Muscle biopsies show that FES of denervated muscles reverses human muscle degeneration from permanent spinal motoneuron lesion

Authors: Kern H 1, Rossini K 2, Carraro U 3, Mayr W 4, Vogelauer M 1, Hoellwarth U 1, Hofer C 1

Source: J Rehabil Res Dev. 2005; 42(3 Suppl 1): 43-53



This paper presents biopsy analyses in support of the clinical evidence of muscle recovery induced by a new system of life-long functional-electrical-stimulation (FES) training in permanent spinal-motoneuron-denervated human muscle. Not earlier than 1 year after subjects experienced complete conus cauda lesion, their thigh muscles were electrically stimulated at home for several years with large skin surface electrodes and an expressly designed stimulator that delivered much longer impulses than those presently available for clinical use. The poor excitability of long-term denervated muscles was first improved by several months of twitch-contraction training. Then, the muscles were tetanically stimulated against progressively increased loads. Needle biopsies of vastus lateralis from long-term denervated subjects showed severe myofiber atrophy or lipodystrophy beginning 2 years after spinal cord injury (SCI). Muscle biopsies from a group of 3.6- to 13.5-year denervated subjects, who underwent 2.4 to 9.3 years of FES, show that this progressive training almost reverted long-term muscle atrophy/degeneration.


1 Department of Physical Medicine, Ludwig Boltzmann Institute of Electrostimulation and Physical Rehabilitation, Wilhelminenspital, Vienna, Austria
2 Consiglio Nazionale delle Ricerche Institute of Neuroscience, Laboratorio di Miologia Applicata, Dipartimento di Scienze Biomediche, Università di Padova, I-35121 Padova, Italy
3 Italian CNR Institute of Neuroscience, and Laboratory of Translational Myology, Interdepartmental Research Center of Myology (cirMYO), Department of Biomedical Sciences, University of Padova, Padova, Italy
4 Center of Biomedical Engineering and Physics, Medical University of Vienna, A-1090 Vienna, Austria