Role of passive and active myostimulation for the changing levels of some cytokines

Injury to the anterior cruciate ligament (ACL) of the knee joint is complicated by development of arthrogenic muscle inhibition due to disregulating afferent influences on the excitability of the spinal and supraspinal tracts. The aim of our work was to study electromyography parameters, and myokine levels in the course of myostimulation in traumatic ACL injury.

28 male athletes with traumatic ACL injuries participated in the study. On admission to the clinic, all patients underwent electromyographic examination of the injured limb by the means of Viking Quest EMG/ EP apparatus (Nicolet, USA). Some patients, 10 days before starting the surgical treatment, underwent passive electrical myostimulation (EMS) of the quadriceps femoris muscle using the INTELECT^® Advanced device (Chattanooga (DJO), USA). Further on, all patients underwent arthroplasty using a Karl Storz arthroscope (Germany). In the postoperative period, during immobilization for 2-weeks, the patients received EMS. After removing the orthosis, the patients switched to active training. The cytokine levels were studied using ELISA reagent kits from Vector-Best, Novosibirsk (IL-6), or from Cloud-Clone Corp. (China) for TGF–β1 assays. Statistical processing of the material was carried out using the Statistica package. vers.10.0 (StatSoft Inc., USA).

The highest average amplitude (μV) was recorded by electromyography in healthy individuals. In patients of the main group, significantly lower values of the average amplitude were recorded. After a 10-day EMS, a significant increase to the reference values of healthy individuals was noted. In the postsurgical dynamics, EMG indicators without EMS treatment remained at the same low levels. Meanwhile, the values following EMS treatment were comparable with those in healthy individuals, thus reflecting a faster and better muscle recovery after injury. The levels of IL-6 and TGF-β1 cytokines (myokines) significantly exceeded the initial levels in the course of EMS. The biological significance of increased IL-6 levels during the muscle exercise may consist the activation of AMP kinase and/or phosphatidylinositol-3-kinase at the level of skeletal muscles thus providing more efficient supply of energy substrate to the muscles. TGF-β1 promotes fibroblast proliferation, thus increasing collagen content.

Passive and active EMS leads to an improvement in electromyography parameters, along with increased concentration of myokines (IL-6 and TGF-β1) in peripheral blood, thus promoting improvement of energy balance, increasing the anti-inflammatory and repair potential of the damaged tissues.