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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.
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Acidente Vascular Cerebral , Dor de Ombro , Estimulação ElétricaRESUMO
In recent years， the incidence of stroke patients in China is increasing， and the motor dysfunction caused by it often seriously affects the quality of daily life of the patients， Neuromuscular electrical stimulation （NMES）， as an emerging rehabilitation therapy， is widely used in the treatment of motor dysfunction in stroke patients. This paper summarizes the parameters and mechanisms of the role of NMES in motor function rehabilitation after stroke and its use in clinical practice. In the future， the specific mechanism of NMES action and efficient and safe therapeutic options should be further explored.
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ObjectiveTo observe the effect of proprioceptive neuromuscular facilitation combined with neuromuscular electrical stimulation on chronic ankle instability (CAI). MethodsFrom April, 2016 to December, 2021, 48 patients with CAI were randomly divided into control group (n = 24) and observation group (n = 24). Both groups accepted routine rehabilitation, and the observation group accepted proprioceptive neuromuscular facilitation combined with neuromuscular electrical stimulation additionally, for eight weeks. They were assessed with Visual Analogue Scale (VAS), peak torque to body weight of ankle dorsiflexors and plantarflexors (AD/W, AP/W), Y Balance Test (YBT) and Foot and Ankle Disability Index (FADI) before and after treatment. ResultsAfter treatment, VAS score, AD/W, AP/W, YBT and FADI improved in the observation group (|t| > 2.208, P < 0.05), while VAS score and AP/W improved in the control group (|t| > 2.156, P < 0.05); and all the VAS score, AD/W, AP/W, YBT and FADI were better in the observation group than in the control group (|t| > 2.067, P < 0.05). ConclusionProprioceptive neuromuscular facilitation combined with neuromuscular electrical stimulation can effectively relieve the pain of patients with CAI, and increase the muscle strength around the ankle, to improve the stability and balance.
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Objective:To observe any effect of electroacupuncture applied to the Jialianquan points in treating post-stroke oropharyngeal dysphagia.Methods:Forty-five stroke survivors with oropharyngeal dysphagia were randomly divided into an electroacupuncture group ( n=15), a neuromuscular electrical stimulation group ( n=15) and a control group ( n=15). All groups received 30 minutes of routine swallowing function training 5 times a week for 3 weeks. The electroacupuncture group was additionally provided with 30 minutes of electroacupuncture applied to the Jialianquan (CV23) points, and the neuromuscular electrical stimulation group instead received 30 minutes of neuromuscular electrical stimulation over the bilateral submental muscles. Videofluoroscopic swallowing studies were performed before and after the 3 weeks of treatment. Standardized swallowing assessment was conducted producing functional oral intake scale ratings, modified barium swallow impairment profiles and the penetration-aspiration scale scores. Surface electromyography was also employed to evaluate submental muscle functioning through measuring the swallowing time, average EMG (AEMG) value and peak amplitude. Results:After the treatment, significant improvement was observed in all of the evaluations with both groups, but the average scores were significantly better in the electroacupuncture and neuromuscular electrical stimulation groups compared with the control group and significantly better in the electroacupuncture group than in the neuromuscular electrical stimulation group.Conclusion:Electroacupuncture at the Jialianquan point can significantly improve the swallowing of stroke survivors with oropharyngeal dysphagia. It is more effective than neuromuscular electric stimulation.
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【Objective】 To investigate the efficacy of low-frequency neuromuscular electrical stimulation in the treatment of penile hypersensitive premature ejaculation. 【Methods】 A total of 66 patients treated during Nov.2021 and Aug.2022 were randomly divided into electrical stimulation group (n=22), local anesthesia group (n=21), and combined therapy group (n=23). The electrical stimulation group received low-frequency neuromuscular electrical stimulation, 5 times a week;the local anesthesia group used compound lidocaine cream 30 minutes before sexual intercourse;the combined therapy group received both treatments. After 3-month treatment, the latency of dorsal nerve somatosensory evoked potential (DNSEP), glans penis somatosensory evoked potential (GPSEP), intravaginal ejaculation latency time (IELT), premature ejaculation diagnostic tool score (PEDT), and spouse sexual satisfaction score were collected. 【Results】 After treatment, IELT, PEDT, spouse’s sexual life satisfaction score, DNSEP and GPSEP of the three groups were significantly improved (P0.05). 【Conclusion】 Low-frequency neuromuscular electrical stimulation is effective in the treatment of penile hypersensitive premature ejaculation, and the combination of local anesthetics is more effective, which is worthy of clinical application and promotion.
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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.
