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后的竞争性延续。我们之前的研究表明，表面神经肌肉电刺激（SNMES）可以显着增加完全脊髓损伤（SCI）个体的肌肉质量。我们发现试点数据表明，SNMES 还可以在完全 SCI 后对葡萄糖耐受的患者增加胰岛素作用。该提案的总体目标是扩展我们的研究，以测试运动疗法是否可以改善患有糖尿病 (DIA) 或糖耐量受损 (IGT) 的完全 SCI 个体的胰岛素作用。具体目标是： 1) 3 个月的抵抗或耐力运动疗法能否有效“治疗”完全性 SCI 个体的 IGT 或 DIA？ 2) SNMES 诱导的运动疗法后，哪些生理适应（肌肉量增加、脂肪量减少、肌肉耐力增加）导致胰岛素作用改善。未来 5 年将研究 100 名 IGT 或 DIA 完全 SCI（截瘫或四肢瘫痪）受试者（84 名开始该项目，78 名预计完成），年龄在 18 至 55 岁之间。阻力训练包括用脚踝负重进行膝关节伸展，每周两次，每次 40 次，持续 3 个月。使用的重量将根据需要增加。耐力运动疗法将使用抽搐刺激，每周 3 次，每次 30 分钟。将使用对照组（不运动）进行比较。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，用于肌肉大小和脂质沉积的磁共振成像，以及用于疲劳测试的 SNMES。拒绝零假设将表明，患有完全 SCI 的患者可以使用基于居住的自我管理阻力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。将使用分块设计来单独评估 IGT 和 DIA。这项研究将探讨预防糖尿病的方法，糖尿病是 SCI 中的一个重要健康问题。这项研究还将使用实用的自我管理锻炼方案，并将测试胰岛素作用和可改变的生理功能之间的联系。因此，这项研究有可能使脊髓损伤患者受益匪浅。