Electrical stimulation in lower motoneuron lesions, from scientific evidence to clinical practice: a successful transition

Submitted: 31 January 2023
Accepted: 28 April 2023
Published: 8 June 2023
Abstract Views: 569
PDF: 236
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Long pulse stimulation in its application in everyday clinical practice still represents a challenge for many therapists and clinicians. It is often unclear how the intervention setup, in particular the parameters pulse width, frequency and amplitude, can influence muscle morphology. In addition, the cause of damage to the lower motoneuron can have multiple reasons and is not anatomically located at the same site. Given the large heterogeneity, it is essential to know the current options and limitations in order to carry out a targeted treatment. A retrospective data analysis of n=128 patients, seen at the Swiss Paraplegic Centre (SPC) in 2022, shows a broad variability in manifestation of lower motoneuron damage. Treatment examples based on different causes of lower motoneuron damage are shown and corresponding stimulation programmes are assigned, as well as the expected results in terms of stimulation duration, volume and configuration.

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Bersch I, Fridén J. Electrical stimulation alters muscle morphological properties in denervated upper limb muscles. Ebiomedicine. 2021;74:103737. PMID: 34896792, PMCID: PMC8671101 DOI: https://doi.org/10.1016/j.ebiom.2021.103737
Chandrasekaran S, Davis J, Bersch I, Goldberg G, Gorgey AS. Electrical stimulation and denervated muscles after spinal cord injury. Neural Regen Res. 2020 Aug;15(8):1397–1407. PMID: 31997798, PMCID: PMC7059583 DOI: https://doi.org/10.4103/1673-5374.274326
Bersch I, Fridén J. Upper and lower motor neuron lesions in tetraplegia: implications for surgical nerve transfer to restore hand function. J Appl Physiol. 2020;129(5):1214–1219. PMID: 32969783 DOI: https://doi.org/10.1152/japplphysiol.00529.2020
Kern H, Hofer C, Mödlin M, Forstner C, Richter WM. Functional Electrical Stimulation (FES) of Long-Term Denervated Muscles in Humans: Clinical Observations and Laboratory Findings. Basic Appl Myol. 2002;6(12):291–299.
Kern H, Carraro U. Home-Based Functional Electrical Stimulation of Human Permanent Denervated Muscles: A Narrative Review on Diagnostics, Managements, Results and Byproducts Revisited 2020. Diagnostics. 2020;10(8):529. PMID: 32751308 DOI: https://doi.org/10.3390/diagnostics10080529
Kern H, Stramare R, Martino L, Zanato R, Gargiulo P, Carraro U. Permanent LMN denervation of human skeletal muscle and recovery by h-b FES: management and monitoring. Europ J Transl Myology. 2010;20(3):91–104. DOI: https://doi.org/10.4081/bam.2010.3.91
Carraro U, Boncompagni S, Gobbo V, Rossini K, Zampieri S, Mosole S, Ravara B, Nori A, Stramare R, Ambrosio F, Piccione F, Masiero S, Vindigni V, Gargiulo P, Protasi F, Kern H, Pond A, Marcante A. Persistent muscle fiber regeneration in long term denervation. Past, present, future. Europ J Transl Myol. 2014;25(2):77–92. PMID: 25844146 DOI: https://doi.org/10.4081/bam.2015.2.77
Mandl T, Meyerspeer M, Reichel M, Kern H, Hofer C, Mayr W, Moser E. Functional Electrical Stimulation of Long‐term Denervated, Degenerated Human Skeletal Muscle: Estimating Activation Using T2‐Parameter Magnetic Resonance Imaging Methods. Artif Organs. 2008;32(8):604–608. PMID: 18782129 DOI: https://doi.org/10.1111/j.1525-1594.2008.00609.x
Alberty M, Mayr W, Bersch I. Electrical Stimulation for Preventing Skin Injuries in Denervated Gluteal Muscles—Promising Perspectives from a Case Series and Narrative Review. Diagnostics. 2023;13(2):219. PMID: 36673029, PMCID: PMC9857944 DOI: https://doi.org/10.3390/diagnostics13020219
Mayr W, Hofer C, Bijak M, Rafolt D, Unger E, Reichel M, Sauermann S, Lanmueller H, Kern H. Functional Electrical Stimulation (FES) of Denervated Muscles: Existing and Prospective Technological Solutions. Basic Appl Myol. 2003 Feb 14;6:287–290.
Kern H, Salmons S, Mayr W, Rossini K, Carraro U. Recovery of long-term denervated human muscles induced by electrical stimulation. Muscle Nerve. 2005 Jan;31(1):98–101. DOI: https://doi.org/10.1002/mus.20149
Boncompagni S, Kern H, Rossini K, Hofer C, Mayr W, Carraro U, Protasi F. Structural differentiation of skeletal muscle fibers in the absence of innervation in humans. Proc Natl Acad Sci U S A. 2007. Dec 4;104(49):19339–19344. PMID: 18042706, PMCID: PMC2148291 DOI: https://doi.org/10.1073/pnas.0709061104
Albertin G, Hofer C, Zampieri S, Vogelauer M, Löfler S, Ravara B, Guidolin D, Fede C, Incendi D, Porzionato A, Caro RD, Baba A, Marcante A, Piccione F, Gargiulo P, Pond A, Carraro U, Kern H. In complete SCI patients, long-term functional electrical stimulation of permanent denervated muscles increases epidermis thickness. Neurol Res. 2018 Apr;40(4):277–282. PMID: 29447083 DOI: https://doi.org/10.1080/01616412.2018.1436877
Kern H, Boncompagni S, Rossini K, Mayr W, Fanò G, Zanin ME, Podhorska-Okolow M, Protasi F, Carraro U. Long-term denervation in humans causes degeneration of both contractile and excitation-contraction coupling apparatus, which is reversible by functional electrical stimulation (FES): a role for myofiber regeneration? J. Neuropathol. Exp. Neurol. 2004 Sep;63(9):919–931. PMID: 15453091 DOI: https://doi.org/10.1093/jnen/63.9.919
Kern H, Carraro U, Adami N, Hofer C, Loefler S, Vogelauer M, Mayr W, Rupp R, Zampieri S. One year of home-based daily FES in complete lower motor neuron paraplegia: recovery of tetanic contractility drives the structural improvements of denervated muscle. Neurol Res. 2010 Feb;32(1):5–12. PMID: 20092690. DOI: https://doi.org/10.1179/174313209X385644

How to Cite

Bersch, I., & Mayr, W. (2023). Electrical stimulation in lower motoneuron lesions, from scientific evidence to clinical practice: a successful transition. European Journal of Translational Myology, 33(2). https://doi.org/10.4081/ejtm.2023.11230

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