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Humanos , Faringe , Transtornos de Deglutição/terapia , Terapia por Acupuntura , Acidente Vascular Cerebral/complicações , Água , Estimulação ElétricaRESUMO
Background & objectives: Osteoarthritis (OA) is the most common form of arthritis that increases with age affecting the population from the middle age to the elderly. The present study was undertaken to find whether neuromuscular stimulation of vastus medialis oblique (VMO) in combination with Maitland’s mobilization and exercises was more effective as compared to Maitland’s mobilization with exercises alone in patients with knee OA. Methods: Sixty patients with knee OA were purposively selected and randomly distributed to two groups that received an intervention for eight weeks. Group A patients received Maitland’s mobilization in combination with exercises and group B patients received the same intervention as group A in combination with neuromuscular stimulation of VMO muscle. After eight weeks, outcome measures, i.e. Numeric Pain Rating Scale (NPRS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) index, were reassessed. Results: Both groups showed significant (P<0.05) within-group improvement in the knee pain levels and stiffness as reflected by NPRS and WOMAC index. Interpretation & conclusions: Patients of both the groups (A and B) were found to be improving significantly in pain and disability, group A patients receiving Maitland’s mobilization in combination with exercises were found to get more relief in pain and disability.
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Objective:To evaluate the effect of neuromuscular electrical stimulation (NMES) on muscle strength and duration of mechanical ventilation through cumulative Meta-analysis and sequential trial analysis (TSA).Methods:Randomized controlled trial (RCT) of NMES intervention in intensive care unit (ICU) patients with mechanical ventilation were searched from PubMed database of US National Library of Medicine, EMbase database of Netherlands Medical Abstract, Web of Science, SinoMed database of China, CNKI, Wanfang data, VIP and other Chinese and English databases from database construction to July 15, 2021. The control group received ICU routine nursing or rehabilitation exercise; the experimental group received NMES (low frequency electric current through electrode stimulation to make muscle groups twitch or contract) based on routine care in ICU. Relevant data were screened, evaluated and extracted by two researchers independently. After extracting data, STATA 15.0 and TSA software were used to analyze the data and evaluate the research results. Results:A total of 9 studies were enrolled, including 619 subjects. Among the 9 articles included, 2 were grade A and 7 were grade B, indicating good overall quality. Cumulative Meta-analysis showed that compared with ICU routine care, NMES improved muscle strength of patients undergoing mechanical ventilation [standardized mean difference ( SMD) = 0.64, 95% confidence interval (95% CI) was 0.07 to 1.21] and shortened the duration of mechanical ventilation ( SMD = -1.84, 95% CI was -2.58 to -1.10). TSA analysis of the two outcomes showed that the sample size of muscle strength outcome index ( n = 518) and mechanical ventilation outcome index ( n = 419) did not meet the expected information (RIS; n values of 618 and 685); the cumulative Z-value line of the muscle strength outcome index crossed the traditional boundary line and TSA boundary line, indicating that more tests were not needed to verify this result. In the outcome index of mechanical ventilation duration, it was found that the cumulative Z-value line only crossed the traditional boundary line, but did not cross the TSA boundary line, indicating that further studies in this area should be carried out in the future to demonstrate this result. Conclusion:NMES can improve ICU patients' muscle strength and reduce the duration of mechanical ventilation.
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Objective@#To evaluate the effect of high-intensity interval somatosensory training combined with neuromuscular acupoint electrical stimulation on blood glucose and motor function among patients with type 2 diabetes mellitus (T2DM), so as to provide insights into prevention of daily life disability among T2DM patients.@*Methods@#T2DM patients treated in Zhejiang Hospital during the period from January 2019 to October 2021 were enrolled and randomly assigned into four groups. Patients in the K group received Kinect somatosensory interaction technology-assisted high-intensity interval training, patients in the N group received neuromuscular acupoint electrical stimulation, and patients in the KN group received high-intensity interval somatosensory training combined with neuromuscular acupoint electrical stimulation, while patients in the C group were given no interventions. The 2 h postprandial plasma glucose and glycated haemoglobin (HbA1c) levels were measured prior to interventions and 4 and 12 weeks post-interventions, and seven physical fitness tests were performed. The blood glucose levels and motor activity were compared among four groups using generalized estimating equations to evaluate the effectiveness of interventions.@*Results@#Totally 199 T2DM patients were enrolled, including 51 patients in the KN group, 49 patients in the K group, 52 patients in the N group and 47 patients in the C group. There were no significant differences in gender, age, course of disease, duration of daily exercises, waist-to-hip ratio, vital capacity or maximal oxygen uptake among the four groups prior to interventions (all P>0.05). There were time-group interaction effects in blood glucose and exercise parameters among the four groups post-interventions (all P>0.05), with the largest changes seen in the KN group. The HbA1c, 2 h postprandial plasma glucose, 2.4 m standing and detour test and back scratch test results reduced by 17.06%, 27.01%, 36.52% and 20.94% 12 weeks post-interventions as compared to those prior to interventions, while 2 min stepping test, 30 s sit-ups, 30 s loading and elbow flexion test, 6 min walking test and sit and reach test results increased by 18.85%, 34.69%, 15.41%, 7.22% and 112.37%, respectively.@*Conclusion@#High-intensity interval somatosensory training combined with neuromuscular acupoint electrical stimulation may improve the blood glucose and motor activity among patients with T2DM.
