Abstract
Study design:
A cross-sectional study design.
Objectives:
To characterize and specifically quantify impairments in muscle function after chronic incomplete spinal cord injury (SCI).
Setting:
University of Florida, Gainesville, FL, USA.
Methods:
Voluntary and electrically elicited contractile measurements were performed and voluntary activation deficits were quantitatively determined in the knee extensor and ankle plantar flexor muscle groups in 10 individuals with chronic incomplete SCI (C5-T8, ASIA C or D) and age-, gender-, height- and body weight matched healthy controls.
Results:
Persons with incomplete-SCI were able to produce only 36 and 24% of the knee extensor torque and 38 and 26% of the plantar flexor torque generated by noninjured controls in the self-reported less-involved and more-involved limbs, respectively (P<0.05). In addition, both indices of explosive or instantaneous muscle strength, torque200 (absolute torque reached at 200 ms) and the average rate of torque development (ARTD) were dramatically reduced in the ankle plantar flexor and knee extensor muscle groups in persons with incomplete-SCI. However, the deficit in instantaneous muscle strength was most pronounced in the ankle plantar flexor muscles, with an 11.7-fold difference between the torque200 measured in the self-reported more involved limb and a 5-fold difference in the less-involved limb compared to control muscles. Voluntary activation deficits ranged between 42 and 66% in both muscle groups. Interestingly, electrically elicited contractile properties did not differ between the groups.
Conclusion:
The resultant impact of incomplete-SCI is that affected muscles not only become weak, but slow to develop voluntary torque. We speculate that the large deficit in torque200 and ARTD in the ankle plantar flexors muscles of persons with incomplete-SCI may limit locomotor function. The results presented in this study provide a quantitative and sensitive assessment of muscle function upon which future research examining rehabilitation programs aimed at restoring muscle function and promoting functional recovery after incomplete-SCI may be based.
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Acknowledgements
We sincerely thank Neeti Pathare and Chetan Phadke for their assistance with data collection and Shivkumar Swaminathan for his help with the data analysis. We also thank all the study participants for their dedication towards this research. Grant support for this study was provided by NIH-KO1HD01348 and the Evelyn F and William L McKnight Brain Institute of the University of Florida. ‘We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research’.
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These results were presented in part at the Society for Neuroscience Annual Conference, San Diego, CA, 2004
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Jayaraman, A., Gregory, C., Bowden, M. et al. Lower extremity skeletal muscle function in persons with incomplete spinal cord injury. Spinal Cord 44, 680–687 (2006). https://doi.org/10.1038/sj.sc.3101892
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DOI: https://doi.org/10.1038/sj.sc.3101892
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