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ABSTRACT BACKGROUND AND OBJECTIVES: Sensory function may be altered in chronic low back pain (CLBP), which may alter the perception of therapeutic currents. The aim of this study was to verify whether the risk of poor prognosis for CLBP pain influences the amplitude elicited at the sensory threshold (ST) in different modalities of neuromuscular electrical stimulation (NMES). METHODS: This is a quasi-experimental counterbalanced study with 40 subjects divided into four groups (n=10 each), according to the risk of poor prognosis for pain: no risk (control group - CG), low (LrG), medium (MrG), and high (HrG) risks. Four modalities of NMES were tested: two medium frequency currents (Aussie current [AC] and Russian current [RC]) and two low frequency currents (commonly known as functional electrical stimulation [FES]), with two phase durations of200 μs (FES_200) and 500 μs (FES_500), in the region of the lumbar multifidus muscles. All subjects were exposed to all current modalities with interval periods, and when the ST was reached, the amplitude of the current measured in mA was recorded. RESULTS: The currents that elicited the highest and lowest amplitude in the ST were FES_200 and AC, respectively. As for the risk of poor prognosis, the highest amplitudes were for the HrG and the lowest for the LrG. CONCLUSION: The amplitude of the current elicited in the ST tended to be higher among those with a higher risk of poor prognosis for pain and, among the currents, those of medium frequency elicited lower amplitudes.
RESUMO JUSTIFICATIVA E OBJETIVOS: A função sensorial é potencialmente alterada na presença de dor lombar crônica (DLC), o que pode alterar a percepção de passagem de correntes terapêuticas. O objetivo deste estudo foi verificar se o risco de mau prognóstico para DLC influencia a amplitude elicitada no limiar sensorial (LS) em diferentes modalidades de estimulação elétrica neuromuscular (EENM). MÉTODOS: Trata-se de um estudo quase-experimental contrabalanceado composto por 40 voluntários alocados em quatro grupos (n=10 cada), de acordo com o risco de mau prognóstico para dor: sem risco (grupo controle - GC), baixo risco (GBR), médio risco (GMR) e alto risco (GAR). Foram testadas quatro modalidades de EENM: duas correntes de média frequência (corrente Aussie [CA] e corrente Russa [CR]) e duas correntes de baixa frequência (comumente denominada estimulação elétrica funcional [FES]), com duas durações de fases 200 μs (FES_200) e 500 μs (FES_500) na região dos músculos multífidos lombares. Todos os voluntários foram submetidos a todas as modalidades de corrente, com períodos de intervalos, e ao ser atingido o LS, foi realizado o registro da amplitude da corrente medida em mA. RESULTADOS: As correntes que elicitaram a maior e a menor amplitude no LS foram, respectivamente, FES_200 e CA. Quanto ao risco de mau prognóstico, as maiores amplitudes foram do GAR e as menores do GBR. CONCLUSÃO: A amplitude da corrente elicitada no LS tendeu a ser mais alta entre aqueles com maior risco de mau prognóstico para dor e, dentre as correntes, aquelas de média frequência elicitaram amplitudes mais baixas.A amplitude da corrente elicitada no LS tendeu a ser mais alta entre aqueles com maior risco de mau prognóstico para dor e, dentre as correntes, aquelas de média frequência elicitaram amplitudes mais baixas.
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Objective:To analyze the factors influencing the poor effect of short-term electrical spinal cord stimulation in the treatment of postherpetic neuralgia (PHN).Methods:The medical records of PHN patients of either sex, aged 40-85 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, who received short-term electrical spinal cord stimulation from July 2017 to July 2022, were retrospectively collected. The therapeutic effect was evaluated using the modified MacNab criteria at 3 months after operation, and the patients were divided into good efficacy group (excellent and good efficacy) and poor efficacy group (fair and poor efficacy). General information, disease course, lesion site, complicated diseases, ossification of the yellow ligament in the diseased spinal segment, severity of pain in the herpetic stage, standard antiviral therapy in the herpetic stage (for more than 7 days) and use of neurotrophic drugs in the herpetic stage (for more than 7 days) were collected. Multivariate logistic regression analysis was used to screen the influencing factors for the poor effect of electrical spinal cord stimulation in the treatment of PHN.Results:A total of 168 patients were eventually enrolled, among which 69 had poor curative effect, and the rate of poor curative effect was 41.1%. The results of multivariate logistic regression analysis showed that the patient′s age ( OR=2.230, P=0.015), course of disease ( OR=2.191, P=0.027), complication with diabetes mellitus( OR=8.859, P=0.010), ossification of ligamentum flavum at the same segment ( OR=6.602, P=0.019), severity of pain in the herpetic stage ( OR=5.788, P=0.038) and non-standard antiviral therapy in the herpetic stage ( OR=6.765, P=0.021) were the influencing factors for the poor effect of electrical spinal cord stimulation in the treatment of PHN. Conclusions:Age, course of disease, complication with diabetes mellitus, ossification of ligamentum flandum at the same segment, severity of pain in the herpetic stage and non-standard antiviral therapy in the herpetic stage are the factors influencing the poor effect of short-term electrical spinal cord stimulation in the treatment of PHN.
