscles thigh muscles. This is a clinically relevant observation because an increase in bulk of the Hamstrings is an effective mechanism for preventing dermatological complications in conus and cauda equina syndrome, specifically pressure sores. Home-based Functional Electrical Stimulation-induced recovery of skin thickness from SCI-induced skin atrophy It is certainly worth noting, that we recently demonstrated, using skin biopsies harvested from the same series of RISE patients, that the skin also became atrophic and flattened (i.e., there were decreased numbers of papillae-like structures per mm of skin and a decreased interdigitation index of dermal-epidermal junctions) after several years of SCI [30], but that these issues recovered from atrophy and flattening after 2-years of home-based Functional Electrical Stimulation applied to treat denervated degenerated muscles [20-22]. Advantages and limitations Patients suffering with SCI must use wheelchairs to gain some mobility independence and this results in them sitting on their Hamstring and Gluteal muscles several hours each day. The prolonged seating sadly contributes to the development of severe atrophy of the muscles and edema of the legs, with increased risks of decubitus ulcers and deep thrombophlebitis [31]. Of particular importance in SCI is whether the connection between the muscle and the nerve is preserved or the muscle is denervated as a result of complete peripheral nerve lesion. In the latter cases, the denervated muscle becomes unexcitable with commercial electrical stimulators and undergoes ultrastructural disorganization within a few months, while severe atrophy with nuclear clumping and fibro-fatty degeneration appears later within 3 to 6 years. Our work with home-based Functional Electrical Stimulation of denervated degenerated muscles is important because it leads to muscle recovery, even in the worst cases of complete, permanent lower motor neuron muscle denervation. Here we review data demonstrating that electrical stimulation by very large electrodes covering the full Quadriceps m., to activate the entire population of denervated muscle fibers of the human thigh, is able to recover both ventral (Quadriceps muscles) and dorsal (Hamstrings muscle group) muscles of the thigh. This conclusion is supported by the fact that compliant enrolled patients of the RISE Project are able to perform electrical stimulation-supported standing-up and walking-in-place trainings [7,18]. Furthermore, QMC-CT of thigh muscles treated for two years with home-based Functional Electrical Stimulation strongly support the efficacy of the Vienna Strategy for home-based Functional Electrical Stimulation of denervated, degenerated muscles. Interestingly, we developed QMC-CT as a by-product of the EU RISE project to complement follow-up in these extreme cases of muscle degeneration, as complete Conus and Cauda Equina syndrome. A noteworthy point is that the Color CT scans taken at enrollment (before any home-based Functional Electrical Stimulation) seem to suggest that the Hamstrings are more atrophic and degenerating than the Quadriceps muscles. [18,27] It is thus not surprising that the effects of home-based functional electrical stimulation are more evident in the Quadriceps than in the co-activated Hamstrings. Nonetheless, the improvements noted in the Hamstrings muscle group are a clinically relevant effect of home-based Functional Electrical Stimulation because the recovered tissues of the dorsal thigh muscle contribute an important cushioning effect for the sitting position. Furthermore, because we harvested muscle tissue through a skin biopsy, we had the opportunity to extend our analyses to skin. Excitingly, we found that the home-based Functional Electrical Stimulation-sustained improvements in muscle structure are extended to skin, whose thickness and flattening worsen in accordance with the extent of years of SCI, but are substantially recovered after 2-years of home-based Functional Electrical Stimulation [20-22]. The improvement of tissue trophism will be even more clinically relevant if patients add home-based functional electrical stimulation of Gluteal muscles to their training workout, as the Vienna Strategy for denervated degenerated muscles SCI strongly recommends. On the other hand, the only limitation of home-based Functional Electrical Stimulation for denervated degenerated muscles, is that it can be applied only in cases of completely denervated Cauda Equina, because the degenerating denervated muscles need a very high-intensity electrical stimulation, that is not comfortable for SCI persons with residual innervation/reinnervation. Byproducts Based on these results, the Colleagues of Vienna have also designed and implemented stimulators for home-based neuromuscular electrical stimulation, especially suited for the requirements of elderly people [32]. As detailed in Kern et al., 2014 [33], older persons were exposed to regular neuromuscular electrical stimulation training at home. Results demonstrate that when training is done two times a week, for a total amount of 24 training sessions (3 × 10 minutes for each session), neuromuscular electrical stimulation for elderly persons is safe and effective. Using this approach, all subjects achieved neuromuscular electrical stimulation-induced full knee extension. The outcomes included a significant increase in muscle strength, which was associated with an increase in the number and size of fast muscle fibers, which are the first to respond to electrical stimulation and are well related to the power of skeletal muscle. In muscle biopsies, a significant increase in the number of Pax7- and NCAM-positive muscle satellite cells was also observed, but there were no signs of muscle damage and/or cellular inflammation. [34-44] Furthermore, there are many more applications of home or in hospital FES to manage disuse muscle atrophy related to several organ diseases, from chronic cardiovascular failures to functional electrical stimulation cycling in spinal cord injury. [45-59] Conclusive remarks In recent years, we have demonstrated the long-term clinical value of co-activation of thigh muscle by home-based Functional Electrical Stimulation training using large surface electrodes. Indeed, the Vienna Strategy is able to reverse, at least at clinically relevant levels, the adverse effects of aging and of SCI, even the effects of the worst case scenario of complete conus and cauda equina syndrome. Continued regularly, home-based Functional Electrical Stimulation for denervated degenerated muscles helps to maintain healthier leg muscles and skin, reducing the risks of life-threatening SCI complications. We have done our best to attract the attention of Colleagues to our results by publishing in top journals and by presentations at International Conferences. Thus, we are now hopeful that we will attract the attention of the international communities of physiatrists to organize independent trials of home-based Functional Electrical Stimulation for denervated degenerated muscles in SCI persons suffering with complete conus and cauda equina syndrome. We hope that many Colleagues will share our desire to offer to these people-in-need the chance to live a better life, as they deserve. Conflict of interest We declare no conflicts of interest in the authorship or publication of this contribution.
Список литературы

