Biology Reference
In-Depth Information
for many decades, only recently was it shown that physical exercise and
activity-dependent interventions have real impact on neurobiological
mechanisms of peripheral nerve regeneration. Here, we will review research
conducted over the past years to investigate the role of walking or running
exercise on nerve regeneration and reinnervation following peripheral nerve
injury, mainly conducted in rodents. The role of the walking/running exer-
cise will be analyzed within the context of the cellular and molecular events
taking place during nerve healing. We will also address other kinds of move-
ment stimulation, in particular, the role of manual mobilization of the
denervated limbs and how this may affect nerve regeneration. We will
end this review by providing a brief synthesis of the main conclusions gath-
ered from clinical research that assessed the efficacy of physical training and
other forms of activity-related treatment in treating and rehabilitating people
with peripheral neuropathy.
2. THE EFFECT OF EXERCISE TRAINING ON NERVE
REGENERATION
2.1. Early studies
Initial studies addressing the effect of physical exercise on nerve regeneration
and functional recovery following PNS injury found conflicting results
(reviewed in van Meeteren, Brakkee, Hamers, Helders, & Gispen, 1997 ).
These studies were conducted in the rat and in the mouse, and occasionally
in other animal models, and employed endurance exercise ( Gutmann &
Jakoubek, 1963; Herbison, Jaweed, & Ditunno, 1974; van Meeteren,
Brakkee, Helders, & Gispen, 1998 ) or muscle overloading by ablation of
synergistic muscles ( Herbison, Jaweed, &Ditunno, 1973 ), to stimulate nerve
regeneration and end-organ reinnervation, usually after sciatic nerve crush
injury. The exercise protocols consisted on either spontaneous exercise, typ-
ically voluntary wheel running ( Irintchev, Draguhn, & Wernig, 1990 ), or
forced exercise, especially swimming ( Gutmann & Jakoubek, 1963;
Herbison et al., 1974; van Meeteren et al., 1998 ) and treadmill running
( Herbison, Jaweed, & Ditunno, 1980 ).
Treadmill running or swimming failed to improve muscle reinnervation
and function in several occasions ( Herbison et al., 1974, 1980; Irintchev
et al., 1990; van Meeteren et al., 1998 ), probably due to excessive physical
exertion. Accordingly, increasing muscular activity by tenotomy of syner-
gists or by swimming exercise was reported to cause considerable muscle
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