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ABSTRACT Objective The extrinsic muscles, such as the posterior tibialis and long flexor of the hallux and the intrinsic of the foot, are part of the active subsystem of the central system of the foot and play an essential role in the control of the medial longitudinal arch resulting from difficulty in contracting the muscle, neuromuscular electrostimulation (NMES) becomes a resource combined with strengthening and recommended for rehabilitation. T this work aims to evaluate the effectiveness of NMES associated with exercise in deforming the medial longitudinal arch. Methods This is a randomized blind clinical trial. 60 asymptomatic participants were divided into three groups: NMES, exercise and control. The NMES and exercise group performed seven exercises for the intrinsic and extrinsic muscles twice a week for 6 weeks, and the NMES group used an NMES associated with five exercises. Navicular height and medial longitudinal arch angle were taken before and after the intervention period. Results No statistically significant differences existed between groups for navicular height and medial longitudinal arch angle. Conclusion NMES associated with exercise does not change the characteristics of the medial longitudinal arch in association with asymptomatic. Level of Evidence I; Randomized clinical trial.
RESUMO Objetivo Os músculos extrínsecos, como o tibial posterior e flexor longo do hálux e os intrínsecos do pé fazem parte do subsistema ativo do foot core system e exercem papel essencial no controle do arco longitudinal medial. Devido à dificuldade na contração desses músculos, a eletroestimulação neuromuscular (EENM) torna-se um recurso aliado ao fortalecimento e é recomendada para reabilitação. O objetivo desse trabalho é avaliar a eficácia da EENM associada ao exercício na deformação do arco longitudinal medial. Métodos Este é um ensaio clínico randomizado cego. 60 participantes assintomáticos foram divididos em três grupos: EENM, exercício e controle. O grupo EENM e exercício realizaram sete exercícios para os músculos intrínsecos e extrínsecos duas vezes por semana por seis semanas, sendo o grupo EENM utilizou a EENM associada a cinco exercícios. A altura do navicular e o ângulo do arco longitudinal medial foram medidos antes e após o período de intervenção. Resultados Não houve diferenças estatisticamente significativas entre os grupos para a altura do navicular e ângulo do arco longitudinal medial. Conclusão A EENM associada ao exercício não altera as características do arco longitudinal medial em indivíduos assintomáticos. Nível de Evidência I; Estudo Clínico Randomizado.
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Abstract Patients with implantable electric stimulation devices are challenging to the anesthesiologist since these cases demand a comprehensive knowledge about how the device operates, the indications for the implant and the implications that must be addressed during the perioperative period. This article is intended to provide the reader with clear and structured information so that the anesthesiologist will be able to safely deal with the situation of a patient with an implantable cardiac stimulation device, who has been programmed for emergent surgery. A search for the scientific evidence available was conducted in Pubmed / Medline, ScienceDirect, OVID, SciELO), for a non-systematic review. The incidence of the use of cardiac electric stimulation devices has been growing. Their operation is increasingly complex, and demands being constantly updated on the knowledge in the area.
Resumen El paciente portador de un dispositivo de estimulación eléctrica cardiaca implantable se convierte en un reto para el anestesiólogo debido a que implica un conocimiento integral que abarca su funcionamiento, las indicaciones que llevaron a su implante y las implicaciones que se deben abordar en el perioperatorio. Este artículo busca proporcionar al lector información clara y estructurada que le permita al anestesiólogo enfrentarse de forma segura al escenario de un paciente con un dispositivo de estimulación eléctrica cardiaca implantable programado para cirugía emergente. Se realizó una búsqueda de la evidencia científica disponible en bases de datos (Pubmed / Medline, ScienceDirect, OVID, SciELO), para una revisión no sistemática. La incidencia en el uso de dispositivos de estimulación eléctrica cardiaca viene en aumento. Su funcionamiento es cada vez más complejo lo cual implica una actualización permanente del conocimiento en esta área.