1. Larsson L., Degens H., Li M., et al. Sarcopenia: Aging-Related Loss of Muscle Mass and Function. Physiological Reviews. 2019; 99: 427-511. DOI:https://doi.org/10.1152/physrev.00061.2017

2. Gava P., Kern H., Carraro U. Age-associated power decline from running, jumping, and throwing male masters world records. Experimental Aging Research. 2015; 41: 115-135. DOI:https://doi.org/10.1080/0361073X.2015.1001648

3. Hopkins R.O., Mitchell L., Thomsen G.E., et al. Implementing a mobility program to minimize post-intensive care syndrome. AACN Advanced Critical Care. 2016; 27: 187-203. DOI:https://doi.org/10.4037/aacnacc2016244.

4. Spillman B.C., Lubitz J. The effect of longevity on spending for acute and long-term care. The New England Journal of Medicine. 2000; 342: 1409-1415. DOI:https://doi.org/10.1056/NEJM200005113421906

5. Carraro U., Gava K., Baba A., et al. To Contrast and Reverse Skeletal Muscle Atrophy by Full-Body In-Bed Gym, a Mandatory Lifestyle for Older Olds and Borderline Mobility-Impaired Persons. Advances in Experimental Medicine and Biology. 2018; 1088: 549-560. DOI:https://doi.org/10.1007/978-981-13-1435-3_25

6. Jones S., Man W.D., Gao W., et al. Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease. Cochrane database of systematic reviews. 2016;10:CD009419. DOI:https://doi.org/10.1002/14651858.CD009419.pub3

7. Carraro U., Kern H., Gava P., et al. Biology of Muscle Atrophy and of its Recovery by FES in Aging and Mobility Impairments: Roots and By-Products. European Journal of Translational Myology. 2015; 25: 221-230. DOI:https://doi.org/10.4081/ejtm.2015.5272

8. Ades P.A., Keteyian S.J., Wright J.S., et al. Increasing Cardiac Rehabilitation Participation From 20% to 70%: A Road Map From the Million Hearts Cardiac Rehabilitation Collaborative. Mayo Clinic Proceedings. 2017; 92: 234-242. DOI:https://doi.org/10.1016/j.mayocp.2016.10.014

9. Vorona S., Sabatini U., Al-Maqbali S., et al. Inspiratory Muscle Rehabilitation in Critically Ill Adults: A Systematic Review and Meta-Analysis. Annals of the American Thoracic Society. 201815: 735-744. DOI:https://doi.org/10.1513/AnnalsATS.201712-961OC

10. Etoom M. Comments on: Influence of transcutaneous electrical nerve stimulation on spasticity, balance, and walking speed in stroke patients: a systematic review and meta-analysis. Journal of Rehabilitation Medicine. 2018; 50: 94. DOI:https://doi.org/10.2340/16501977-2303

11. Kiper P., Turolla A. Updates and comments on: Influence of transcutaneous electrical nerve stimulation on spasticity, balance, and walking speed in stroke patients: A systematic review and meta-analysis. Journal of Rehabilitation Medicine. 2019; 51: 317-318. DOI:https://doi.org/10.2340/16501977-2538

