Efficiency of pulsed electromagnetic field and neuromuscular electrical stimulation on painful shoulder following stroke / Eficiência do campo eletromagnético pulsado e da estimulação elétrica neuromuscular em ombro doloroso após acidente vascular cerebral

INTRODUCTION: Shoulder pain after stroke, a complication with a prevalence of up to 16­84% usually occurs after 2­3 months and leads to patients withdrawing from rehabilitation programs, staying in the hospital longer, having less limb function and having a great negative impact on their quality of life. The aim of the present study was to determine the effect of PEMF and NMES in reducing shoulder pain in patients with stroke. MATERIAL AND METHODS: A prospective, randomized controlled trial included 51 patients with shoulder pain following stroke. The patients were randomly assigned to three groups (17 people in each group): Pulsed Electromagnetic Field (PEMF), Neuromuscular Electrical Stimulation (NMES) and Control group. The outcome measures were Visual Analogue Scale (VAS), Modified Ashworth Scale (MAS) and Fugl Meyer Assessment­Upper Extremity (FMA-UE), Active and Passive Range of Motion (AROM/PROM) assessed at the baseline, six weeks into the intervention, and one week into the follow-up. RESULTS: VAS score for pain showed a mean change of 1.60, 1.60 and 4.94 in PEMF, NMES, and control respectively after 20 sessions. It showed pain was significantly improved in all the groups (p<0.001), but the effectiveness of the PEMF and NMES groups was superior to the control group. CONCLUSION: The current literature showed that PEMF & NMES are effective in improving post-stroke shoulder pain, spasticity, range of motion and motor function and a novel method for stroke patients undergoing rehabilitation.

INTRODUÇÃO: Dor no ombro após acidente vascular cerebral com prevalência de 16­84% geralmente ocorre após 2­3 meses e pode resultar na suspensão de programas de reabilitação, internações hospitalares mais longas e redução da função dos membros, prejudicando qualidade de vida dos pacientes com AVC. O objetivo do presente estudo foi determinar o efeito da PEMF e da EENM na redução da dor no ombro em pacientes com acidente vascular cerebral. MATERIAL E MÉTODOS: Um estudo prospectivo, randomizado e controlado incluiu 51 pacientes com dor no ombro pós-AVC. Os pacientes foram divididos aleatoriamente em três grupos (17 pessoas em cada grupo): grupo Campo Eletromagnético Pulsado (PEMF), grupo Estimulação Elétrica Neuromuscular (EENM) e grupo Controle. As medidas de resultados foram na Escala Visual Analógica (VAS), Escala de Ashworth Modificada (MAS) e Avaliação de Fugl Meyer ­ Extremidade Superior (FMA-UE), Amplitude de Movimento (AROM/PROM) foram avaliadas no início do estudo, após seis semanas de tratamento, e após um acompanhamento semanal. RESULTADOS: A pontuação VAS para dor mostrada uma alteração média de 1,60, 1,60 e 4,94 na PEMF, EENM e Controle, respectivamente, após 20 sessões. Mostrou melhora significativa entre os três grupos (p<0,001), mas a eficácia do grupo PEMF e EENM foi superior ao grupo Controle. CONCLUSÃO: O presente estudo mostrou que PEMF e EENM são eficazes na melhora da dor no ombro pós-AVC, espasticidade, amplitude de movimento e função motora e um novo método para pacientes com AVC em reabilitação. Nossas descobertas indicam que a eficácia da EENM é claramente superior à do PEMF na manutenção da analgesia a longo prazo.

Effect of Long-term Peripheral Nerve Stimulation on Neuro-Muscular Complex Morphologic Recovery in Experiment / Efecto de la Estimulación del Nervio Periférico a Largo Plazo sobre la Recuperación Morfológica del Complejo Neuromuscular en Experimento

SUMMARY: Peripheral nerve injury is an extremely important medical and socio-economic problem. It is far from a solution, despite on rapid development of technologies. To study the effect of long-term electrical stimulation of peripheral nerves, we used a domestically produced electrical stimulation system, which is approved for clinical use. The study was performed on 28 rabbits. Control of regeneration was carried out after 3 month with morphologic techniques. The use of long-term electrostimulation technology leads to an improvement in the results of the recovery of the nerve trunk after an injury, both directly at the site of damage, when stimulation begins in the early period, and indirectly, after the nerve fibers reach the effector muscle.

La lesión de los nervios periféricos es un problema médico y socioeconómico extremadamente importante. Sin embargo, y a pesar del rápido desarrollo de las tecnologías, aún no tiene solución. Para estudiar el efecto de la estimulación eléctrica a largo plazo de los nervios periféricos, utilizamos un sistema de estimulación eléctrica de producción nacional, que está aprobado para uso clínico. El estudio se realizó en 28 conejos. El control de la regeneración se realizó a los 3 meses con técnicas morfológicas. El uso de tecnología de electro estimulación a largo plazo conduce a una mejora en los resultados de la recuperación del tronco nervioso después de una lesión, tanto directamente en el lugar del daño, cuando la estimulación comienza en el período temprano, como indirectamente, después de que las fibras nerviosas alcanzan el músculo efector.

Clinical effect and prognostic factor of electric stimulation and biofeedback therapy on postpartum pelvic organ prolapse / Efeito clínico e fator prognóstico da estimulação elétrica e terapia de biofeedback no prolapso de órgãos pélvicos pós-parto / Efecto clínico y factor pronóstico de la estimulación eléctrica y la terapia de biorretroalimentación en el prolapso posparto de órganos pélvicos

ABSTRACT Objective: To explore the effects of electric stimulation and biofeedback therapy in patients with postpartum pelvic organ prolapse and to identify factors that can affect therapeutic efficacy outcomes. Method: This retrospective study analysed clinical data about patients with postpartum pelvic organ prolapse. A total of 328 women with pelvic organ prolapse at 6 weeks postpartum were recruited from one tertiary hospitals in Sichuan province in China, between March 2019 and March 2022. The prognostic factors of therapeutic efficacy were analysed using logistic regression and decision tree model. Results: Overall, 259 women showed clinical benefits from the treatment. The logistic regression model showed that parity, pelvic floor muscle training at home, and the pelvic organ prolapse quantitation stage before treatment were independent prognostic factors. The decision tree model showed that the pelvic organ prolapse quantitation stage before treatment was the main prognostic factor, followed by parity. There was no significant difference in the area under the receiver operating characteristic curve between the two models. Conclusion: Parity, pelvic floor muscle training at home, and the pelvic organ prolapse quantitation stage before treatment were important prognostic factors of electric stimulation and biofeedback therapy on postpartum pelvic organ prolapse.