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Humans , Cardiac Pacing, Artificial , Perioperative Period , Cardiac Resynchronization Therapy Devices , Radiography , Defibrillators, Implantable , Electric Stimulation/methods , AnesthesiologistsABSTRACT
BACKGROUND: Diabetic wound healing disorder is one of the common complications of diabetes, but its pathogenesis has not yet been elucidated. Electrical stimulation therapy is one of the commonly used methods in the clinical treatment of wound injury, which can effectively promote the healing of injured skin. OBJECTIVE: To investigate the effects of electrical stimulation therapy on wound healing and angiogenesis in diabetic rats and its potential mechanism. METHODS: Forty-two SPF male Sprague-Dawley rats were enrolled in this study. A rat model of diabetic refractory wounds was established in 24 rats by tail vein injection of streptozotocin (50 mg/kg) combined with back skin wounds, and model rats were randomly divided into model group and electrical stimulation group. Meanwhile, normal rats were taken to cause back wounds as a blank control group. The electrical stimulation group was treated with electrical stimulation for 21 days. The blank control group and the model group were fed normally. The wound healing was evaluated on the 3rd, 7th, 14th and 21st days after treatment. After treatment, the rat serum and wound tissue were taken for index detection. The pathological morphology of rat wounds was observed by hematoxylin-eosin staining. The serum endothelial nitric oxide synthase, angiopoietin 1 and vascular endothelial growth factor levels were detected by enzyme-linked immunosorbent assay. The expression levels of angiopoietin receptor 2 and vascular endothelial growth factor receptor 2 proteins were detected by immunohistochemistry and western blot. An ethical approval was obtained from the Animal Experimental Ethics Committee of the Affiliated Hospital of Southwest Medical University. RESULTS AND CONCLUSION: The wound healing rate of diabetic rats was close to 90% on the 14th day after electrical stimulation, while the healing rate in the model group was less than 60% (P < 0.01). The serum endothelial nitric oxide synthase, angiopoietin 1 and vascular endothelial growth factor levels were significantly higher in the electrical stimulation group than the model group (P < 0.05 or P < 0.01). Meanwhile, compared with the model group, the electrical stimulation group had more neovascularization, larger vascular lumen, higher expression of angiopoietin receptor 2 and vascular endothelial growth factor receptor 2 around the blood vessels (P < 0.05 or P < 0.01). These findings indicate that electrical stimulation therapy can significantly promote wound healing and neovascularization in diabetic rats, and its mechanism is related to the increase of endothelial nitric oxide synthase, angiopoietin 1 and vascular endothelial growth factor levels and up-regulation of angiopoietin receptor 2 and vascular endothelial growth factor receptor 2 levels.
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Objective To assess the clinical effects of percutaneous electrical stimulation on refractory lower urinary tract symptoms in elderly female patients.Methods Elderly female patients with refractory lower urinary tract symptoms from July 2016 to December 2017 were recruited.According to cystoscopy results,patients were divided into an interstitial cystitis group,a suspected interstitial cystitis group and an overactive bladder group.All patients received 3 courses of transcutaneous low-frequency electrical stimulation treatment in the suprapubic bladder area,with 40 min per time,4 times per day,7 days per course.Bladder diaries,pain scores and overactive bladder symptom scores were recorded before and after treatment.Results A total of 27 patients with a mean age of 74.3 years were enrolled.Under the cystoscope with water dilatation,9 cases were found to have mucosal bleeding,with mast cells detected in mucosal specimens examined via electron microscopy(in the interstitial cystitis group),5 cases had superficial mucosal congestion (in the suspected interstitial cystitis group)and 13 cases showed normal imaging(in the overactive bladder group).In the interstitial cystitis group,the 24-h urinary frequency improved from 15.4 ± 2.5 times before treatment to 11.9 ± 2.0 times after treatment (P ＜0.05),but pain scores had no significant difference before and after treatment[(8.3±2.0) and (8.2±1.6),P＞0.05].In the suspected interstitial cystitis group,the 24-h urinary frequency improved from (11.8 ± 1.5) times before treatment to (8.4±1.1) times after treatment,and pain scores decreased from (6.4±1.1) to (4.2±1.1) (P＜0.05).In the overactive bladder group,the 24-h urinary frequency improved from (19.2±2.0) times before treatment to (15.9 ± 1.3) times after treatment(P ＜0.05),and the overactive bladder symptom score(OABSS)decreased from (8.9±1.6) to (5.9±1.6)(P＜0.05).Conclusions Percutaneous electrical stimulation is an easy,safe and effective treatment in elderly females with refractory lower urinary tract symptoms,and should be encouraged in clinical practice.