12. Bersch I., Tesini S, Bersch U, Frotzler A. Functional electrical stimulation in spinal cord injury: clinical evidence versus daily practice. Artificial Organs. 2015; 39: 849-854. DOI:https://doi.org/10.1111/aor.12618

13. Lin S., Sun Q., Wang H., Xie G. Influence of transcutaneous electrical nerve stimulation on spasticity, balance, and walking speed in stroke patients: a systematic review and meta-analysis. Journal of Rehabilitation Medicine. 2018; 50: 3-7. DOI:https://doi.org/10.2340/16501977-2266

14. Burgess L.C., Immins T., Swain I., Wainwright T.W. Effectiveness of neuromuscular electrical stimulation for reducing oedema: A systematic review. Journal of Rehabilitation Medicine. 2019;51:237-243. DOI:https://doi.org/10.2340/16501977-2529

15. Laubacher M., Aksoez E.A., Brust A.K., et al. Stimulation of paralysed quadriceps muscles with sequentially and spatially distributed electrodes during dynamic knee extension. Journal of NeuroEngineering and Rehabilitation. 2019;16:5. DOI:https://doi.org/10.1186/s12984-018-0471-y

16. Angeli C.A., Boakye M., Morton R.A., et al. Recovery of Over-Ground Walking after Chronic Motor Complete Spinal Cord Injury. The New England Journal of Medicine. 2018; 379: 1244-1250. DOI:https://doi.org/10.1056/NEJMoa1803588

17. Wagner F.B., Mignardot J.B., Le Goff-Mignardot C.G., et al. Targeted neurotechnology restores walking in humans with spinal cord injury. Nature.2018; 563: 65-71. DOI:https://doi.org/10.1038/s41586-018-0649-2

18. Kern H., Carraro U., Adami N., et al. Home-based functional electrical stimulation rescues permanently denervated muscles in paraplegic patients with complete lower motor neuron lesion. Neurorehabilitation and Neural Repair. 2010; 24: 709-721. DOI:https://doi.org/10.1177/1545968310366129

19. https://www.schuhfried.com/umbraco/Surface/AuthenticationSurface/Login?return Url=%2Fportal

20. Albertin G., Hofer C., Zampieri S., et al. In complete SCI patients, long-term functional electrical stimulation of permanent denervated muscles increases epidermis thickness. Journal of Neurology Research. 2018; 40: 277-282. DOI:https://doi.org/10.1080/01616412.2018.1436877

21. Albertin G., Kern H., Hofer C., et al. Two years of Functional Electrical Stimulation by large surface electrodes for denervated muscles improve skin epidermis in SCI. European Journal of Translational Myology.2018; 28: 7373. DOI:https://doi.org/10.4081/ejtm.2018.7373

22. Albertin G., Ravara B., Kern H., et al. Two-years of home based functional electrical stimulation recovers epidermis from atrophy and flattening after years of complete Conus-Cauda Syndrome. Medicine (Baltimore). 2019; 98(52): e18509. DOI:https://doi.org/10.1097/MD.0000000000018509

23. Kern H., Hofer C., Mayr W. Protocols for clinical work package of the European Project RISE. Basic Appl Myol. European Journal of Translational Myology. 2008; 18: 39-44.

24. Edmunds K.J., Gíslason M.K., Arnadottir I.D., et al. Quantitative Computed Tomography and Image Analysis for Advanced Muscle Assessment. European Journal of Translational Myology. 2016; 26: 6015. DOI:https://doi.org/10.4081/ejtm.2016.6015

25. Edmunds K., Gíslason M., Sigurðsson S., et al. Advanced quantitative methods in correlating sarcopenic muscle degeneration with lower extremity function biometrics and comorbidities. PLOS One. 2018; 13(3):e0193241. DOI:https://doi.org/10.1371/journal.pone.0193241

26. Ricciardi C., Edmunds K.J., Recenti M., et al. Assessing cardiovascular risks from a mid-thigh CT image: a tree-based machine learning approach using radiodensitometric distributions. Scientific Reports. 2020; 10(1): 2863. DOI:https://doi.org/10.1038/s41598-020-59873-9.

27. Kern H., Boncompagni S., Rossini K., et al. Long-term denervation in humans causes degeneration of both contractile and excitation- contraction coupling apparatus, wich is reversibile by functional electrical stimulation (FES). A role for myofiber regeneration? Journal of Neuropathology & Experimental Neurology. 2004; 63: 919-931.

