Muscle Plasticity in Response

to Electrical Stimulation
- Naveen Gurung
- Palak Kakwani
- Janani Iyer
Anatomy of Skeletal Muscle
Sliding Filament Theory
 Muscle Plasticity

What is Muscle Plasticity?

• Muscle Plasticity refers to the ability of the muscle to adapt and change in
response to various stimuli or conditions.
• Their diameters, lengths, strengths, and vascular supplies are altered, and
even the types of muscle fibers are altered slightly.
• This remodeling process is often quite rapid, occurring within a few weeks.
 Key Aspects of Muscle Plasticity
1. Muscle Hypertrophy: Increase in the size of the muscle fibre as a result of
structural changes like increase in protein synthesis, enlargement of individual
muscle cells & increase in no. of contractile proteins.
2. Muscle Atrophy: Decrease in muscle size and mass as a result of disuse, ageing,
etc.
3. Hyperplasia of Muscle Fiber: Under rare conditions of extreme muscle force
generation, the actual number of muscle fibers has been observed to increase
(but only by a few percent), in addition to the fiber hypertrophy process. When
it does occur, the mechanism is linear splitting of previously enlarged fibers.
4. Type of Muscle Fiber Transformation: Muscle plasticity enables the
transformation of one muscle fiber type to another in response to various
stimuli.
5. Angiogenesis: It is the growth and development of new blood vessels
within muscle tissue. This increased vascularization provides a greater
supply of oxygen and nutrients to the muscle, supporting its function and
overall metabolic capacity
6. Neural Adaptations: During strength training, the nervous system learns
to recruit and synchronize muscle fibers more effectively, leading to
improved force production. This contributes to the strength gains
observed alongside muscle hypertrophy.
 Electrical Stimulation

• Electrical Stimulation refers to the application of electrical currents to excite