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Spinal cord injury can lead to varied degrees of sensory and motor dysfunction, with high incidence, high disability rate and high cost, causing a huge burden on the patient's family and society. The researches on spinal cord injury have received much attention from all sectors of society. At present, drug therapy is the main treatment for spinal cord injury, and the clinical application of non-pharmacological treatments is still controversial. In recent years, with the deepening of the research on spinal cord injury, the application of electrical stimulation in the treatment of spinal cord injury has made some progress. The author reviews the electrical stimulation, brain stimulation, magnetic stimulation of spinal cord injury, so as to provide reference for the clinical treatment of spinal cord injury.
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Objective@#To assess the clinical effects of percutaneous electrical stimulation on refractory lower urinary tract symptoms in elderly female patients.@*Methods@#Elderly female patients with refractory lower urinary tract symptoms from July 2016 to December 2017 were recruited.According to cystoscopy results, patients were divided into an interstitial cystitis group, a suspected interstitial cystitis group and an overactive bladder group.All patients received 3 courses of transcutaneous low-frequency electrical stimulation treatment in the suprapubic bladder area, with 40 min per time, 4 times per day, 7 days per course.Bladder diaries, pain scores and overactive bladder symptom scores were recorded before and after treatment.@*Results@#A total of 27 patients with a mean age of 74.3 years were enrolled.Under the cystoscope with water dilatation, 9 cases were found to have mucosal bleeding, with mast cells detected in mucosal specimens examined via electron microscopy(in the interstitial cystitis group), 5 cases had superficial mucosal congestion(in the suspected interstitial cystitis group)and 13 cases showed normal imaging(in the overactive bladder group). In the interstitial cystitis group, the 24-h urinary frequency improved from 15.4±2.5 times before treatment to 11.9±2.0 times after treatment(P<0.05), but pain scores had no significant difference before and after treatment[(8.3±2.0) and (8.2±1.6), P>0.05]. In the suspected interstitial cystitis group, the 24-h urinary frequency improved from (11.8±1.5) times before treatment to (8.4±1.1) times after treatment, and pain scores decreased from (6.4±1.1) to (4.2±1.1)(P<0.05). In the overactive bladder group, the 24-h urinary frequency improved from (19.2±2.0) times before treatment to (15.9±1.3) times after treatment(P<0.05), and the overactive bladder symptom score(OABSS)decreased from (8.9±1.6) to (5.9±1.6)(P<0.05).@*Conclusions@#Percutaneous electrical stimulation is an easy, safe and effective treatment in elderly females with refractory lower urinary tract symptoms, and should be encouraged in clinical practice.
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Spinal cord injury can lead to varied degrees of sensory and motor dysfunction,with high incidence,high disability rate and high cost,causing a huge burden on the patient's family and society.The researches on spinal cord injury have received much attention from all sectors of society.At present,drug therapy is the main treatment for spinal cord injury,and the clinical application of nonpharmacological treatments is still controversial.In recent years,with the deepening of the research on spinal cord injury,the application of electrical stimulation in the treatment of spinal cord injury has made some progress.The author reviews the electrical stimulation,brain stimulation,magnetic stimulation of spinal cord injury,so as to provide reference for the clinical treatment of spinal cord injury.
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Objective To observe the effect of spinal cord stimulation on expression of spinal GLT-1 and GLAST in rats with diabetic neuropatbic pain.Methods Forty-eight healthy male SD rats,only 2 months old,weighting 250-300 g,using the random number table method,were divided into four groups (n=12):the control group (group C),diabetes neuralgia group (group D),false stimulation group (group N)and spinal cord stimulation group (group S).The model of diabetes was induced by the pedtoneal injec-tion of streptozocin (STZ),electrodes were placed into the epidural space 1 9 days after injection of STZ in groups N and S,in addition,group S was performed 26-28 days after injection of STZ.Mechanical contrac-tion leg threshold (MWT)were determined one day before STZ injection,2 d,7 d,14 d and 28 d after STZ injection.The rats were sacrificed,the lumbar spinal cord tissue were obtained for determination of GLT-1 and GLAST expression in spinal cord tissues on 28 d after measurement of MWT.Results Compared with group C,MWT was decreased 14 d and 28 d after STZ injection,and expression levels of GLT-1 and GLAST mRNA were increased on 14 d and 28 d (P<0.05);Compared with before STZ injection,MWT of group D,group N and group S was decreased on 14 d and 28 d (P<0.05);Compared with group D, MWT was increased,and expression levels of GLT-1 and GLAST mRNA were increased in group S on 28 d after STZ injection (P<0.05 ).Conclusion The mechanism of spinal cord stimulation reducing rats diabetes neuralgia may be related to elevating the expression of GLT-1 and GLAST.