28. Boncompagni S., Kern H., Rossini K., et al. Structural differentiation of skeletal muscle fibers in the absence of innervation in humans. Proceedings of the National Academy of Sciences of the USA. 2007; 104: 19339- 19344.

29. Kern H., Carraro U., Adami N., et al. One year of home-based daily FES in complete lower motor neuron paraplegia: recovery of tetanic contractility drives the structural improvements of denervated muscle. Journal of Neurology Research. 2010; 32: 5-12. DOI:https://doi.org/10.1179/174313209X385644

30. Ravara B., Hofer C, Kern H, et al. Dermal papillae flattening of thigh skin in Conus Cauda Syndrome. European Journal of Translational Myology. 2018; 28:7914. DOI:https://doi.org/10.4081/ejtm.2018.7914

31. Hitzig S.L., Eng J.J., Miller W.C., Sakakibara B.M. An evidence-based review of aging of the body systems following spinal cord injury. Spinal Cord. 2011; 49: 684-701. DOI:https://doi.org/10.1038/sc.2010.178

32. Krenn M., Haller M., Bijak M., et al. Safe neuromuscular electrical stimulator designed for the elderly. Artificial Organs 2011; 35: 253-256. DOI:https://doi.org/10.1111/j.1525-1594.2011.01217.x

33. Kern H., Barberi L., Löfler S., et al. Electrical stimulation counteracts muscle decline in seniors. Frontiers in Aging Neuroscience. 2014; 6: 189. DOI:https://doi.org/10.3389/fnagi.2014.00189

34. Zampieri., Pietrangelo L., Loefler S, et al. Lifelong physical exercise delays age-associated skeletal muscle decline. The Journals of Gerontology Series A Biological Sciences and Medical Sciences. 2015; 70: 163-173.

35. Mayr W. Neuromuscular Electrical Stimulation for Mobility Support of Elderly. European Journal of Translational Myology. 2015; 25: 263-268.

36. Protasi F. Mitochondria Association to Calcium Release Units is Controlled by Age and Muscle Activity. European Journal of Translational Myology. 2015; 25: 257-262.

37. Sarabon N., Löfler S., Hosszu G., Hofer C. Mobility Test Protocols for the Elderly: A Methodological Note. European Journal of Translational Myology. 2015; 25: 253-256.

38. Cvecka J, Tirpakova V, Sedliak M, Kern H, Mayr W, Hamar D. Physical Activity in Elderly. European Journal of Translational Myology. 2015; 25: 249-252.

39. Zampieri S., Mosole S., Löfler S., et al. Physical Exercise in Aging: Nine Weeks of Leg Press or Electrical Stimulation Training in 70 Years Old Sedentary Elderly People. European Journal of Translational Myology. 2015; 25:237-242.

40. Sajer S., Guardiero G.S., Scicchitano B.M. Myokines in Home-Based Functional Electrical Stimulation-Induced Recovery of Skeletal Muscle in Elderly and Permanent Denervation. European Journal of Translational Myology. 2018; 28:7905.

41. Scicchitano B.M., Sica G., Musarò A. Stem Cells and Tissue Niche: Two Faces of the Same Coin of Muscle Regeneration. European Journal of Translational Myology. 2016;26(4):6125. doi:https://doi.org/10.4081/ejtm.2016.6125. eCollection 2016 Sep 15.

42. Barberi L., Scicchitano B.M., Musaro A. Molecular and Cellular Mechanisms of Muscle Aging and Sarcopenia and Effects of Electrical Stimulation in Seniors. European Journal of Translational Myology. 2015;25(4):231-6. doi:https://doi.org/10.4081/ejtm.2015.5227. eCollection 2015 Aug 24. Review.

43. Taylor M.J., Fornusek C., Ruys A.J. Reporting for Duty: The duty cycle in Functional Electrical Stimulation research. Part I: Critical commentaries of the literature. European Journal of Translational Myology. 2018 Nov 7;28(4):7732. doi:https://doi.org/10.4081/ejtm.2018.7732. eCollection 2018 Nov 2.

44. Taylor M.J., Fornusek C., Ruys A.J. The duty cycle in Functional Electrical Stimulation research. Part II: Duty cycle multiplicity and domain reporting. European Journal of Translational Myology. 2018 Nov 7;28(4):7733. doi:https://doi.org/10.4081/ejtm.2018.7733. eCollection 2018 Nov 2

45. Taylor M.J., Schils S., Ruys A.J. Home FES: An Exploratory Review. European Journal of Translational Myology. 2019 Nov 12;29(4):8285. doi:https://doi.org/10.4081/ejtm.2019.8285. eCollection 2019 Oct 29.