RESUMO Objetivo: Explorar o efeito da estimulação elétrica e da terapia de biofeedback em pacientes com prolapso de órgãos pélvicos pós-parto e identificar fatores que podem afetar os resultados da eficácia terapêutica. Método: Este estudo é uma análise retrospectiva de dados clínicos de pacientes com prolapso de órgãos pélvicos pós-parto. Um total de 328 mulheres com prolapso de órgãos pélvicos nas seis semanas pós-parto foram recrutadas em um hospital terciário na província de Sichuan, na China, entre março de 2019 e março de 2022. Os fatores prognósticos de eficácia terapêutica foram analisados por meio de regressão logística e modelo de árvore de decisão. Resultados: No geral, 259 mulheres apresentaram benefícios clínicos com o tratamento. O modelo de regressão logística mostrou que a paridade, o treinamento muscular do assoalho pélvico em casa e o estágio de quantificação do prolapso de órgãos pélvicos antes do tratamento foram fatores prognósticos independentes. O modelo de árvore de decisão mostrou que o estágio de quantificação do prolapso de órgãos pélvicos antes do tratamento foi o principal fator prognóstico, seguido pela paridade. Não houve diferença significativa na área sob a curva ROC entre os dois modelos. Conclusão: A paridade, o treinamento muscular do assoalho pélvico em casa e o estágio de quantificação do prolapso de órgãos pélvicos antes do tratamento foram importantes fatores prognósticos da estimulação elétrica e da terapia de biofeedback no prolapso de órgãos pélvicos pós-parto.

RESUMEN Objetivo: Explorar el efecto de la estimulación eléctrica y la terapia de biorretroalimentación en pacientes con prolapso posparto de órganos pélvicos e identificar los factores que pueden afectar los resultados de la eficacia terapéutica. Método: Este estudio es un análisis retrospectivo de los datos clínicos de pacientes con prolapso posparto de órganos pélvicos. Entre marzo de 2019 y marzo de 2022, se reclutaron un total de 328 mujeres con prolapso de órganos pélvicos en las seis semanas posteriores al parto en un hospital terciario de la provincia de Sichuan, China. Los factores pronósticos de eficacia terapéutica se analizaron mediante regresión logística y el modelo de árbol de decisión. Resultados: En total, 259 mujeres mostraron beneficios clínicos relacionados con el tratamiento. El modelo de regresión logística mostró que la paridad, el entrenamiento en casa de la musculatura del suelo pélvico y la etapa de cuantificación del prolapso de órganos pélvicos antes del tratamiento fueron factores pronósticos independientes. El modelo de árbol de decisión mostró que la etapa de cuantificación del prolapso de órganos pélvicos previa al tratamiento fue el principal factor pronóstico, seguido de la paridad. No hubo diferencias significativas en el área bajo la curva ROC entre los dos modelos. Conclusión: La paridad, el entrenamiento en casa de la musculatura del suelo pélvico y la etapa de cuantificación del prolapso de órganos pélvicos previa al tratamiento fueron factores pronósticos importantes de la estimulación eléctrica y la terapia de biorretroalimentación en el prolapso posparto de órganos pélvicos.

Neuroestimulación del nervio vago, hipocampal y de núcleos anteriores y centromedianos del tálamo en epilepsia temporal: revisión de la literatura / Neurostimulation of the vagus nerve, hippocampal and anterior and centromedian nuclei of the thalamus in temporal epilepsy: literature review

Introducción: En pacientes con epilepsia del lóbulo temporal refractarios que no son candidatos a cirugía, se debe considerar la estimulación eléctrica cerebral como una opción. Contenido: La estimulación eléctrica cerebral es la administración directa de pulsos eléctricos al tejido nervioso que permite modular un sustrato patológico, interrumpir la manifestación clínica de las crisis y reducir la gravedad de estas. Así, dada la importancia de estos tratamientos para los pacientes con epilepsia del lóbulo temporal refractaria, se hace una revisión de cuatro tipos de estimulación eléctrica. La primera, la del nervio vago, es una buena opción en crisis focales y crisis generalizadas o multifocales. La segunda, la del hipocampo, es más útil en pacientes no candidatos a lobectomía por riesgo de pérdida de memoria, con resonancia magnética normal o sin esclerosis mesial temporal. La tercera, la del núcleo anterior, es pertinente principalmente en pacientes con crisis focales, pero debe realizarse con precaución en pacientes con alto riesgo de cambios cognitivos, como los ancianos, o en los que presentan alteración del estado de ánimo basal, y, por último, la del núcleo centromediano se recomienda para el tratamiento crisis focales en el síndrome de Rasmussen y crisis tónico-clónicas en el síndrome de Lennox-Gastaut. Conclusiones: El interés por la estimulación eléctrica cerebral ha venido aumentando, al igual que las estructuras diana en las cuales se puede aplicar, debido a que es un tratamiento seguro y eficaz en pacientes con epilepsia del lóbulo temporal para controlar las crisis, pues disminuye la morbimortalidad y aumenta la calidad de vida.