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RESUMO Objetivo Verificar o efeito agudo da eletroestimulação sobre o fluxo salivar de pacientes com hipossalivação. Método Ensaio clínico não controlado que avaliou o efeito de uma única aplicação da Transcutaneous Electric Nerve Stimulation (TENS) sobre o fluxo salivar de 15 pacientes com hipossalivação induzida por radioterapia (RT), utilizada no tratamento de câncer de cabeça e pescoço. A média de idade dos pacientes foi de 56,8 ± 6,46 anos e o gênero masculino foi predominante (73%). A TENS foi programada com 50Hz de frequência, 250μs de largura de pulso e a intensidade foi ajustada ao longo dos 20 minutos conforme máxima tolerância. Os eletrodos foram fixados bilateralmente sobre a região das glândulas salivares. A avaliação do fluxo salivar foi realizada por meio de sialometria estimulada, antes e imediatamente após a aplicação da TENS. Resultados Em 80% dos casos, o tratamento oncológico incluiu quimioterapia. A RT foi aplicada em 80% dos casos na região e orofaringe, com intensidade média de 64,6 ± 7,27 Gy. Após a TENS, o fluxo salivar aumentou significativamente (p = 0,0051), passando de 0,05 (0,00; 0,40) mL/min para 0,10 (0,07;0,40) mL/min. A resposta à TENS foi diretamente correlacionada à intensidade da corrente elétrica tolerada (r = 0,553; p = 0,032) e à dose utilizada na RT (r = -0,514; p = 0,050). Conclusão A TENS aumentou significativamente o fluxo salivar de pacientes com hipossalivação induzida pela RT.
ABSTRACT Purpose To verify the acute effect of electrostimulation on the salivary flow of patients with hyposalivation. Methods Uncontrolled clinical trial evaluating 15 patients with hyposalivation induced by radiotherapy (RT) used for head and neck cancer treatment. Mean age of the patients was 56.8 ± 6.46 years. Males outnumbered females (73%). Transcutaneous Electrical Nerve Stimulation (TENS) was adjusted with 50Hz of frequency and 250μs of pulse width. Intensity was adjusted over a 20-minute period according to maximum tolerance. The electrodes were attached bilaterally on the region of the salivary glands. Evaluation of the salivary flow was performed through sialometry before and immediately after application of TENS. Results The most prevalent region for RT was the oropharynx (80.0% of cases). The mean dose used in RT was 64.6 ± 7.27 Gy. After TENS, salivary flow increased significantly (p = 0.0051) from 0.05 (0.00; 0.40) mL/min to 0.10 (0.07: 0.40) mL/min. The response to TENS was directly correlated with the intensity of the tolerated electric current (r = 0.553; p = 0.032) and the dose used in RT (r = -0.514; p = 0.050). Conclusion TENS was able to increase the salivary flow rate of patients with RT-induced hyposalivation.
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Humans , Male , Female , Salivary Glands/radiation effects , Xerostomia/therapy , Transcutaneous Electric Nerve Stimulation , Head and Neck Neoplasms/radiotherapy , Radiation Dosage , Radiotherapy/adverse effects , Saliva/metabolism , Salivation/radiation effects , Xerostomia/etiology , Radiotherapy, Intensity-Modulated , Middle AgedABSTRACT
AIMS: To assess accommodation phenomena characteristics (threshold, time and amplitude/intensity) during stimulation with interferential current, comparing male and female healthy adults. METHODS: A non randomized clinical trial with intentional sampling by gender included 30 healthy adult volunteers aged between 18 and 25 years, who were divided in two groups (15 in the Female Group and 15 in the Male Group) and received a tetrapolar interferential current for 20 minutes, close to L1 and L5 vertebrae. The subjects were instructed to refer an intense but comfortable paresthesia sensation and to report the moment it diminished (accommodation), requiring increasing of the current intensity. The first three events of accommodation (AV1, AV2 and AV3), including time and amplitude threshold, were analyzed. The differences from AV1 to AV2 (D1) and AV2 to AV3 (D2) were also considered. The number of accommodations for each subject during the 20 minutes experiment was identified. ANOVA and Student's t-test were used for analysis and the significance level was set at 5%. RESULTS: In the Male Group the mean time for accommodation was higher in AV3 compared to AV1 and AV2. In the Female Group the accommodation mean time was higher in AV3 in relation to AV2, and in AV2 in relation to AV1. No differences were found in the Male Group for D1 and D2, but in the Female Group, D2 was superior to D1. Women were accommodated more quickly than men in all three assessments, but the differences between one evaluation and another were constant considering both groups. Both groups showed similar current intensity behavior comparing the three evaluations within the same group. In the comparison between groups, women had lower mean values of intensity in the three evaluations. The Female Group had 7.5±1.5 accommodations, and the Male Group had 5.9±2.0 accommodations (p=0.0367) during the 20 minutes of the experiment. CONCLUSIONS: In this sample of healthy young adults, men required higher interferential current amplitude to obtain a comfortable paresthesia and took more time to have accommodations, while women had more accommodation episodes.