46. Quittan M., Sochor A., Wiesinger G.F., et al. Strength improvement of knee extensor muscles in patients with chronic heart failure by neuromuscular electrical stimulation. Artificial Organs. 1999 May;23(5):432-5. DOI:https://doi.org/10.1046/j.1525-1594.1999.06372.x.

47. Deley G., Denuziller J., Babault N. Functional electrical stimulation: cardiorespiratory adaptations and applications for training in paraplegia. Sports Medicine. 2015 Jan;45(1):71-82. DOI:https://doi.org/10.1007/s40279-014-0250-2.

48. Braz G.P., Russold M.F., Fornusek C., et al. Cardiorespiratory and Muscle Metabolic Responses During Conventional Versus Motion Sensor-Assisted Strategies for Functional Electrical Stimulation Standing After Spinal Cord Injury. Artificial Organs. 2015 Oct;39(10):855-62. DOI:https://doi.org/10.1111/aor.12619. PMID: 26471136

49. Crevenna R., Wolzt M., Fialka-Moser V., et al. Long-term transcutaneous neuromuscular electrical stimulation in patients with bipolar sensing implantable cardioverter defibrillators: a pilot safety study. Artificial Organs. 2004 Jan;28(1):99-102. DOI:https://doi.org/10.1111/j.1525-1594.2004.40006.x. PMID: 14720294

50. Coste C.A., Bergeron V., Berkelmans R., et al. Comparison of strategies and performance of functional electrical stimulation cycling in spinal cord injury pilots for competition in the first ever CYBATHLON. European Journal of Translational Myology. 2017 Dec 5;27(4):7219. DOI:https://doi.org/10.4081/ejtm.2017.7219. eCollection 2017 Dec 5.

51. Volodeeva E.A., Yastrebceva I.P., Belova V.V., Baklushin A.E. Evaluating the effectiveness of electrical stimulation and vazoselective alternating electrostatic field at patients with ischemic stroke. Bulletin of rehabilitation medicine. 2015; 1(65): 28-32 (In Russ.)

52. Molchanova E.E. Clinical efficiency of dynamic electroneurostimulation in the acute period of the ischemic stroke. Bulletin of rehabilitation medicine. 2015; 1(65): 33-36 (In Russ.)

53. Evstigneeva L.P., Polyanskaya T.P., Vlasov A.A. The role of dynamic electricneurostimulation in reducing pain and improving quality of life of patients with osteoporosis. Bulletin of rehabilitation medicine. 2015; 3(67): 19-28 (In Russ.)

54. Drobyshev V.A., Gerasimenko O.N., Romanovskaya N.S., Vlasov A.A., Shashukov D.A. Effectiveness of dynamic electrical stimulation in complex treatment in acute period of ischemic stroke. Bulletin of rehabilitation medicine. 2016; 2(72): 21-26 (In Russ.)

55. Kadochnikova E.Y., Vlasov A.A., Alekseeva L.I., Didikina I.G., Ershova O.B., Zaitseva E.M., Korotkova T.A., Popova T.A., Sukhareva M.L., Taskina E.A.,Sharapova E.P., Solodovnikov A.G., Lesnyak O.M. The effectiveness of dynamic electroneurostimulation (DENS) In the pain management in knee osteoarthritis (results of a multicenter randomized study). Bulletin of rehabilitation medicine. 2016; 3(73): 14-22 (In Russ.)

56. Gertsik Yu.G., Gertsik G.Ya. Biophysical preconditions for applying magnetic and electrical stimulation of bone tissue at the rehabilitation activities in traumatology. Bulletin of rehabilitation medicine. 2016; 3(73): 58-61 (In Russ.)

57. Drobyshev V.A., Shpagin L.A., Pospelova T.I. Zechariah O.I., Vlasov A.A. The dynamic electric correction clinical and functional manifestations of peripheral polyneuropathy of patients with multiple myeloma. Bulletin of rehabilitation medicine. 2016; 5(75): 19-24 (In Russ.)

58. Molchanova E.E. The experience of the combined application of dynamic electroneurostimulation and acupuncture in acute period of ischemic stroke. Bulletin of rehabilitation medicine. 2017; 2(78): 63-67 (In Russ.)

59. Tkachenko P.V., Daminov V.D., Karpov O.E. Synchronized application of the exoskeleton with functional electrostimulation in the spinal cord injury patients. Bulletin of rehabilitation medicine. 2017; 3(85): 123-130 (In Russ.)

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