Abstract：
Spinal cord injury (SCI) where the lower motor neuron is compromised leads to atrophy and degenerative changes in the respective muscle. This type of lesion becomes especially critical when the gluteal muscles and/or the hamstrings are affected as they usually offer a cushioning effect to protect from skin injuries. Previous research conducted over the past 30 years has made advancements in the development of parameters for the optimal application of long pulse stimulation with the aim to restore muscle structure and trophic aspects in people with chronic SCI (<20 years post-injury). This work provides an overview of previous achievements in the field through a narrative literature review before presenting preliminary results in the form of a case series from an ongoing study investigating the acute effects of six months of long pulse stimulation on the tissue composition of the gluteal muscles in five people with chronic SCI (>20 years post-injury). Participants underwent a 33-min home-based long pulse stimulation program five times a week, and their muscle and adipose tissue thicknesses were assessed at baseline, after three and six months, respectively, using magnetic resonance imaging. The results show that the largest increase in muscle thickness occurred at the level of the height of the acetabulum (+44.37%; χ2(2) = 0.5; p = 0.779), whereas the most important decrease in adipose tissue occurred at the level of the sacroiliac joint (SIJ) reference (−11.43%; χ2(2) = 1.6; p = 0.449) within only six months of regular stimulation despite the preceding long denervation period. The underlying mechanism and physiology of muscular resuscitation from myofibrillar debris as presented in chronic denervation to functional contractile entities remain to be investigated further.
摘要：
下运动神经元受损的脊髓损伤（SCI）导致相应肌肉的萎缩和退行性变化。当臀肌和/或腿筋受到影响时,这种类型的损伤变得尤其严重,因为它们通常提供缓冲作用以防止皮肤损伤。过去30年进行的先前研究在长脉冲刺激的最佳应用参数开发方面取得了进步，目的是恢复慢性SCI患者的肌肉结构和营养方面（受伤后20年）。这项工作通过叙述性文献综述概述了该领域的先前成就，然后以正在进行的研究调查了六个月长脉冲刺激对臀肌组织组成的急性影响的病例系列的初步结果。五个患有慢性SCI的人（受伤后20年）。参与者每周接受五次33分钟的家庭长脉冲刺激计划，他们的肌肉和脂肪组织厚度在基线时进行评估，三个月和六个月后，分别,使用磁共振成像。结果表明，肌肉厚度的最大增加发生在髋臼高度水平（44.37％；χ2（2）=0.5；p=0.779），而脂肪组织最重要的减少发生在骶髂关节（SIJ）参考水平（-11.43％；χ2（2）=1.6；p=0.449），尽管有较长的神经支配期，但在常规刺激后仅六个月内发生。从慢性去神经支配到功能性收缩实体的肌原纤维碎片进行肌肉复苏的潜在机制和生理学仍有待进一步研究。