or modulate nerves, muscles or others tissues in the body.
• Electrical stimulation has long been advocated as a way of inducing
hypertrophy in paralysed muscles, improving blood flow & increasing
stimulated strength.
Muscle Plasticity in Response to Electrical
Stimulation
• Application of Electrical stimulation to the muscles, activates the motor
neurons that innervate the muscle fibre.
• This leads to muscle contractions, similar to those generated during
voluntary muscle activation.
• These contractions can produce a range of physiological and biochemical
responses within the muscle tissue, resulting in various adaptations over
time.
Muscle Plasticity in Response to Electrical
Stimulation
1. Muscle Hypertrophy
2. Muscle Hyperplasia
3. Muscle Fiber Type Transformation
4. Strength & Power Enhancement
5. Angiogenesis
6. Muscle Rehabilitation
7. Neural Adaptations
 Factors Affecting Muscle Plasticity
1. Growth Factors (IGF-I)
2. Hormones (Growth Hormone, Thyroid Hormones, Testosterone,
Glucocorticoids)
3. Satellite Cell Proliferation & Differentiation (Critical role in muscle regeneration
post injury)
4. External Loading (Exercise, Sedentary Lifestyle, Disuse Atrophy)
5. Neural Activity
6. Metabolic Stress
7. Diabetes (Known to cause skeletal muscle atrophy)
8. Obesity (Often leads to a decrease in force produced per muscle cross-sectional
area, and power produced per muscle mass)
 Exercise Response to Muscle Plasticity
• Skeletal muscle consists of two type of contractile protein- Actin and Myosin.
• Two types of Myosin-Myosin Light Chain (MLC) and Myosin Heavy Chain
(MHC). In humans, there are three types of MHC:
1. MHC-1-Type 1 Slow oxidative – 10-180 muscle fibers recruited from 1 motor
unit.
2. MHC-2A Type 2A Fast twitch oxidative 300-800 muscle fibers recruited
from 1 motor unit.
3. MHC-2X Type 2X Fast twitch glycolytic
• The Motor unit recruitment pattern follows Type 1 to Type 2A to Type 2X
 Muscle Plasticity in Reduced Activity
• When a muscle is not loaded optimally, there are changes in the
properties in Type 1 and 2 fibers.
• Fitts et al. (2000) proved that the Type 1 and 2A muscle fibers are
atrophied in individuals on a space flight due to decreased weight-
bearing.
• When muscle becomes inactive, the rate of protein synthesis
decreases, which decreases the contractile protein.
• This reduces the number of cross bridges and also the electrochemical
efficiency.
 Muscle Plasticity in Response to Exercise
Training
• Studies in muscle plasticity in response to exercise training are based on:
• Resistance training (High resistance and low repetition)
• Endurance training (Low resistance and high repetition)
• Four principles of training:
1. Overload
2. Specificity
3. Reversibility
4. Individuality
Muscle Fibre Changes in Strength Training
• Strength is defined as the ability of muscle to produce tension in single maximal
effort.
• Neural Adaptations due to strength training:
1. Increased coordination
2. Increased activation of prime movers
3. Increased inhibition of antagonists
• Morphological adaptations due to strength training:
1. Increased expression of MHC- 2A and decreased 2X
2. Increase in the cross-sectional area of type 2 fast twitch muscle fibres
3. Changes in the metabolic capacity of the muscle.
Muscle Fibre Changes in Strength Training
• Hypertrophy of the muscle: Days after the onset of training
• Can occur due to:
1. Thyroid hormone regulates MHC gene expression
2. Mechanical factors like tension plays role in hypertrophy.
• Training breaks down the muscle fibres which gets rebuilt subsequently
due to overshooting of protein synthesis.
• Hyperplasia of the muscle also takes place which helps in hypertrophy.
 Muscle Fibre Changes in Endurance Training
• The ability to perform low resistance activity for high repetitions is termed as
endurance.
• The changes in muscle fibres due to endurance training includes:
1. Increase number of type 1 slow oxidative muscle fibers due to increased
stimulation of Myosin Heavy chain type 1 fibers.
2. Increased cross-sectional area of type 1 fibers
3. Increased capillary surrounding each muscle fibre
4. Increased myoglobin content and increase mitochondria and oxidative enzymes
5. Glycogen and fat storage along with the enzymes for beta-oxidation of fat also
increases due to endurance training.
Faradic Currents & its Response to Muscle
Plasticity
• The most commonly used ES for motor stimulation in clinical
rehabilitation is the faradic current (FC) which is a short duration
interrupted DC with pulsed duration of 0.1-1 ms and frequency
between 50 and 100hz .
• The frequency range in this currents leads to tetanic muscle
contraction, and the tension developed during one twitch has no time
to relax before the occurrence of the next twitch, so that the successive
twitches get cumulated resulting in increase in muscle strength.
• FC has been shown to be effective in normal muscles and diseased
state
Russian Currents & its Response to Muscle
Plasticity
• Russian currents are alternating currents with a frequency of 2.5khz
that are burst modulated at a frequency of 50hz with a 50% duty cycle.
• The theoretical basis for its use that the skin provides less resistance
for high carrier frequency of 2500hz and the RC stimulates nearly all
the motor units of muscle to contract synchronously leading to greater
muscle hypertrophy.
• This allows less electrical energy to dissipate peripherally and more
electrical energy to penetrate to the muscle and evoke greater fibre
recruitment
 Chronic Low Frequency Stimulation and
its Response to Muscle Plasticity
• The metabolic transformation of fast twitch muscle fibres exposed to low
frequency stimulation was characterised by increase in enzyme activity involved
in aerobic-oxidative metabolism and simultaneous decrease in glycogenolytic
and glycolytic metabolic capacities
• Contractile protein- after CLFS there was a change in the contractile
machinery of the muscle. Stimulated muscles displayed a greater proportion of
type 1 fibres
• Ca regulatory proteins- fast to slow transformation included also exchanges of
fast with slow isoforms of the regulatory proteins at the level of the thin
filament.
• Effects of electrical stimulation such as increases of capillary density
and blood flow, may allow better access of any substance to target
muscles. An additional change contributing to an altered responsiveness
of the muscle, might relate to the increase in satellite cell activation
under influence of low-frequency stimulation.54
• These few suggestions point out the possibilities of using stimulation
induced changes either on their own or in combination with other
therapeutic interventions for treatment of neuromuscular disorders.