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bjective To observe the changes of upper extremity sensory function in patients with radicular cervical spondylosis and evaluate the treatment effect, by using the method of suspension exercise therapy (SET) and soft tissue manipulation. Methods A total of 72 patients with cervical spondylosis were divided into observation group (treated by SET combined with manipulation)and control group (treated by purely cervical traction) by simple random method. Both groups received 4-week continuous treatment for 6 times per week. The somatosensory evoked potential(SEP), current perception threshold (CPT) before and after the treatment in two groups were separatedly tested, and changes in visual analogue scale (VAS) pain scores of the affected limbs were examined, so as to determine the effective rate of treatment. Results After treatment, the latency of SEP was shortened mainly in brachial plexus potential N9 and cervical spinal potential N13 in two groups (P<0.05). The CPT levels and the VAS pain scores of the affected limbs were reduced in two groups (P<0.01), and the treatment effect in observation group was better that in control group (P<0.01)．Conclusion SET combined with soft tissue manipulation can effectively promote the repair of nerve sense function of cervical spondylotic radiculopathy.
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Objective To analysis the consequence of current perception threshold (CPT) by different frequency and time of transcutaneous electrical nerve stimulation (TENS). Methods CPT of foramen area and arm area was measured to evaluate the effect of TENS. Different frequency and time of TENS was given to 30 healthy volunteers. Stimulating to Hegu, CPT of the foramen area and the arm area on the same side was measured. Results CPT of the foramen area increased with stimulation. Low frequency of TENS inhibited the chronic pain significantly(P＜0.05),high frequency of TENS inhibited both of the chronic pain and the acute pain(P＜0.05). The inhibition of pain is more influenced by the frequency of TENS than the time of it. Conclusion Channel and point of TENS can influence CPT of the specific reaction area. And the choice of appropriate frequency of the treatment is more important than extending the treatment time alone.
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INTRODUCTION: The Perception Sensory Threshold (ST) for sinusoidal current stimuli at 5, 250, and 2,000 Hz is commonly used in the assessment of peripheral nerve fibers (C, Aδ, and Aβ, respectively). However, the neuroselectivity of these frequencies is far from consensus. In addition, Reaction Time (RT) measurements suggest that 2,000 Hz stimuli excite Aβ-fibers, 250 Hz Aβ- or Aδ-fibers, as well as 5 Hz Aβ-, Aδ- or C-fibers. Therefore, we suppose that the sinusoidal current neuroselectivity may be better observed if ST and RT parameters are jointly evaluated. In addition, we have investigated whether there are other sets of frequencies that could be used. METHODS: Thus this work investigates ST and RT for stimuli with frequency ranging from 1 to 3,000 Hz, on 28 healthy subjects aged from 19 to 44 years old (27.1±5.49). ST and RT dissimilarity among different frequencies was evaluated applying bi-dimensional Fisher Quadratic Discriminant. RESULTS: The lowest classification error (3.6%) was obtained for 1, 250, and 3,000 Hz. Error for 5, 250, and 2,000Hz was 16.7%. Stimulation frequency at 1 Hz evoked more sensations related to C-fibers (53% of reports) than to Aβ-fibers (36%). However, this behavior did not repeat itself at 5 Hz (only 21% of perceptions were related to C-fibers against 64% to Aβ-fibers). Sensations related to Aβ-fibers prevailed for the highest frequencies presented to the subjects (2,000 Hz - 82% and 3,000 Hz - 93%). Mean RT values showed a decreasing trend with frequency. CONCLUSION: These results suggest that frequencies 1, 250, and 3,000 Hz are more neuroselective than 5, 250, and 2,000 Hz for the evaluation of peripheral sensitive fibers. Furthermore, they show RT usefulness.
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The definition of Pain, “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (International Association for the Study of Pain : IASP, 1994), which is often used to explain its subjectivity. It is necessary to evaluate the pain objectively for diagnosis and effectiveness of therapy.<BR>As an evaluation method of chronic pain, Visual Analog Scale (VAS) and Numerical Rating Scale (NRS) are used. Recent years, face visual analog scale and Current Perception Threshold (CPT) testing are also used commonly. Drug challenge test draws attention as it combines an evaluation method and an effective therapy. Meanwhile as a therapy of chronic pain, the reports of epiduroscopy and phototherapy are increasing. The epiduroscopy is an endoscopic operation for patients with the chronic low back pain. In Japan the therapy is performed increasingly for patients with the low back pain of spinal canal stenosis, failed back syndrome and lumbar disc herniation. Regarding the phototherapy, the reports which show the effectiveness of linear polarized infrared raytherapy and xenon phototherapy are mainly observed. Though the nerve block is still the dominant therapy in pain clinics, acupuncture therapy and phototherapy are prospected to increase their demands in future.
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OBJECTIVE: We measured current perception threshold (CPT) with transcutaneous electrical nerve stimulation (TENS) to prove the selective increment of the threshold of C sensory fiber and to determine onset time and duration of effect for application of TENS. METHOD: TENS were applied to fifteen control volunteers for 20 minutes on hand three times per week for 2 weeks duration. The CPT was tested at the distal interphalangeal joint of the second finger with 5 Hz, 250 Hz, and 2,000 Hz in frequency, respectively. The test was repeated immediately and 30 minutes after cessation of TENS. These tests were performed on the first, eighth, and fifteenth day on application of TENS. RESULTS: The baseline CPT of C fiber was 32.7 +/- 6.4 10 2 mA, A gamma fiber 23.2 +/- 9.4 10(-2) mA, and A beta fiber 83.9 +/- 18.1 10(-2) mA. At 30 minutes after cessation of TENS in the fifteenth day, the CPT of C fiber increased markedly and that of A gamma fiber increased a little. The CPT of A beta fiber didn't increase for 2 weeks. CONCLUSION: With application of TENS, the threshold of C and A gamma fibers selectively increased, especially 30 minutes after removal of TENS application. This effect was outstanding after 2 weeks' application.