Three Newly Designed Arm Slings for the Stroke Patient with Shoulder Subluxation: A case report

We reported three types of newly designed arm slings (the "V" strap pouch arm sling, the Modified hemisling, the Tripod arm sling). The three slings and the conventional hemisling were all tested by a single stroke patient for the correction of shoulder subluxation. Sling effectiveness was evaluated by simple shoulder AP X-rays, quantitative electromyography (root mean square; RMS), strap tension, and preference of the patient. Of the four types, the "V" strap pouch arm sling reduced the vertical displacement the most. RMS values of the supraspinatus muscle tended decrease and strap tension was also lower after using the "V" strap pouch arm sling compared with others. The patient also preferred the "V" strap pouch arm sling to the other slings. We suggested that "V" strap pouch arm sling was the most effective among four types of arm slings (including conventional hemisling) for the correction of shoulder subluxation, and patient's preference.

The Effect of the Suspension, Electrical Stimulation and Treadmill Training in the Hindlimb Muscle of the Rats

OBJECTIVE: The purposes of this study were to investigate the effect of suspension, the electrical stimulation and full weight bearing treadmill training on the muscle atrophy and transformation of muscle fibers. METHOD: Forty Spraque-Dawley rats were divided into control and 3 intervention groups: suspension control (n= 10), suspension with weight bearing treadmill (n=10), and suspension with electrical stimulation (n=10). After 4 weeks intervention, both gastrocnemius and soleus were dissected and the muscle weight and transformation of muscle fibers were analyzed. RESULTS: In suspension control and suspension electrical stimulation groups, muscle to body weight ratio of gastro-cnemius was decreased compared to control group (p<0.05). In all intervention groups, muscle to body weight ratio of soleus was decreased compared to control group (p<0.05). In suspension electrical stimulation group, type I muscle fiber ratio of gastrocnemius was increased compared to control and suspension control groups (p<0.05). In suspension electrical stimulation group, type IIa muscle fiber ratio of gastrocnemius was increased compared to suspension control group (p<0.05). CONCLUSION: It is suggested that muscle atrophy induced by disuse and transformation of muscle fiber can be prevented by electrical stimulation intervention.

Effect of EMG-triggered Electrical Stimulation to Improve Arm Function in Patients with Chronic Hemiplegia

OBJECTIVE: The purpose of this study was to identify the effect of EMG-triggered electrical neuromuscular stimulation for recovery of hemiplegic arm function. METHOD: EMG-triggered electrical stimulation was applied to the extensor digitorum communis (EDC) of 8 chronic hemiplegics who showed no functional changes for more than 3 months. Stimulation was started when the amplitude of processed EMG signal from the same muscle exceeded the preset threshold. The therapeutic effect was evaluated by kinesiologic and clinical methods before and after 4 weeks. Quantitative EMG from EDC, excursion of second metacarpophalangeal joint, and functional measurements were used. We also evaluated cognitive and perceptual effect on recovery of arm function. RESULTS: Subjects treated with EMG-triggered electrical stimulation showed significant gain in amplitude of quantitative EMG and excursion sum during maximal exertion comparing to those of pre-treatment (p0.05). CONCLUSION: These results suggest that EMG-triggered electrical stimulation might be an effective therapeutic modality to improve motor function of the hemiplegic arm of chronic brain injured patients.

The Changes of Skin Temperature and Sympathetic Skin Response after Thoracic Sympathectomy in Patients with Palmar Hyperhidrosis

OBJECTIVE: The purposes of these study were to evaluate the changes of temperature and sympathetic skin response (SSR) before and after sympathectomy in patients with palmar hyperhidrosis and to quantify long standing effect of sympathectomy. METHOD: The SSR and skin temperature were measured before, one day and 30 days after thoracoscopic sympathectomy. SSR was recorded from palm and sole bilaterally. Temperature was recorded on 9 sites of each hand and 11 site of each sole. Patient's satisfaction with operation was assessed by 10-point scale. RESULTS: One day after sympathectomy, the amplitude of SSR was significantly decreased and latency of SSR was delayed in all cases on bilateral palm and sole. However, after sympathectomy 30 days, the amplitude of SSR was normalized in all cases on bilateral sole. All patients who had undergone sympathectomy showed significant clinical improvement. The temperature increased dramatically over 3degrees C on postoperation 1 day and maintained 1.72degrees C higher in post-operation 30 days than pre-operation on both hands. There was no significant difference of temperature among pre-operation and post-operation 1 day and post-operation 30 days on sole. CONCLUSION: Our study proved effect of thoracoscopic sympathectomy to the patients with palmar hyperhidrosis objectively and quantified the decrement of sympathetic tone. Further study is needed for long term follow up over 2 months or more.