Introduction: In patients with refractory temporal lobe epilepsy who are not candidates for surgery, electrical brain stimulation should be considered as another option. Contents: Electrical brain stimulation is the direct administration of electrical pulses to nerve tissue that modulates a pathological substrate, interrupts the clinical manifestation of seizures, and reduces their severity. Thus, given the importance of these treatments for patients with refractory temporal lobe epilepsy, four types of electrical stimulation are reviewed. The first, vagus nerve stimulation, is a good option in focal seizures and generalized or multifocal seizures. The second, hippocampal stimulation, is more useful in patients who are not candidates for lobectomy due to the risk of memory loss, with normal MRI or without mesial temporal sclerosis. The third, the anterior nucleus, is mainly in patients with focal seizures, but with caution in patients at high risk of cognitive changes such as the elderly, or in those with baseline mood disturbance and, finally, the centromedian nucleus is recommended for the treatment of focal seizures in Rasmussen's syndrome and tonic-clonic seizures in Lennox-Gastaut syndrome. Conclusions: the interest in brain electrical stimulation has been increasing as well as the target structures in which it can be applied because it is a safe and effective treatment in patients with temporal lobe epilepsy to control seizures, decreasing morbidity and mortality and increasing quality of life

Effect of transcutaneous acupoint electrical stimulation at Neiguan (PC 6) on general anesthesia under preserving spontaneous breathing in thoracoscopic lobectomy / 中国针灸

OBJECTIVE@#To evaluate the effect of transcutaneous acupoint electrical stimulation (TEAS) at Neiguan (PC 6) on general anesthesia under preserving spontaneous breathing in thoracoscopic lobectomy.@*METHODS@#A total of 66 patients of primary lung cancer undergoing thoracoscopic lobectomy were divided to an observation group (33 cases, 1 case discontinued) and a control group (33 cases). In the observation group, TEAS at Neiguan (PC 6) was used 30 min before anesthesia induction till the end of surgery. The surgery time, maximum value of partial pressure of end-tidal carbon dioxide (PETCO2) and minimum value of oxygen saturation (SpO2) of the two groups were recorded. The dosage of propofol, sufentanil, remifentanil and dexmedetomidine were analyzed. Separately, before induction (T0), at the start of surgery (T1), thoracic exploration (T2) and lobectomy (T3), as well as 30 min (T4) and 60 min (T5) after lobectomy, the mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), serum cortisol (Cor) and norepinephrine (NE) were measured. The time of post anesthesia care unit (PACU) stay, ambulation, flatus, chest drainage and the incidence of nausea and vomiting were compared between the two groups.@*RESULTS@#The maximum value of PETCO2, the dosage of propofol and remifentanil in the observation group were lower than those in the control group (P < 0.05, P < 0.01), the minimum value of SpO2 in the observation group was higher than that of the control group (P < 0.01). At T1-T5, the MAP, HR, serum Cor and NE levels in the observation group were all lower than those in the control group (P < 0.05). The ambulation time, the time for the flatus, chest drainage time, and the incidence of nausea and vomiting in the observation group were all lower than those in the control group (P<0.001, P < 0.01).@*CONCLUSION@#For the general anesthesia under preserving spontaneous breathing in thoracoscopic surgery, TEAS at Neiguan (PC 6) relieves stress response, reduces opioids dosage and promotes postoperative recovery.

Characteristics of responsiveness of cochlear nerve to electrical stimulation in patients with cochlear nerve deficiency / 中华耳鼻咽喉头颈外科杂志

Objectives: This study aimed to evaluate the responsiveness of cochlear nerve to electrical stimulation in patients with cochlear nerve deficiency(CND), to compare their results with those measured in implanted children with normal-sized cochlear nerves, and to investigate the characteristics of the cochlear nerve injury of children with CND. Methods: Participants were children who underwent cochlear implantation at Shandong Provincial ENT Hospital from January 2012 to January 2020, including CND group and control group. The CND group included 51 subjects (male:20; female: 31) who were diagnosed with CND and had normal cochlea. For the CND group, four children had been bilaterally implanted, the mean implantation age was (2.7±1.5) years old. The control group included 21 subjects (male:10; femal:11) who had normal-sized cochlear nerve and normal cochlea. For the control group, all children had been unilaterally implanted except one, and the mean implantation age was (3.0±1.9)years old. Three subjects in the CND group used CI422 electrode arrays, and all the other subjects used CI24RECA/CI512 electrode arrays. The electrically evoked compound action potentials (ECAP) had been tried to record for each electrode using Custom Sound EP software (v. 4.3, Cochlear Ltd.) at least six months post first activation. Furthermore, ECAP amplitude growth functions (AGF) were measured at multiple electrode locations across the electrode array. Generalized linear mixed effect models with the subject group and electrode location as the fixed effects and subjects as the random effect were used to compare results of ECAP measurements. Results: In the control group, ECAP could been recorded at all electrodes (100%), but it could only be recorded in 71% (859/1 210) electrodes in the CND group. Additionally, the percentage of electrodes with measurable ECAP decreased from electrode 1 to electrode 22 in the CND group. Compared to the control group, the ECAP thresholds significantly increased, the ECAP amplitudes and AGF slopes significantly decreased, and the ECAP latency significantly increased in the CND group (P<0.01). GLMM showed that the stimulating site had a significant effect on the ECAP threshold, maximum amplitude, and AGF slope (P<0.01), but had no significant effect on the ECAP latency (P>0.05) in the CND group. However, the stimulating site had no significant effects on the ECAP measurements in the control group. Furthermore, the functional status of cochlear nerve varied greatly among CND group. From electrode 1 to electrode 22, the ECAP thresholds gradually increased, the ECAP maximum amplitudes and AGF slopes gradually decreased in the CND group. Conclusion: Compared with patients with normal-sized cochlear nerve, not only the number of residual spinal ganglion neurons reduce,but also the function of spinal ganglion neurons damages in CND patients. The degree of cochlea nerve deterioration varies greatly among CND patients. Generally, the deterioration of cochlear nerve tends to increase from the basal to the apical site of the cochlea.

