TY - JOUR
T1 - Neuromuscular Electrical Stimulation Preserves Leg Lean Mass in Geriatric Patients
AU - Karlsen, Anders
AU - Cullum, Christopher Kjaer
AU - Norheim, Kristoffer Larsen
AU - Scheel, Frederik Ulrik
AU - Zinglersen, Amanda Hempel
AU - Vahlgren, Julie
AU - Schjerling, Peter
AU - Kjaer, Michael
AU - Mackey, Abigail L
PY - 2020/4
Y1 - 2020/4
N2 - AIM: To examine changes in lean mass during hospitalization in geriatric patients and the effect of muscle activation by neuromuscular electrical stimulation.METHODS: Thirteen patients (69-94 years) at a geriatric ward completed tests at hospital admission (day 2-3) and discharge (day 8-10). One leg received daily stimulation of the knee extensors while the other leg served as a control leg. Lean mass was evaluated by DEXA scans and muscle thickness by ultrasound scans. Muscle biopsies were collected from both legs at admission and discharge in 9 patients and analyzed for fibre size, satellite cell number and activation and expression of genes associated with muscle protein synthesis and breakdown, connective tissue and cellular stress.RESULTS: The relative decline in leg lean mass and midthigh region lean mass was larger in the control (-2.8±1.5%) vs. the stimulated leg (-0.5±1.4%, p<0.05). Although there were no changes in fibre size or satellite cell number, the mRNA data revealed that, compared to control, the stimulation resulted in a downregulation of Myostatin (p<0.05) and a similar trend for MAFbx (p=0.099), together with an upregulation of Collagen I (p<0.001), TenascinC (p<0.001), CD68 (p<0.01) and Ki67 (p<0.05) mRNA.CONCLUSION: These findings demonstrate a moderate decline in leg lean mass during a hospital stay in geriatric patients, while leg lean mass was preserved with daily neuromuscular electrical muscle activation. At the cellular level the stimulation had a clear influence on suppression of atrophy signaling pathways in parallel with a stimulation of connective tissue and cellular remodeling processes.
AB - AIM: To examine changes in lean mass during hospitalization in geriatric patients and the effect of muscle activation by neuromuscular electrical stimulation.METHODS: Thirteen patients (69-94 years) at a geriatric ward completed tests at hospital admission (day 2-3) and discharge (day 8-10). One leg received daily stimulation of the knee extensors while the other leg served as a control leg. Lean mass was evaluated by DEXA scans and muscle thickness by ultrasound scans. Muscle biopsies were collected from both legs at admission and discharge in 9 patients and analyzed for fibre size, satellite cell number and activation and expression of genes associated with muscle protein synthesis and breakdown, connective tissue and cellular stress.RESULTS: The relative decline in leg lean mass and midthigh region lean mass was larger in the control (-2.8±1.5%) vs. the stimulated leg (-0.5±1.4%, p<0.05). Although there were no changes in fibre size or satellite cell number, the mRNA data revealed that, compared to control, the stimulation resulted in a downregulation of Myostatin (p<0.05) and a similar trend for MAFbx (p=0.099), together with an upregulation of Collagen I (p<0.001), TenascinC (p<0.001), CD68 (p<0.01) and Ki67 (p<0.05) mRNA.CONCLUSION: These findings demonstrate a moderate decline in leg lean mass during a hospital stay in geriatric patients, while leg lean mass was preserved with daily neuromuscular electrical muscle activation. At the cellular level the stimulation had a clear influence on suppression of atrophy signaling pathways in parallel with a stimulation of connective tissue and cellular remodeling processes.
KW - Muscle atrophy
KW - gene expression
KW - muscle activation
KW - neuromuscular electrical stimulation
KW - satellite cells
UR - http://www.scopus.com/inward/record.url?scp=85081745187&partnerID=8YFLogxK
U2 - 10.1249/MSS.0000000000002191
DO - 10.1249/MSS.0000000000002191
M3 - Journal article
C2 - 31688649
SN - 0195-9131
VL - 52
SP - 773
EP - 784
JO - Medicine and Science in Sports and Exercise
JF - Medicine and Science in Sports and Exercise
IS - 4
ER -