RAMP-ES to maximise bone stimulation in SCI
Research type
Research Study
Full title
Electrically-stimulated synergistic Recruitment of Antagonist Muscle Pairs (RAMP-ES), to maximise bone stimulation in the paralysed limbs of people with spinal cord injury
IRAS ID
253814
Contact name
Sylvie A.F. Coupaud
Contact email
Sponsor organisation
University of Strathclyde
Duration of Study in the UK
1 years, 2 months, 0 days
Research summary
In the lower-limb long bones, the largest loads arise from muscles acting on the bones via tendons. When such loads are suddenly removed through injury or paralysis, the skeleton can detect reduced mechanical strains and adapt to them, causing bone loss and a weakening of the skeleton. This disuse osteoporosis occurs after spinal cord injury (SCI), leading to a high risk of fragility fractures and associated morbidity and mortality from complications. Physical interventions that recruit paralysed muscle can potentially reverse disuse osteoporosis. Electrically-Stimulated (ES) exercise has been evaluated in studies aimed at tackling muscle atrophy and disuse osteoporosis in individuals with SCI. Significant and sustained improvements in bone mineral density (BMD) at fracture-prone sites in SCI have been demonstrated from long-term ES-cycling. However, the magnitude of those improvements has not reached clinical relevance, likely due to an inability to replicate the high peak muscle loads produced during daily activities in uninjured individuals. To achieve larger muscle forces and increase BMD changes from ES-exercise, we propose a novel approach of stimulating antagonist muscle pairs (e.g. knee flexors/extensors) simultaneously. Compared to existing ES exercise protocols, Recruitment of Antagonist Muscle Pairs (RAMP)-ES could significantly increase loading at key sites in the long bones.
The purpose of the study is to produce RAMP protocols based on a user-friendly ES system, with the potential to achieve clinically-relevant improvements in bone health in SCI.
REC name
West of Scotland REC 4
REC reference
20/WS/0051
Date of REC Opinion
7 Apr 2020
REC opinion
Further Information Favourable Opinion