Transcutaneous electrical acupoint stimulation based on electro-oculogram signal regulation for children with mental retardation: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical efficacy of transcutaneous electrical acupoint stimulation (TEAS) at Changqiang (GV 1) based on the modulation of electro-oculogram (EOG) signal for children with mental retardation, and explore the evaluation effect of the goal attainment scale (GAS) in children with mental retardation.@*METHODS@#Sixty children with mental retardation were randomly divided into a treatment group and a control group, with 30 cases in each one. The children in the control group were treated with conventional rehabilitation, 5 times a week. On the basis of the control group, TEAS at Changqiang (GV 1) under the modulation of EOG signal was adopted in the treatment group. When the similarity between the collected EOG signal and the template was within the range of EOG threshold, one electric stimulation was triggered at Changqiang (GV 1) for 20 s (continuous wave, 70-100 Hz in frequency, 0.1-0.2 ms in pulse width), lasting 30 min in each treatment, the intervention was given twice a week. One course of treatment was composed of 4 weeks, and 3 courses were required in total in the two groups. The infant-junior high school student's social living ability scale (S-M) and GAS were scored and compared before and after treatment in the two groups.@*RESULTS@#After treatment, the scores of self-living ability in the treatment group and communication ability in the control group were higher than those before treatment (P<0.01, P<0.05). The scores of collective activity and motor ability in the treatment group were higher than those in the control group (P<0.05). After treatment, GAS scores were higher than before treatment in both groups (P<0.001), and the score in the treatment group was higher than the control group (P<0.05).@*CONCLUSION@#TEAS under the modulation of EOG signal is conductive to improving the collective, motor and self-living abilities of the children with mental retardation and promoting children's individual goals. Compared with the standard score of S-M, the T value of GAS can better reflect the subtle progress of individual.

Post-stroke dysphagia treated with four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical efficacy on post-stroke dysphagia treated with four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation.@*METHODS@#Sixty patients with post-stroke dysphagia were randomly divided into an observation group and a control group, with 30 cases in each group. The neuromuscular electrical stimulation was adopted in the control group. Besides the treatment as the control group, in the observation group, the four-step acupuncture therapy for opening orifices and benefiting throat was supplemented. Step 1: the three areas of scalp acupuncture on the affected side were stimulated. Step 2: pricking method was operated on the posterior pharyngeal wall. Step 3: bleeding technique was operated at Jinjin (EX-HN 12) and Yuye (EX-HN 13). Step 4: deep insertion of needle was operated at three-pharynx points. The needles were retained for 30 min at the three areas of scalp acupuncture and the three-pharynx points. The intervention of each group was delivered once daily, 6 times a week, at the interval of 1 day. One course of treatment was 1 week and 4 successive courses were required. The rating of Kubota water swallow test, the score of standardized swallowing assessment (SSA) and the rating of Rosenbek penetration- aspiration scale (PAS) were observed before and after treatment in patients of the two groups. The incidence of clinical complications and clinical efficacy were compared between the two groups.@*RESULTS@#Compared with those before treatment, the rating of Kubota water swallow test, the scores of SSA and the rating of PAS of patients in the two groups were decreased after treatment (P<0.01), and the values of the observation group were lower than those of the control group after treatment (P<0.05). The incidence of clinical complications in the observation group was 13.3% (4/30), lower than 36.7% (11/30) in the control group (P<0.05). The total effective rate in the observation group was 93.3% (28/30), which was better than 70.0% (21/30) in the control group (P<0.05).@*CONCLUSION@#The four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation can improve the swallowing function of patients with post-stroke dysphagia and reduce the incidence of clinical complications.

Adaptive repetitive control of wrist tremor suppression based on functional electrical stimulation / 生物医学工程学杂志

Tremor is an involuntary and repetitive swinging movement of limb, which can be regarded as a periodic disturbance in tremor suppression system based on functional electrical stimulation (FES). Therefore, using repetitive controller to adjust the level and timing of FES applied to the corresponding muscles, so as to generate the muscle torque opposite to the tremor motion, is a feasible means of tremor suppression. At present, most repetitive control systems based on FES assume that tremor is a fixed single frequency signal, but in fact, tremor may be a multi-frequency signal and the tremor frequency also varies with time. In this paper, the tremor data of intention tremor patients are analyzed from the perspective of frequency, and an adaptive repetitive controller with internal model switching is proposed to suppress tremor signals with different frequencies. Simulation and experimental results show that the proposed adaptive repetitive controller based on parallel multiple internal models and series high-order internal model switching can suppress tremor by up to 84.98% on average, which is a significant improvement compared to the traditional single internal model repetitive controller and filter based feedback controller. Therefore, the adaptive repetitive control method based on FES proposed in this paper can effectively address the issue of wrist intention tremor in patients, and can offer valuable technical support for the rehabilitation of patients with subsequent motor dysfunction.

Research progress on transcranial electrical stimulation for deep brain stimulation / 生物医学工程学杂志

Transcranial electric stimulation (TES) is a non-invasive, economical, and well-tolerated neuromodulation technique. However, traditional TES is a whole-brain stimulation with a small current, which cannot satisfy the need for effectively focused stimulation of deep brain areas in clinical treatment. With the deepening of the clinical application of TES, researchers have constantly investigated new methods for deeper, more intense, and more focused stimulation, especially multi-electrode stimulation represented by high-precision TES and temporal interference stimulation. This paper reviews the stimulation optimization schemes of TES in recent years and further analyzes the characteristics and limitations of existing stimulation methods, aiming to provide a reference for related clinical applications and guide the following research on TES. In addition, this paper proposes the viewpoint of the development direction of TES, especially the direction of optimizing TES for deep brain stimulation, aiming to provide new ideas for subsequent research and application.

