Targeted rehabilitation after extracellular matrix scaffold transplantation for the treatment of volumetric muscle loss

Am J Phys Med Rehabil. 2014 Nov;93(11 Suppl 3):S79-87. doi: 10.1097/PHM.0000000000000145.


Rehabilitation therapy is an important aspect of recovery after volumetric muscle loss. However, the traditional rehabilitation approach involves a period of rest and passive loading followed by gradual active loading. Extracellular matrix is a naturally occurring material consisting of structural proteins that provide mechanical strength, structural support, and functional molecules with diverse bioactive properties. There is evidence to suggest that the addition of aggressive regenerative rehabilitation protocols immediately after surgical implantation of an extracellular matrix scaffold to an area of volumetric muscle loss has significant benefits for extracellular matrix remodeling. Rehabilitation exercises likely provide the needed mechanical signals to encourage cell migration and site-specific differentiation in the temporal framework required for constructive remodeling. Herein, the authors review the literature and present an example of an aggressive rehabilitation program implemented immediately after extracellular matrix transplantation into a severely injured quadriceps muscle.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Adult
  • Afghan Campaign 2001-
  • Exercise Therapy / methods*
  • Explosive Agents / adverse effects
  • Extracellular Matrix / transplantation*
  • Follow-Up Studies
  • Humans
  • Injury Severity Score
  • Leg Injuries / complications
  • Leg Injuries / diagnosis
  • Leg Injuries / surgery*
  • Male
  • Military Personnel
  • Muscle Weakness / prevention & control
  • Muscular Atrophy / etiology
  • Muscular Atrophy / rehabilitation*
  • Muscular Atrophy / surgery
  • Postoperative Care / methods
  • Preoperative Care / methods
  • Quadriceps Muscle / injuries
  • Quadriceps Muscle / surgery*
  • Reconstructive Surgical Procedures / methods*
  • Reconstructive Surgical Procedures / rehabilitation
  • Regenerative Medicine / methods
  • Risk Assessment
  • Tensile Strength
  • Tissue Scaffolds
  • Treatment Outcome


  • Explosive Agents