OBJETIVOS: Avaliar características dos fenômenos de acomodação (limiar, tempo e amplitude/intensidade) durante estimulação com corrente interferencial, comparando adultos saudáveis do gênero masculino e feminino. MÉTODOS: Um ensaio clínico não randomizado com amostragem intencional por gênero incluiu 30 voluntários adultos saudáveis com idade entre 18 e 25 anos, que foram divididos em dois grupos (15 no Grupo Feminino e 15 no Grupo Masculino) e receberam uma corrente interferencial tetrapolar por 20 minutos, na altura das vértebras L1 e L5. Os sujeitos foram instruídos a referir uma sensação de parestesia intensa mas confortável e relatar o momento em que ela diminuiu (acomodação), requerendo aumento da intensidade da corrente. Foram analisados os três primeiros fenômenos de acomodação (AV1, AV2 e AV3), incluindo tempo e limiar de amplitude. Foram consideradas também as diferenças entre AV1 e AV2 (D1) e entre AV2 e AV3 (D2). Foi identificado o número total de acomodações para cada sujeito nos 20 minutos do experimento. Para a análise foram usados ANOVA e teste t de Student e o nível de significância foi definido em 5%. RESULTADOS: No Grupo Masculino, o tempo médio para acomodação foi maior em AV3 comparado com AV1 e AV2. No Grupo Feminino, o tempo médio foi maior em AV3 em relação a AV2 e em AV2 em relação a AV1. Não foram encontradas diferenças no Grupo Masculino entre D1 e D2, mas no Grupo Feminino, D2 foi superior a D1. As mulheres apresentaram acomodação mais rapidamente do que os homens em todas as três avaliações, mas as diferenças entre uma avaliação e outra foram constantes considerando os dois grupos. Ambos os grupos apresentaram comportamento semelhante na intensidade da corrente, comparando as três avaliações dentro do mesmo grupo. Na comparação entre os grupos, as mulheres apresentaram valores médios de intensidade mais baixos em todas as três avaliações. O Grupo Feminino apresentou 7,5±1,5 acomodações e o Grupo Masculino 5,9±2,0 acomodações (p=0,0367) durante os 20 min do experimento. CONCLUSÕES: Nesta amostra de jovens adultos saudáveis, os homens necessitaram de corrente interferencial com maior amplitude para obter uma parestesia confortável e demoraram mais tempo para apresentar acomodação, enquanto as mulheres tiveram mais episódios de acomodação.
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Male , Female , Electric Stimulation Therapy , Sex Characteristics , Physical Therapy ModalitiesABSTRACT
The recovery of quadriceps muscle strength and knee function after knee surgery is important. Recently, neuro-muscular electrical stimulation (NMES), which is a method in which an electrical current is applied to the surrounding targeted muscle, has been incorporated into muscle-strengthening programs. The objective of this review was to evaluate the safety and effectiveness of NMES in patients who have undergone knee surgery. A database search was performed in 8 Korean databases, Medline, Embase, and the Cochrane Library. Article selection and quality assessment were performed by 2 reviewers. Of the 580 articles selected, 14 papers (randomized controlled trials) were included in the final assessment. In the results of the meta-analysis, NMES combined with rehabilitation demonstrated a significant improvement in the enhancement of quadriceps muscle strength after anterior cruciate ligament reconstruction. On the basis of the currently available data, NMES with rehabilitation is associated with favorable outcomes, and should be considered a safe and effective procedure for enhancing quadriceps muscle strength.