Análise comparativa do tratamento do ardor bucal com terapia a laser de baixa intensidade e estimulação elétrica nervosa transcutânea: um ensaio clínico randomizado / Comparative analysis of the treatment of burning mouth with low-intensity laser therapy and transcutaneous electrical nerve stimulation: a randomized clinical trial

Introdução: O manejo de pacientes com ardor bucal é um desafio no cotidiano clínico da odontologia. Objetivo: Comparar o efeito da Terapia a Laser de Baixa Intensidade (LLLT) e da Estimulação Elétrica Nervosa Transcutânea (TENS) no tratamento do ardor bucal. Metodologia: Ensaio clínico randomizado constituído por 25 pacientes com ardor bucal que foram tratados por TENS (n=12) e por LLLT (n=13). Os protocolos de tratamento foram aplicados semanalmente por 8 semanas. O teste análise de variância (ANOVA) dois fatores foi usado para verificar se existia diferença significativa entre os tempos T0 (antes de iniciar o tratamento), T1 (após a 4ª sessão de tratamento), T2 (após a 8ª sessão de tratamento) e T3 (30 dias após o término do tratamento) em relação aos sintomas, analisados por meio da Escala Visual Analógica (EVA), fluxo salivar não estimulado, xerostomia e disgeusia com as intervenções de TENS e LLLT. Resultados: A maioria dos pacientes foi do sexo feminino no período pós-menopausa com média de idade no grupo TENS de 59,25 anos e no grupo LLLT de 62,08. Hipertensão e dislipidemia foram as alterações sistêmicas mais frequentes. Ansiedade e depressão foram os únicos transtornos psiquiátricos relados. A maioria dos pacientes fazia uso de medicamentos como anti-hipertensivos e antidepressivos. Não foram observadas variações expressivas no que se refere a xerostomia e a disgeusia nos dois grupos analisados. A TENS e a LLLT foram eficazes na redução dos sintomas relatados pelos pacientes (p˂0,001), entretanto, observou-se entre os tempos T2 e T3 que o grupo LLLT apresentou uma melhor resposta quando comparado ao TENS (p=0,003). Os pacientes do grupo TENS apresentaram aumento do fluxo salivar entre os tempos T1 e T2, enquanto o grupo LLLT apresentou uma diminuição (p=0,052). Conclusão: A TENS e a LLLT foram eficazes na redução dos sintomas do ardor bucal durante o tratamento e 30 dias após o término do tratamento, sendo que o grupo LLLT apresentou uma melhor resposta na sessão de acompanhamento pós-tratamento quando comparado ao grupo TENS (AU).

Introduction: The management of patients with burning mouth is a challenge in the clinical routine of dentistry. Objective: To compare the effect of Low Intensity Laser Therapy (LLLT) and Transcutaneous Electrical Nerve Stimulation (TENS) in the treatment of burning mouth. Methodology: Randomized clinical trial consisting of 25 patients with burning mouth who were treated with TENS (n=12) and LLLT (n=13). Treatment protocols were applied weekly for 8 weeks. The two-way analysis of variance (ANOVA) test was used to verify whether there was a significant difference between the times T0 (before starting treatment), T1 (after the 4th treatment session), T2 (after the 8th treatment session) and T3 (30 days after the end of treatment) in relation to symptoms, analyzed using the Visual Analogue Scale (VAS), unstimulated salivary flow, xerostomia and dysgeusia with TENS and LLLT interventions. Results: Most patients were female in the postmenopausal period, with a mean age of 59.25 years in the TENS group and 62.08 in the LLLT group. Hypertension and dyslipidemia were the most frequent systemic alterations. Anxiety and depression were the only psychiatric disorders reported. Most patients used drugs such as antihypertensives and antidepressants. Significant variations were not observed with regard to xerostomia and dysgeusia in the two groups analyzed. TENS and LLLT were effective in reducing the symptoms reported by patients (p˂0.001), however, it was observed between times T2 and T3 that the LLLT group showed a better response when compared to TENS (p=0.003). Patients in the TENS group showed an increase in salivary flow between times T1 and T2, while the LLLT group showed a decrease (p=0.052). Conclusion: TENS and LLLT were effective in reducing the symptoms of burning mouth during treatment and 30 days after the end of treatment, and the LLLT group showed a better response in the posttreatment follow-up session when compared to the TENS group (AU).

Variação da atividade elétrica entre o repouso e a máxima contração voluntária dos músculos masseteres em homens adultos / Variation of electrical activity between rest and maximum voluntary contraction of masseter muscles in adult men / Variación de la actividad eléctrica entre el descanso y la contracción voluntaria máxima de los músculos maseteros en hombres adultos

Introdução: A eletromiografia de superfície (EMGs) é um exame objetivo, indolor, não invasivo e de fácil aplicação utilizado para avaliar as atividades elétricas de determinado músculo ou grupo muscular durante a máxima contração voluntária, repouso e dinâmica funcional. Objetivo: Comparar a variação do potencial elétrico dos músculos masseteres entre o repouso e máxima contração voluntária em indivíduos com faixas etárias diferentes. Método: A pesquisa foi aprovada em comitê de ética e executada na Clínica Escola do Departamento de Fonoaudiologia da Universidade Federal de Sergipe obedecendo aos rigores éticos e de biossegurança. A amostra foi composta por 26 adultos sem queixas orofaciais, sexo masculino e idade variando entre 26 e 42 anos, divididos em Grupo 1 e Grupo 2, os quais assinaram um termo de consentimento livre e esclarecido concordando com a participação na pesquisa. Os voluntários foram submetidos à avaliação eletromiográfica dos músculos masseteres durante o repouso e máxima contração voluntária. Resultados: Houve uma diminuição da atividade elétrica do masseter quando se comparou o G1 com o G2, porém não foi observada uma linearidade desse declínio ao analisar o universo estudado. Por isso, deve-se levar em consideração que o envelhecimento é um processo fisiológico particular de cada ser, sendo influenciado por múltiplos fatores intrínsecos e extrínsecos ao organismo. Observou-se, também, que no repouso nenhum indivíduo teve absolutamente 0 nos seus registros eletromiográficos, caracterizando um estado basal de atividade elétrica para garantia do tônus. Conclusão: Foi verificado que os voluntários com 30 anos ou mais apresentaram um declínio nos potenciais mioelétricos e, possivelmente, um déficit de força associado.

