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      Home FES: An Exploratory Review

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          Abstract

          This review of literature focuses on the multiple uses of Functional Electrical Stimulation (FES) and how this modality may be a valuable home-based therapy. Papers pertaining to home FES exercise were collected using the Web of Science, Google Scholar databases and collegial hints. In our opinion, the following statements summarize the results. FES may be used to induce health benefits in populations with paralysis, and in persons with musculoskeletal, cardiorespiratory and renal pathology. The EU Project Rise showed how FES could have a variety of encouraging outcomes for patients with denervated muscles following traumatic injuries. As suggested by recent literature, FES has proven to be a viable form of exercise for elderly individuals. Thus, Home FES may be an option for patients looking for an additional form of muscle and cardiopulmonary physical therapy.

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          Most cited references77

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          Age-Associated Loss of OPA1 in Muscle Impacts Muscle Mass, Metabolic Homeostasis, Systemic Inflammation, and Epithelial Senescence

          Summary Mitochondrial dysfunction occurs during aging, but its impact on tissue senescence is unknown. Here, we find that sedentary but not active humans display an age-related decline in the mitochondrial protein, optic atrophy 1 (OPA1), that is associated with muscle loss. In adult mice, acute, muscle-specific deletion of Opa1 induces a precocious senescence phenotype and premature death. Conditional and inducible Opa1 deletion alters mitochondrial morphology and function but not DNA content. Mechanistically, the ablation of Opa1 leads to ER stress, which signals via the unfolded protein response (UPR) and FoxOs, inducing a catabolic program of muscle loss and systemic aging. Pharmacological inhibition of ER stress or muscle-specific deletion of FGF21 compensates for the loss of Opa1, restoring a normal metabolic state and preventing muscle atrophy and premature death. Thus, mitochondrial dysfunction in the muscle can trigger a cascade of signaling initiated at the ER that systemically affects general metabolism and aging.
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            Quadriceps weakness and osteoarthritis of the knee.

            The quadriceps weakness commonly associated with osteoarthritis of the knee is widely believed to result from disuse atrophy secondary to pain in the involved joint. However, quadriceps weakness may be an etiologic factor in the development of osteoarthritis. To explore the relation between lower-extremity weakness and osteoarthritis of the knee. Cross-sectional prevalence study. Population-based, with recruitment by random-digit dialing. 462 volunteers 65 years of age or older. Radiographs of the knee were graded for the presence of osteoarthritis. Knee pain and function were assessed with the Western Ontario and McMaster Universities Arthritis Index, the strength of leg flexors and extensors was assessed with isokinetic dynamometry, and lower-extremity lean tissue mass was assessed with dual-energy x-ray absorptiometry. Among participants with osteoarthritis, quadriceps weakness, but not hamstring weakness, was common. The ratio of extensor strength to body weight was approximately 20% lower in those with than in those without radiographic osteoarthritis. Notably, among women with tibiofemoral osteoarthritis, extensor weakness was present in the absence of knee pain and was seen in participants with normal lower-extremity lean mass (extensor strength, 30.1 lb-ft for those with osteoarthritis and 34.8 lb-ft for those without osteoarthritis; P < 0.001). After adjustment for body weight, age, and sex, lesser quadriceps strength remained predictive of both radiographic and symptomatic osteoarthritis of the knee (odds ratio for prevalence of osteoarthritis per 10 lb-ft loss of strength, 0.8 [95% CI, 0.71 to 0.90] for radiographic osteoarthritis and 0.71 [CI, 0.51 to 0.87] for symptomatic osteoarthritis). Quadriceps weakness may be present in patients who have osteoarthritis but do not have knee pain or muscle atrophy; this suggests that the weakness may be due to muscle dysfunction. The data are consistent with the possibility that quadriceps weakness is a primary risk factor for knee pain, disability, and progression of joint damage in persons with osteoarthritis of the knee.
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              Reduced quadriceps strength relative to body weight: a risk factor for knee osteoarthritis in women?

              To determine whether baseline lower extremity muscle weakness is a risk factor for incident radiographic osteoarthritis (OA) of the knee. This prospective study involved 342 elderly community-dwelling subjects (178 women, 164 men) from central Indiana, for whom baseline and followup (mean interval 31.3 months) knee radiographs were available. Lower extremity muscle strength was measured by isokinetic dynamometry and lean tissue (i.e., muscle) mass in the lower extremities by dual x-ray absorptiometry. Knee OA was associated with an increase in body weight in women (P = 0.0014), but not in men. In both sexes, lower extremity muscle mass exhibited a strong positive correlation with body weight. In women, after adjustment for body weight, knee extensor strength was 18% lower at baseline among subjects who developed incident knee OA than among the controls (P = 0.053), whereas after adjustment for lower extremity muscle mass, knee extensor strength was 15% lower than in the controls (P not significant). In men, in contrast, adjusted knee extensor strength at baseline was comparable to that in the controls. Among the 13 women who developed incident OA, there was a strong, highly significant negative correlation between body weight and extensor strength (r = -0.740, P = 0.003), that is, the more obese the subject, the greater the reduction of quadriceps strength. In contrast, among the 14 men who developed incident OA, a modest positive correlation existed between weight and quadriceps strength (r = 0.455, P = 0.058). No correlation between knee flexor (hamstring) strength and knee OA was seen in either sex. Reduced quadriceps strength relative to body weight may be a risk factor for knee OA in women.
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                Author and article information

                Contributors
                Journal
                Eur J Transl Myol
                EJTM
                European Journal of Translational Myology
                PAGEPress Publications, Pavia, Italy
                2037-7452
                2037-7460
                12 November 2019
                29 October 2019
                : 29
                : 4
                : 8285
                Affiliations
                [1 ] Faculty of Engineering and IT, The University of Sydney , Camperdown, Australia
                [2 ] Charles Perkins Centre, The University of Sydney , Camperdown, Australia
                [3 ] Discipline of Anatomy and Histology, Faculty of Medicine and Health, The University of Sydney , Camperdown, Australia
                [4 ] EquiNew, River Falls, Wisconsin, United States of America
                Author notes
                Level 5, Abercrombie Building, The University of Sydney, NSW, 2006, Australia. Mobile Phone: + 61 478 033 859. mj.taylor.1290@ 123456gmail.com

                Authors contributions

                MJT drafted the manuscript and was responsible for literature review and critical synthesis and analysis of literature, SS was responsible for review of the equine literature and assisted with reformatting and organisation of the work, AJR was the primary supervisor of related thesis work.

                MJT is a former PhD student at the University of Sydney, Australia. He is currently a Researcher: Learning, Technology and Innovation at the University of Sydney Business School.

                Conflict of interest: The authors have no conflicts to disclose.

                Article
                10.4081/ejtm.2019.8285
                6974778
                641502e3-88e5-4a1f-9676-c0719c03e6f9
                Copyright @

                This article is distributed under the terms of the Creative Commons Attribution Noncommercial License ( by-nc 4.0) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

                History
                : 15 May 2019
                : 31 October 2019
                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 86, Pages: 10
                Funding
                Funding: No funding was obtained for this project.
                Categories
                Review

                electrical stimulation,home fes,spinal cord injury,osteoarthritis,cardiopulmonary and renal failure,elderly,muscle weakness,physical therapy

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