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The cellular response of skeletal muscle in the first week after a change in activity : clues to signalling pathways whose responses may inform stimulation regimes and improve functional outcomes

The outcome of all FES is determined to some extent by the properties of the skeletal muscles that are the effectors. Muscle cells change their properties in response to changes in activity: both the stimulation used to prepare the muscle for FES and the subsequent functional use of the muscle affect the protein expression within the stimulated muscle cells. Transcriptional analysis of muscle samples taken at various times after the initiation of stimulation and with various pattern of stimulation can reveal the signalling pathways that are invoked by changes in activity, and the progressive change in protein expression that underlie the desired increases in strength and endurance. Understanding the cellular response of the muscle may allow us to create models of the response space and potentially to optimise the pattern of delivery of stimulation to maximise benefit and minimise inconvenience.