Introduction: Surface electromyography (EMGs) is an objective, painless, non-invasive and easily applied test used to assess the electrical activities of a particular muscle or muscle group during maximum voluntary contraction, rest and functional dynamics. Objective: Compare the variation in the electrical potential of the masseter muscles between rest and maximum voluntary contraction in individuals with different age groups. Method: The research was approved by the ethics committee and carried out at the Clínica Escola of the department of Speech, Language and Hearing Sciences at the Federal University of Sergipe, obeying ethical and biosafety rigors. The sample consisted of 26 adults without orofacial complaints, male with age from 26 to 42 years old, divided into Group 1 and Group 2, who signed a consent form agreeing to participate in the research. The volunteers underwent electromyographic evaluation of the masseter muscles during rest and maximum voluntary contraction. Results: There was a decrease in the electrical activity of the masseter when comparing G1 to G2; however, there was no linearity of this decline when analyzing the universe studied. Therefore, it must be taken into account that aging is a particular physiological process of each individual, being influenced by multiple factors, intrinsic and extrinsic to the organism. It was also observed at rest, no individual had absolutely 0 in their electromyographic records, characterizing a baseline state of electrical activity to guarantee tone. Conclusion: It was found that volunteers aged 30 years or more showed a decline in myoelectric potentials and possibly an associated strength deficit.

Introducción: Electromiografía de superficie (EMG) es una prueba objetiva, indolora, no invasiva y de fácil aplicación que se utiliza para evaluar actividades eléctricas de un músculo o grupo muscular en particular durante la contracción voluntaria máxima, el reposo y la dinámica funcional. Objetivo: Comparar la variación del potencial eléctrico de los maseteros entre reposo y contracción voluntaria máxima en individuos de diferentes grupos de edad. Método: La investigación fue aprobada por el comité de ética y realizada en la Clínica Escola del departamento de logopedia de la Universidad Federal de Sergipe obedeciendo rigores éticos y de bioseguridad. La muestra estuvo conformada por 26 adultos sin quejas orofaciales, varones y edades comprendidas entre 26 y 42 años dividido en Grupo 1 y Grupo 2, quienes firmaron formulario de consentimiento aceptando participar en la investigación. Los voluntarios se sometieron a evaluación electromiográfica de los músculos maseteros durante reposo y la máxima contracción voluntaria. Resultados: Hubo disminución en la actividad eléctrica del masetero cuando se comparó G1 con G2, sin embargo no hubo linealidad de esta disminución al analizar el universo estudiado. Por tanto, hay que tener en cuenta que el envejecimiento es proceso fisiológico particular de cada ser, siendo influenciado por múltiples factores intrínsecos y extrínsecos al organismo. También se observó que en reposo ningún individuo tenía absolutamente 0 en sus registros electromiográficos, caracterizando estado basal de actividad eléctrica para garantizar el tono. Conclusión: Se encontró que los voluntarios de 30 años o más mostraron una disminución en los potenciales mioeléctricos y posiblemente un déficit de fuerza asociado.

Clinical Investigation of Key Parameter Range of AMG Muscle Relaxant Monitor / 中国医疗器械杂志

The accelerometry(AMG) muscle relaxant monitor is the most widely used quantitative muscle relaxant monitor to assess the degree of neuromuscular at present. In this study, the ulnar nerve was stimulated by using train of four stimulation(TOF) mode of the AMG muscle relaxant monitor, and the movement of the adductor pollicis muscle was monitored. In this way, the distribution range of key parameters (acceleration peak value, response time, and TOF ratio) of the adductor pollicis muscle during the use of muscle relaxant in clinical practice is analyzed and will provide a practical basis for the development and improvement of the muscle relaxant monitor.

Acupoint injection combined with Vitalstim electrical stimulation for post-stroke dysphagia:a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical efficacy of acupoint injection combined with Vitalstim electrical stimulation for post-stroke dysphagia.@*METHODS@#A total of 98 patients with dysphagia after first stroke were randomized into an acupoint injection group (35 cases, 2 cases dropped off), an electrical stimulation group (31 cases, 3 cases dropped off) and a combination group (32 cases, 3 cases dropped off). Injection of mecobalamin into Tunyan point, Vitalstim electrical stimulation and the combination of injection of mecobalamin into Tunyan point and Vitalstim electrical stimulation were applied respectively in the 3 groups, once a day, 10 times as one course, 2 courses were required. Before and after treatment, the tongue muscle thickness and video fluoroscopic swallowing study (VFSS) score were observed in the 3 groups.@*RESULTS@#After treatment, the tongue muscle thickness was decreased (P<0.05), the VFSS scores were increased (P<0.05) compared with before treatment in the 3 groups, and the variation of tongue muscle thickness and VFSS score in the combination group was greater than the acupoint injection group and the electrical stimulation group (P<0.05).@*CONCLUSION@#Both acupoint injection of mecobalamin and Vitalstim electrical stimulation have therapeutic effect on dysphagia after stroke, and the two have synergistic effect.