Subject(s)
Humans , Anterior Cruciate Ligament Reconstruction , Electric Stimulation Therapy , Electric Stimulation , Knee , Methods , Quadriceps Muscle , RehabilitationABSTRACT
OBJECTIVE: To assess the effect of neuromuscular electrical stimulation (NMES) on the recovery of abdominal muscle strength in postnatal women with diastasis of recti abdominis muscles (DRAM). METHODS: Sixty women, 2 months postnatal, participated in this study. They were divided randomly into two equal groups. Group A received NMES in addition to abdominal exercises; group B received only abdominal exercises. The intervention in both groups was for three times per week for 8 weeks. The outcome measures were body mass index (BMI), waist/hip ratio, inter recti distance (IRD), and abdominal muscle strength in terms of peak torque, maximum repetition total work, and average power. RESULTS: Both groups showed highly significant (p<0.05) improvement in all outcomes. Further, intergroup comparisons showed significant improvement (p<0.05) in all parameters in favor of group A, except for the BMI. CONCLUSION: NMES helps reduce DRAM in postnatal women; if combined with abdominal exercises, it can augment the effects.
Subject(s)
Female , Humans , Abdominal Muscles , Body Mass Index , Electric Stimulation Therapy , Electric Stimulation , Exercise , Muscles , Outcome Assessment, Health Care , Postnatal Care , TorqueABSTRACT
Objective To explore the therapeutic effect of transcranial electrical stimulation (tDCS) on verbal dysfunction after stroke.Methods 86 patients with stroke aphasia were included in the study.They were divided into two groups according to the time of treatment and single and double numbers.43 patients in the control group received language rehabilitation training,43 cases in the observation group were given tDCS combined with language rehabilitation training.The clinical treatment effect was compared between the two groups.Results The effective rates of the observation group and the control group were 93.02％ and 62.79％ respectively,the difference between the two groups was statistically significant (χ2=7.667,P＜0.05).The language proficiency scores of the observation group and the control group were (176.60±13.23) and (144.62±10.29),respectively,which were significantly higher than pre-treatment (t=6.553,7.919,all P＜0.05),which of the observation group was superior to the control group,the difference between the two groups was statistically significant (t=6.830,P＜0.05).The CADL scores of the observation group and the control group were (85.86±6.87)points and (68.76±5.88)points,respectively,which were significantly higher than pre-treatment (t=6.879,8.472,all P＜0.05),which of the observation group was better than the control group,the difference was statistically significant (t=6.692,P＜0.05).ConclusiontDCS combined with language rehabilitation training can improve the verbal function of patients and improve their daily communication ability,which is beneficial to the rehabilitation of patients,and it is worth to learn.
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Objective To study and analyze the functional electrical stimulation therapy compliance of patients with paralysis of limb movement disorder and its influence factors. Methods A total of 168 patients with paralysis of limb movement disorder from December 2014 to August 2016 were selected as the research object, and the treatment compliance of all the patients were evaluated, then the treatment compliance of patients with different gender, ages, education degree, social support degree, disease course, treatment cognition, psychology state, pecuniary condition, living conditions and medical insurance situation were compared too, then the relationship between those study factors and treatment compliance of these patients were analyzed by the Logistic regression analysis. Results One hundred and four cases of 168 patients with paralysis of limb movement disorder with higher treatment compliance of functional electrical stimulation therapy, the rate was 61.90%,the treatment compliance of patients with different gender, ages, education degree, social support degree, disease course, treatment cognition, psychology state, pecuniary condition, living conditions and medical insurance situation all had obvious differences, and those study factors all had close relationship to the treatment compliance of these patients by the Logistic regression analysis, all P<0.05. Conclusions The functional electrical stimulation therapy compliance of patients with paralysis of limb movement disorder still need to be improved, and its influence factors are more, so they should be paid to targeted intervention according to these influence factors.
