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Thread: Shrinking legs!

  1. #1

    Shrinking legs!

    At the risk of sounding vain...
    I'm a complete T8 para. I'm almost a year from my accident, and just noticed that my legs are really starting to shrink. Is there anything that can be done to help keep them from atrophying? Standing in a standing frame? Some sort of leg stimulator bike? Anything?

  2. #2
    FES bike. It's not 100% guarantee that your legs will not atrophy but at least it is something. Maybe there is a spinal cord injury Center in your area that is offering a program.

    I know that when I was in the trials I had some muscle mass return. Nothing major but, it was something. As your injury is new it may be more beneficial.
    Get involved in politics as if your life depended on it, because it does. -- Justin Dart

    I shall not tolerate ignorance or hate speech on this site.

  3. #3
    Atrophy can only be prevented or treated by active muscle contraction. Standing does not do this. FES is the only current way to do this, but can be quite expensive.

    Do you have spasticity? Over treating spasticity with medication can cause atrophy too. One advantage of some hypertonicity is that it helps to maintain muscle mass.

    (KLD)

  4. #4
    Senior Member soonerborn's Avatar
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    Ya I have the same problem im one year after and i use an electric stim. machine about 2 to 3 hundred and it comes with pads that stick on anywhere. I use it on my back cause im a T8 and stomach, legs, butt and it keeps them up pretty good just have to do it every other day. Also helps with pressure sores on my butt!

  5. #5
    Standing doesn't do anything for muscle size, but it IS important for bone density, circulation, stretching, all that.

  6. #6
    Quote Originally Posted by soonerborn
    Ya I have the same problem im one year after and i use an electric stim. machine about 2 to 3 hundred and it comes with pads that stick on anywhere. I use it on my back cause im a T8 and stomach, legs, butt and it keeps them up pretty good just have to do it every other day. Also helps with pressure sores on my butt!
    I am close to your level, and I tried the electric stim thingy in rehab, but it didnt do anythin (like didnt work at all), my PT said that is was because of my injury level T6? You're relatively close, I wonder why it worked for you?

  7. #7
    Quote Originally Posted by smiller
    At the risk of sounding vain...
    I'm a complete T8 para. I'm almost a year from my accident, and just noticed that my legs are really starting to shrink. Is there anything that can be done to help keep them from atrophying? Standing in a standing frame? Some sort of leg stimulator bike? Anything?
    Smiller,

    There are two types of leg muscle atrophy in spinal cord injury. The first is called non-use atrophy and results from not using the muscles in your legs. Note that paralysis does necessarily mean that the muscles are not being activated. Spasticity is muscle activity and I have often said that it is free exercise. One should not take so much baclofen and anti-spasticity drug that the muscle loses all tone and spasticity.

    The second is due to motoneuronal damage or nerve root damage. These may occur when the injury is at T10 or lower (most of the lumbosacral spinal cord is localed between T10 and L1 vertebral body). It may result if there had been compromised of blood flow to the lower spinal cord (perhaps due to compression or hemorrhage).

    Regarding stimulation, most FES (functional electrical stimulation) uses surface electrodes. The electrical current must pass from the electrodes through the skin. Generally, the current does not go very deep. What the current does is to stimulate the nerves entering the muscle, releasing their neurotransmitters (acetylcholine) to cause the muscle contraction.

    When the motoneurons or the spinal roots are damaged, the nerves to the muscle are gone. Therefore, stimulation of the muscle from the surface by standard stimulators usually does not activate the deeper parts of the muscles when the peripheral axons are gone.

    For many years, we were taught that there is some kind of trophic factor that nerves bring to muscle and the atrophy results from the loss of the trophic factor rather than loss of activity. However, recent studies suggest that this is not so. If one uses a strong enough stimulator that can send sufficiently current deep into the muscle, or actually implant the electrodes deep into muscle, the stimulation can activate muscles.

    Such stimulators deliver over 100x the standard currents. When high currents are used, the electrodes must have a large surface area so that the current is spread out over a wide area of skin. High current density can burn skin. The stimulator must be specially designed to deliver very high current levels. Studies with high current stimulators show that even muscles that are atrophied due to peripheral damage can be maintained.

    Wise.

  8. #8
    Bravo doctor!

    Once again, you always put issues into their proper perspective and give the reader options, but beyond that, motivation. It is amazing to me how the mindset of sci's has changed over the years. I recall when I began reading sci forums 9 years ago, acceptance of one's fate was the status quo, and using the words, 'hope' and 'cure' were considered unrealistic.

    Thanks.

  9. #9
    Words 'hope' and 'cure' are deffinitely those we want to hear. But are they really realistic. I must say I am still at that 'staus quo' since nothing so far give me any hope. I consider muscle atrophy as 'collateral damage' and therefore mostly aestetical issue. On the other hand science is developing (not miracles comming) so lets stay opimistic and see what future will bring.

  10. #10
    If FES was tried with negative results, is it possible for the motorneurons to work and FES work later on down the road?

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