Experimental study of electric field stimulation combined with polyethylene glycol in the treatment of spinal cord injury in rats / 生物医学工程学杂志

Electric field stimulation (EFS) can effectively inhibit local Ca 2+ influx and secondary injury after spinal cord injury (SCI). However, after the EFS, the Ca 2+ in the injured spinal cord restarts and subsequent biochemical reactions are stimulated, which affect the long-term effect of EFS. Polyethylene glycol (PEG) is a hydrophilic polymer material that can promote cell membrane fusion and repair damaged cell membranes. This article aims to study the combined effects of EFS and PEG on the treatment of SCI. Sprague-Dawley (SD) rats were subjected to SCI and then divided into control group (no treatment, n = 10), EFS group (EFS for 30 min, n = 10), PEG group (covered with 50% PEG gelatin sponge for 5 min, n = 10) and combination group (combined treatment of EFS and PEG, n = 10). The measurement of motor evoked potential (MEP), the motor behavior score and spinal cord section fast blue staining were performed at different times after SCI. Eight weeks after the operation, the results showed that the latency difference of MEP, the amplitude difference of MEP and the ratio of cavity area of spinal cords in the combination group were significantly lower than those of the control group, EFS group and PEG group. The motor function score and the ratio of residual nerve tissue area in the spinal cords of the combination group were significantly higher than those in the control group, EFS group and PEG group. The results suggest that the combined treatment can reduce the pathological damage and promote the recovery of motor function in rats after SCI, and the therapeutic effects are significantly better than those of EFS and PEG alone.

Effects of transcranial magneto-acoustic electrical stimulation on calcium signals in prefrontal nerve clusters / 生物医学工程学杂志

Transcranial magneto-acoustic electrical stimulation (TMAES) is a novel method of brain nerve regulation and research, which uses induction current generated by the coupling of ultrasound and magnetic field to regulate neural electrical activity in different brain regions. As the second special envoy of nerve signal, calcium plays a key role in nerve signal transmission. In order to investigate the effect of TMAES on prefrontal cortex electrical activity, 15 mice were divided into control group, ultrasound stimulation (TUS) group and TMAES group. The TMAES group received 2.6 W/cm 2 and 0.3 T of magnetic induction intensity, the TUS group received only ultrasound stimulation, and the control group received no ultrasound and magnetic field for one week. The calcium ion concentration in the prefrontal cortex of mice was recorded in real time by optical fiber photometric detection technology. The new object recognition experiment was conducted to compare the behavioral differences and the time-frequency distribution of calcium signal in each group. The results showed that the mean value of calcium transient signal in the TMAES group was (4.84 ± 0.11)% within 10 s after the stimulation, which was higher than that in the TUS group (4.40 ± 0.10)% and the control group (4.22 ± 0.08)%, and the waveform of calcium transient signal was slower, suggesting that calcium metabolism was faster. The main energy band of the TMAES group was 0-20 Hz, that of the TUS group was 0-12 Hz and that of the control group was 0-8 Hz. The cognitive index was 0.71 in the TMAES group, 0.63 in the TUS group, and 0.58 in the control group, indicating that both ultrasonic and magneto-acoustic stimulation could improve the cognitive ability of mice, but the effect of the TMAES group was better than that of the TUS group. These results suggest that TMAES can change the calcium homeostasis of prefrontal cortex nerve clusters, regulate the discharge activity of prefrontal nerve clusters, and promote cognitive function. The results of this study provide data support and reference for further exploration of the deep neural mechanism of TMAES.

Phase amplitude coupling analysis of local field potentials in working memory of rats affected by transcranial magneto-acoustic-electrical stimulation / 生物医学工程学杂志

Transcranial magneto-acoustic-electrical stimulation is a new non-invasive neuromodulation technology, in which the induced electric field generated by the coupling effect of ultrasound and static magnetic field are used to regulate the neural rhythm oscillation activity in the corresponding brain region. The purpose of this paper is to investigate the effects of transcranial magneto-acoustic-electrical stimulation on the information transfer and communication in neuronal clusters during memory. In the experiment, twenty healthy adult Wistar rats were randomly divided into a control group (five rats) and stimulation groups (fifteen rats). Transcranial magneto-acoustic-electrical stimulation of 0.05~0.15 T and 2.66~13.33 W/cm 2 was applied to the rats in stimulation groups, and no stimulation was applied to the rats in the control group. The local field potentials signals in the prefrontal cortex of rats during the T-maze working memory tasks were acquired. Then the coupling differences between delta rhythm phase, theta rhythm phase and gamma rhythm amplitude of rats in different parameter stimulation groups and control group were compared. The experimental results showed that the coupling intensity of delta and gamma rhythm in stimulation groups was significantly lower than that in the control group ( P<0.05), while the coupling intensity of theta and gamma rhythm was significantly higher than that in the control group ( P<0.05). With the increase of stimulation parameters, the degree of coupling between delta and gamma rhythm showed a decreasing trend, while the degree of coupling between theta and gamma rhythm tended to increase. The preliminary results of this paper indicated that transcranial magneto-acoustic-electrical stimulation inhibited delta rhythmic neuronal activity and enhanced the oscillation of theta and gamma rhythm in the prefrontal cortex, thus promoted the exchange and transmission of information between neuronal clusters in different spatial scales. This lays the foundation for further exploring the mechanism of transcranial magneto-acoustic-electrical stimulation in regulating brain memory function.

Avaliação da linguagem em cirurgia de craniotomia com paciente acordado: relato de caso / Language assessment in awake craniotomy: case report

RESUMO O objetivo deste relato foi descrever o caso de um paciente submetido à craniotomia, acordado, para a ressecção neurocirúrgica de um glioma e a avaliação linguística pré-operatória, intraoperatória e pós-operatória. Paciente do gênero masculino, 27 anos, escolaridade nível superior incompleto, apresentando vômitos, confusão mental e crise convulsiva tônico-clônica. Após a avaliação do paciente pela equipe e devidas orientações pré-operatórias, a proposta de excisão da lesão em estado de vigília foi esclarecida e aceita. Ao iniciar o procedimento, os campos foram ajustados para manter as vias aéreas e os olhos acessíveis para mapeamento com estimulação elétrica e avaliação da linguagem no período intraoperatório. Devido à localização do tumor próximo à área motora da fala, foram propostas tarefas para a avaliação da linguagem em quatro momentos: pré-operatório, intraoperatório, pós-operatório imediato e pós-operatório mediato. As habilidades linguísticas testadas nas quatro avaliações foram: compreensão e expressão da linguagem oral, transposição linguística, linguagem associativa, nomeação, discriminação visual, fluência e organização da sintaxe. Com o objetivo de controlar e eliminar o efeito de aprendizagem da testagem, foram solicitadas as mesmas tarefas, porém, com diferentes conteúdos para a testagem das habilidades nas quatro fases. A cirurgia com o paciente acordado permitiu a ressecção completa e segura do tumor, sem prejuízo motor ou linguístico. O engajamento da equipe, a interação interdisciplinar e o planejamento cirúrgico detalhado constituem um pilar para o bom resultado de um procedimento tão complexo e delicado.