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Objective To evaluate the effect of spinal cord stimulation on the expression of neuronal nitric oxide synthase (nNOS) in the rats with diabetic neuropathic pain.Methods Forty-eight pathogen-free healthy male Sprague-Dawley rats,aged 2 nonths,weighing 250-300 g,were divided into 4 groups (n =12 each) using a random number table:control group (group C),diabetes mellitus group (group DM),sham operation group (group S) and spinal cord stimulation group (group SCS).Diabetic neuropathic pain was produced by intraperitoneal injection of 1％ streptozocin 75 mg/kg and confirmed by blood glucose level＞16.7 mmol/L on day 2 after streptozocin injection.Electrodes were implanted into the epidural space at 19 days after successful establishment of the model in S and SCS groups,and in addition spinal cord stimulation (frequency 50 Hz,pulse width 0.2 ms,intensity=2/3 of the lowest intensity) was performed for 30 min once a day at 26-28 days after successful establishment of the model in group SCS.The mechanical paw withdrawal threshold (MWT) was measured at 1 day before establishment of the model (T1) and 2,7,14 and 28 days after successful establishment of the model (T2-5).The rats were sacrificed after the last measurenent of MWT at T5,and the lumbar segment of the spinal cord was removed for determination of nitric oxide (NO) content and nNOS expression in spinal cord tissues.Results Compared with group C,the MWT was significantly decreased at T4.5,and the NO content and nNOS expression in the spinal cord were increased in DM,S and SCS groups (P＜0.05).Compared with group DM,the MWT was significantly increased at Ts,and the NO content and nNOS expression in the spinal cord were decreased in group SCS (P＜0.05).Conclusion The mechanism by which spinal cord stimulation allenuales diabetie neuropalhic pain is related to inhibiting nNOS expression and reducing NO production in rals.
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OBJECTIVE: To investigate the efficacy of portable microcurrent therapy device (PMTD) of the hip internal rotators in the treatment of in-toeing gait caused by increased femoral anteversion in children over 8 years of age. METHODS: Eleven children (22 legs; 4 boys and 7 girls; mean age, 10.4±1.6 years) with in-toeing gait caused by increased femoral anteversion were included in the present study. All children received 60 minutes of PMTD (intensity, 25 µA; frequency, 8 Hz) applied to the hip internal rotators daily for 4 weeks. Hip internal rotation (IR) angle, external rotation (ER) angle, and midmalleolar-second toe angle (MSTA) measurement during stance phase at transverse plane and Family Satisfaction Questionnaire, frequency of tripping and fatigue like pains about the PMTD were performed before treatment and at 4 weeks after initial PMTD treatment. Paired t-test and Fisher exact test were used for statistical analysis. RESULTS: Hip IR/ER/MSTA was 70.3°±5.4°/20.1°±5.5°/–11.4°±2.7°, and 55.7°±7.8°/33.6°±8.2°/–2.6°±3.8° before treatment and at 4 weeks after initial PMTD treatment, respectively (p<0.01). Ten of 11 (91%) children's family stated that they were generally satisfied with the PMTD treatment. The frequency of tripping and fatigue like pains was significantly lower at 4 weeks after PMTD treatment (p<0.05). Excellent inter-rater and intra-rater reliability was observed for repeated MSTA measurements between the examiners (k=0.91–0.96 and k=0.93–0.99), respectively. CONCLUSION: PMTD of the hip internal rotators can be effective in improving the gait pattern of children with in-toeing gait caused by increased femoral anteversion.
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Child , Female , Humans , Bone Anteversion , Electric Stimulation Therapy , Fatigue , Gait , Hip , Leg , Pilot Projects , ToesABSTRACT
OBJECTIVE: To investigate the effect of laryngopharyngeal neuromuscular electrical stimulation (NMES) on dysphonia in patients with dysphagia caused by stroke or traumatic brain injury (TBI). METHODS: Eighteen patients participated in this study. The subjects were divided into NMES (n=12) and conventional swallowing training only (CST, n=6) groups. The NMES group received NMES combined with CST for 2 weeks, followed by CST without NMES for the next 2 weeks. The CST group received only CST for 4 weeks. All of the patients were evaluated before and at 2 and 4 weeks into the study. The outcome measurements included perceptual, acoustic and aerodynamic analyses. The correlation between dysphonia and swallowing function was also investigated. RESULTS: There were significant differences in the GRBAS (grade, roughness, breathiness, asthenia and strain scale) total score and sound pressure level (SPL) between the two groups over time. The NMES relative to the CST group showed significant improvements in total GRBAS score and SPL at 2 weeks, though no inter-group differences were evident at 4 weeks. The improvement of the total GRBAS scores at 2 weeks was positively correlated with the improved pharyngeal phase scores on the functional dysphagia scale at 2 weeks. CONCLUSION: The results demonstrate that laryngopharyngeal NMES in post-stroke or TBI patients with dysphonia can have promising effects on phonation. Therefore, laryngopharyngeal NMES may be considered as an additional treatment option for dysphonia accompanied by dysphagia after stroke or TBI.