Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Jul 27, 2024
Open Peer Review Period: Jul 27, 2024 - Sep 21, 2024
Date Accepted: Nov 12, 2024
(closed for review but you can still tweet)
Multi-parametric MRI Assessment of Morpho-Functional Muscle Changes Following a 6-Months FES-cycling Training: A Pilot Study in People with Complete Spinal Cord Injury
ABSTRACT
Background:
Spinal cord injury (SCI) causes debilitating secondary conditions such as severe muscle deterioration, cardiovascular, and metabolic dysfunctions, significantly impacting patients' quality of life. Functional Electrical Stimulation (FES) combined with cycling exercise (FES-cycling) has shown promise in improving muscle function and health in individuals with SCI
Objective:
This pilot study aims to investigate the potential role of multiparametric Magnetic Resonance Imaging (mpMRI) to assess muscle health during and after FES-cycling rehabilitation program.
Methods:
Four male participants with chronic SCI underwent a 6-month FES-cycling training program, consisting of two 30-minute sessions per week. MRI scans were performed at baseline (T0), after 3 months (T1), at the end of the training (T2), and one-month post-training (T3). The MRI protocol included T1-weighted imaging for volume quantification, Dixon imaging for fat fraction, Multi Echo Spin Echo for T2 relaxation times, and Diffusion Tensor Imaging (DTI) to assess diffusion parameters.
Results:
Muscle hypertrophy was observed, with an average increase in muscle volume of 22.3% at T1 and 36.7% at T2 compared to baseline. One month post-training, muscle volume remained 23.2% higher than baseline. Fat fraction decreased from 11.1% at T0 to 9.1% at T2, with a rebound to 10.9% at T3. T2 relaxation times showed a reduction even though this was not consistent among subjects. DTI parameters revealed subtle changes in muscle tissue microstructure, with a decrease in Fractional Anisotropy mainly associated to a decrease of Axial and an increase of Radial Diffusivity.
Conclusions:
Although preliminary, this study provides evidence that 6 months of low-intensity FES-bike training can increase muscle volume and decrease fat infiltration in individuals with SCI. The study demonstrates that the use of mpMRI provides comprehensive insights into both macroscopic and microscopic changes within muscle tissues, supporting its integration into clinical practice for assessing the efficacy of rehabilitation interventions.
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