ABSTRACT The purpose of this report is to describe the case of a patient who underwent awake craniotomy for neurosurgical resection of a glioma and pre, intra and postoperative linguistic assessment. Male patient, 27 years old, incomplete higher education presenting vomiting, mental confusion and tonic-clonic seizures. After the evaluation of the patient by the team and due preoperative guidance, the proposal of excision of the lesion while awake was clarified and accepted. At the start of the procedure, the fields were adjusted to keep the airway and eyes accessible for mapping with electrical stimulation and intraoperative language assessment. Due to the location of the tumor close to the speech motor area, tasks were proposed for the assessment of language in four moments: preoperative, intraoperative, immediate postoperative and mediate postoperative. The language skills tested in the four assessments were: comprehension and expression of oral language, linguistic transposition, associative language, naming, visual discrimination, fluency and syntax organization. In order to control and eliminate the learning effect of testing, the same tasks were requested, but with different contents for testing skills in the four phases. Surgery with the patient awake allowed the complete and safe resection of the tumor, without motor or linguistic damage to the patient. Team engagement, interdisciplinary interaction and detailed surgical planning constitute the pillar for the good result of such a complex and delicate procedure

Effect of transcutaneous abdominal electrical stimulation in people with constipation due to spinal cord injuries: a pilot study / Efecto de la electroestimulación abdominal transcutánea sobre el estreñimiento en personas con lesión de la médula espinal: estudio piloto / Efeito da eletroestimulação abdominal transcutânea no quadro de constipação em pessoas com lesão medular: estudo piloto

ABSTRACT Objective: To evaluate the effect of abdominal electrical stimulation (EE) on bowel movement frequency and feces consistency and expelled amount in people with constipation due to spinal cord injuries (SCI). Method: This is an experimental, crossover, randomized pilot study with two treatment groups: conventional intestinal rehabilitation and conventional rehabilitation associated with EE via 8- and 20-Hz Functional Electrical Stimulation (FES) of the abdominal muscles. Both groups were followed for two weeks with daily 30-minute EE sessions. Participants were hospitalized in a rehabilitation institute in the municipality of São Paulo. Data were analyzed using descriptive and inferential statistics. Results: This study included 10 people with SCI, of which most were male (70%), with a mean age of 39 years (SD = 16.37). EE, associated with conventional treatment, was more effective in increasing defecation frequency (p = 0.029) and amount of feces expelled (p = 0.031). Conclusion: Abdominal EE, associated with conventional treatment, helped to increase defecation frequency and amount of feces expelled in people with constipation due to SCI. This pilot study will serve as the basis for a future clinical trial with greater sampling and statistical evidence.

RESUMEN Objetivo: Evaluar el efecto de la electroestimulación abdominal (EE) sobre la frecuencia de las evacuaciones, la consistencia y la cantidad de heces en personas con estreñimiento debido a una lesión de la médula espinal (LME). Método: Estudio piloto experimental de tipo crossover-aleatorizado en dos grupos de tratamiento: convencional rehabilitación intestinal y convencional asociado a EE con Functional Electrical Stimulation (FES) de 8 y 20 Hz aplicados a los músculos abdominales. Se realizó un seguimiento de ambos grupos durante dos semanas con 30 minutos de sesión diaria de EE. Los participantes estaban hospitalizados en un instituto de rehabilitación de la ciudad de São Paulo. Los datos se analizaron mediante estadística descriptiva e inferencial. Resultados: Diez personas con LME participaron en el estudio, la mayoría hombres (70%) con una edad media de 39 años (DE = 16,37). La EE asociada al tratamiento convencional demostró ser más eficaz en el aumento de la frecuencia de evacuación (p = 0,029) y la cantidad de heces (p = 0,031). Conclusión: La EE abdominal asociada al tratamiento convencional ayudó a aumentar la frecuencia de evacuación y la cantidad de heces en el contexto de estreñimiento en personas con LME. Este estudio piloto servirá de base para futuros ensayos clínicos con mayor muestreo y evidencia estadística.

RESUMO Objetivo: Avaliar o efeito da eletroestimulação (EE) abdominal sobre a frequência de evacuações, a consistência e a quantidade de fezes em pessoas com constipação decorrente da lesão medular (LM). Método: Estudo piloto experimental do tipo crossover-randomizado em dois grupos de tratamento: convencional de reabilitação intestinal e convencional associado à EE com Functional Electrical Stimulation (FES) de 8 e 20 Hz aplicados na musculatura abdominal. Ambos os grupos em seguimento por duas semanas, com 30 minutos de sessão diária de EE. Os participantes estavam internados em um instituto de reabilitação da cidade de São Paulo. Os dados foram analisados por meio de estatística descritiva e inferencial. Resultados: Participaram do estudo 10 pessoas com LM, a maioria do sexo masculino (70%), com média de idade de 39 anos (DP = 16,37). A EE, associada ao tratamento convencional, mostrou-se mais eficaz no aumento da frequência evacuatória (p = 0,029) e na quantidade de fezes (p = 0,031). Conclusão: A EE abdominal associada ao tratamento convencional auxiliou no aumento da frequência evacuatória e na quantidade de fezes no quadro de constipação em pessoas com LM. Este estudo piloto servirá como base para um futuro ensaio clínico com maior amostragem e comprovação estatística.