Muscle Plasticity, Fitness, and Health after Spinal Cord Injury

脊髓损伤后的肌肉可塑性、健身和健康

• 批准号: 7800945
• 负责人: Kevin K. McCully
• 金额: $ 35.56万
• 依托单位: UNIVERSITY OF GEORGIA
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-07-10 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7800945
• 关键词: Address; Aerobic; Affective; Age; Ankle; Award; Blood Glucose; Chronic; Control Groups; Data; Deposition; Diabetes Mellitus; Diagnosis; Electric Stimulation; Exercise; Fatigue; Fatty acid glycerol esters; Glucose; Grant; Health; Hypertrophy; Individual; Insulin; Intramuscular; Knee; Leg; Lifting; Link; Lipids; Magnetic Resonance Imaging; Metabolism; Methods; Molecular; Muscle; Non-Insulin-Dependent Diabetes Mellitus; OGTT; Paraplegia; Physical therapy exercises; Physiological; Physiological Adaptation; Plasma; Protocols documentation; Quadriplegia; Research; Resistance; Self-Administered; Spinal cord injury; Surface; Techniques; Testing; Thigh structure; Time; Training; Treatment Efficacy; Weight; base; cardiovascular disorder risk; design; diabetic; fitness; impaired glucose tolerance; improved; muscle form; neuromuscular; prevent; programs; residence; response; strength training; sugar

DESCRIPTION (provided by applicant): This proposed research is a revised competing continuation of a previous award. Our previous research showed that surface neuromuscular electrical stimulation (SNMES) can markedly increase muscle mass in individuals with complete spinal cord injury (SCI). We found pilot data that suggested that SNMES can also increase insulin action after complete SCI who are glucose tolerant. The general aim of this proposal is to extend our research to test whether exercise therapy can improve insulin action in complete SCI individuals who are either diabetic (DIA) or have impaired glucose tolerance (IGT). The specific aims are: 1) Can 3 months of resistance or endurance exercise therapy be affective at "treating" IGT or DIA in complete, SCI individuals; and 2) What are the physiological adaptations (increased muscle mass, decreased fat mass, increased muscle endurance) are responsible for the improved insulin action following SNMES-induced exercise therapy. 100 subjects (84 to start the program, 78 expected to finish) with complete SCI (either paraplegic or quadriplegic) who are either IGT or DIA, 18 to 55 yrs of age, will be studied over the next 5 yrs. The resistance training will consist of knee extensions with ankle weights, two sessions of 40 lifts per week for 3 months. The weight used will be increased as needed. Endurance exercise therapy will use twitch stimulations for 30 minutes three times per week. A control group (no exercise) will be used for comparison. The following techniques will be used to assess the efficacy of the therapies; an oral glucose tolerance test for insulin action, magnetic resonance imaging for muscle size and lipid deposits, and SNMES for the fatigue tests. Rejection of the null hypothesis will show that those with a complete SCI can use either residence-based, self-administered resistance or endurance exercise therapy to treat IGT/DIA and reduce the risk of cardiovascular disease. In addition, physiological adaptations that best predict changes in insulin action will be determined. A blocked design will be used to separately evaluate IGT and DIA. This research will address methods to prevent diabetes which is an important health problem in SCI. This study will also use practical self-administered exercise protocols, and will test links between insulin action and modifiable physiological functions. Thus, this research has the potential to significantly benefit people with spinal cord injuries.

描述（由申请人提供）：这项拟议的研究是先前奖项的修订竞争延续。我们先前的研究表明，表面神经肌肉电刺激（SNME）可以显着增加完全脊髓损伤（SCI）的个体的肌肉质量。我们发现了试验数据，表明SNMES在完全具有葡萄糖耐受性的SCI后也可以增加胰岛素作用。该提案的总体目的是扩展我们的研究，以测试运动疗法是否可以改善糖尿病患者（DIA）或葡萄糖耐受性受损（IGT）的胰岛素作用。具体目的是：1）在完整的SCI个体中“治疗” IGT或DIA时，3个月的抵抗力或耐力运动治疗可以具有情感性； 2）什么是生理适应性（增加肌肉质量，脂肪质量降低，肌肉耐力增加）是导致SNMES诱导的运动治疗后改善胰岛素作用的。在接下来的5年中，将研究100名具有IGT或DIA的完整SCI（截瘫或四肢瘫痪），即IGT或DIA的100名受试者（有望完成78个），他们是IGT或DIA，年龄18至55岁。阻力训练将包括脚踝重量的膝关节伸展，每周两次举行40次升降机，持续3个月。使用的重量将根据需要增加。耐力运动疗法每周将使用抽搐刺激30分钟。对照组（无运动）将用于比较。以下技术将用于评估疗法的功效；用于胰岛素作用的口服葡萄糖耐量测试，肌肉大小和脂质沉积物的磁共振成像以及用于疲劳测试的SNME。拒绝零假设将表明，具有完整SCI的人可以使用基于居住的，自我管理的抗药性或耐力运动疗法来治疗IGT/DIA并降低心血管疾病的风险。此外，将确定最能预测胰岛素作用变化的生理适应。封闭的设计将用于分别评估IGT和DIA。这项研究将解决预防糖尿病的方法，这是SCI中重要的健康问题。这项研究还将使用实用的自我管理运动方案，并将测试胰岛素作用和可修改的生理功能之间的联系。因此，这项研究有可能使脊髓损伤的人有效。