Neuromuscular Electrical Stimulation Preserves Leg Lean Mass in Geriatric Patients

Anders Karlsen; Christopher Kjaer Cullum; Kristoffer Larsen Norheim; Frederik Ulrik Scheel; Amanda Hempel Zinglersen; Julie Vahlgren; Peter Schjerling; Michael Kjaer; Abigail L. Mackey

doi:10.1249/mss.0000000000002191

Neuromuscular Electrical Stimulation Preserves Leg Lean Mass in Geriatric Patients

Anders Karlsen, Christopher Kjaer Cullum, Kristoffer Larsen Norheim, Frederik Ulrik Scheel, Amanda Hempel Zinglersen, Julie Vahlgren, Peter Schjerling, Michael Kjaer, Abigail L. Mackey

6 Citations (Scopus)

Abstract

Aim This study aimed 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 yr) at a geriatric ward completed tests at hospital admission (days 2-3) and discharge (days 8-10). One leg received daily stimulation of the knee extensors, whereas the other leg served as a control leg. Lean mass was evaluated by dual-energy x-ray absorptiometry scans and muscle thickness by ultrasound scans. Muscle biopsies were collected from both legs at admission and discharge in nine patients and analyzed for fiber 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%) versus the stimulated leg (-0.5% ± 1.4%, P < 0.05). Although there were no changes in fiber size or satellite cell number, the mRNA data revealed that, compared with 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, whereas 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.

Original language	English
Journal	Medicine & Science in Sports & Exercise
Volume	Publish Ahead of Print
ISSN	0195-9131
DOIs	https://doi.org/10.1249/mss.0000000000002191
Publication status	Published - 1 Apr 2020

Keywords

Muscle Atrophy
Muscle Activation
Neuromuscular Electrical Stimulation
Satellite Cells
Gene Expression

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10.1249/mss.0000000000002191

https://journals.lww.com/acsm-msse/Fulltext/publishahead/Neuromuscular_Electrical_Stimulation_Preserves_Leg.96459.aspx

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@article{eb19ce08d6a142ecbb005c201335b558,

title = "Neuromuscular Electrical Stimulation Preserves Leg Lean Mass in Geriatric Patients",

abstract = "Aim This study aimed 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 yr) at a geriatric ward completed tests at hospital admission (days 2-3) and discharge (days 8-10). One leg received daily stimulation of the knee extensors, whereas the other leg served as a control leg. Lean mass was evaluated by dual-energy x-ray absorptiometry scans and muscle thickness by ultrasound scans. Muscle biopsies were collected from both legs at admission and discharge in nine patients and analyzed for fiber 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%) versus the stimulated leg (-0.5% ± 1.4%, P < 0.05). Although there were no changes in fiber size or satellite cell number, the mRNA data revealed that, compared with 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, whereas 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.",

keywords = "Muscle Atrophy, Muscle Activation, Neuromuscular Electrical Stimulation, Satellite Cells, Gene Expression",

author = "Anders Karlsen and Cullum, {Christopher Kjaer} and Norheim, {Kristoffer Larsen} and Scheel, {Frederik Ulrik} and Zinglersen, {Amanda Hempel} and Julie Vahlgren and Peter Schjerling and Michael Kjaer and Mackey, {Abigail L.}",

year = "2020",

month = apr,

day = "1",

doi = "10.1249/mss.0000000000002191",

language = "English",

volume = "Publish Ahead of Print",

journal = "Medicine & Science in Sports & Exercise",

issn = "0195-9131",

publisher = "Lippincott Williams & Wilkins",

}

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 - 2020/4/1

Y1 - 2020/4/1

N2 - Aim This study aimed 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 yr) at a geriatric ward completed tests at hospital admission (days 2-3) and discharge (days 8-10). One leg received daily stimulation of the knee extensors, whereas the other leg served as a control leg. Lean mass was evaluated by dual-energy x-ray absorptiometry scans and muscle thickness by ultrasound scans. Muscle biopsies were collected from both legs at admission and discharge in nine patients and analyzed for fiber 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%) versus the stimulated leg (-0.5% ± 1.4%, P < 0.05). Although there were no changes in fiber size or satellite cell number, the mRNA data revealed that, compared with 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, whereas 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 This study aimed 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 yr) at a geriatric ward completed tests at hospital admission (days 2-3) and discharge (days 8-10). One leg received daily stimulation of the knee extensors, whereas the other leg served as a control leg. Lean mass was evaluated by dual-energy x-ray absorptiometry scans and muscle thickness by ultrasound scans. Muscle biopsies were collected from both legs at admission and discharge in nine patients and analyzed for fiber 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%) versus the stimulated leg (-0.5% ± 1.4%, P < 0.05). Although there were no changes in fiber size or satellite cell number, the mRNA data revealed that, compared with 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, whereas 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 - Muscle Activation

KW - Neuromuscular Electrical Stimulation

KW - Satellite Cells

KW - Gene Expression

U2 - 10.1249/mss.0000000000002191

DO - 10.1249/mss.0000000000002191

M3 - Journal article

C2 - 31688649

SN - 0195-9131

VL - Publish Ahead of Print

JO - Medicine & Science in Sports & Exercise

JF - Medicine & Science in Sports & Exercise

ER -

Neuromuscular Electrical Stimulation Preserves Leg Lean Mass in Geriatric Patients

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