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OBJECTIVE@#To observe the therapeutic effect of scalp-nape acupuncture for pharyngeal dysphagia of stroke at recovery stage on the basis of neuromuscular electrical stimulation (NMES) and rehabilitation training.@*METHODS@#A total of 42 patients with pharyngeal dysphagia of stroke at recovery stage were randomized into an observation group and a control group, 21 cases in each group. Conventional medical symptomatic treatment was given in both groups. NMES and rehabilitation training were adopted in the control group, 30 min for each one. On the basis of the treatment in the control group, scalp-nape acupuncture was given in the observation group, scalp acupuncture was applied at lower 2/5 of anterior and posterior oblique lines of parietal and temporal, nape acupuncture was applied at Fengchi (GB 20), Yiming (EX-HN 14), Gongxue (Extra), Zhiqiang (Extra), Tunyan (Extra), etc. The treatment was given once a day, 5 days a week for 3 weeks in both groups. Before and after treatment, the videofluoroscopic dysphagia scale (VDS) score, the Kubota water swallowing test grade, the functional oral intake scale (FOIS) grade and the swallowing quality of life (SWAL-QOL) score were observed in both groups.@*RESULTS@#After treatment, the VDS scores were decreased and the SWAL-QOL scores were increased compared before treatment (P<0.05), the Kubota water swallowing test grade and FOIS grade were improved compared before treatment (P<0.05) in both groups. The changes of VDS score and SWAL-QOL score, Kubota water swallowing test grade and FOIS grade in the observation group were superior to those in the control group (P<0.05).@*CONCLUSION@#Based on NMES and rehabilitation training, scalp-nape acupuncture can enhance the therapeutic effect on pharyngeal dysphagia of stroke at recovery stage, and improve the patients' swallowing function and quality of life.
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Humanos , Pontos de Acupuntura , Terapia por Acupuntura , Deglutição , Transtornos de Deglutição/terapia , Qualidade de Vida , Couro Cabeludo , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral , Resultado do Tratamento , ÁguaRESUMO
Background: Neuromuscular electrical stimulation (NMES) has been noted as an effective pre-conditioning intervention for an increase of the rate of development (RFD). However, it is unknown whether NMES increases muscle flexibility. Therefore, the purpose of this study was to investigate whether neuromuscular electrical stimulation (NMES) at 20% of maximal voluntary isometric contraction (MVIC) torque level for 5 seconds used as a warm-up is effective for improving the range of motion (ROM) following increased tolerance for muscle extensibility with/without alteration of the MTU stiffness. Methods and Results: Maximum ROM and ROM with standardized torque (30N) were measured in both legs in thirteen healthy males before and after NMES intervention at a 20% MVIC level for 5 seconds. The maximum ROM increased after intervention compared with before intervention on the NMES side, while it was not changed on the non-NMES side. In addition, there were no significant differences in the ROM with standardized torque in any measurements. Conclusion: It is concluded that NMES at 20% MVIC for 5 seconds could be effective for improving ROM following an increased tolerance for muscle extensibility without alteration of the MTU stiffness.
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Objective:1. To detect any change in the PTEN/Akt/FoxO1 signaling pathway in the muscles of rats with chronic hypoxia-hypercapnia treated using neuromuscular electrical stimulation (NMES), and 2. To document the role of chronic hypoxia-hypercapnia in inducing muscle atrophy.Methods:Thirty-two male Sprague-Dawley rats were randomly divided into a control group, a model group, a mock stimulation group, and an NMES group, each of eight. All of the rats in the model group, the mock stimulation group and the NMES group were placed in a hypoxia-hypercapnia chamber with a 9-11% O 2 and 5.5-6.5% CO 2 atmosphere for 8h per day and 7d per week, lasting 4 weeks. The control group were placed in a similar chamber with normal air. In the last 2 weeks, after the 8h in the chamber, the NMES group were given 30min of electrical stimulation at 100Hz to the calf muscles of their bound lower limbs. The mock stimulation group were only bound without any electrical stimulation. After the 4-week intervention, the gastrocnemius muscles were resected and their cross-sectional areas (CSAs) were observed using hematoxylin-eosin staining. Immunohistochemistry and western blotting were employed to detect the protein expression of phosphatase and tensin (PTEN), p-Akt, Akt and FoxO1. Results:Compared with the control group, a significant decrease was observed in the average CSA and in the expression of p-Akt and Akt in the model group, while a significant increase was found in the average protein expression of PTEN and FoxO1. Compared with the model group, there was a significant increase in the average CSA, as well as the average expression of p-Akt and Akt in the NMES group, but a significant decrease in the average expression of PTEN and FoxO1.Conclusion:Neuromuscular electrical stimulation can relieve muscle atrophy from chronic hypoxia-hypercapnia by inducing skeletal muscle protein synthesis through regulating the PTEN/Akt/FoxO1 signaling pathway, at least in rats.
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Objective:To evaluate the effect of lower limb neuromuscular electrical stimulation (NMES) on mechanical ventilation patients in intensive care unit (ICU).Methods:Databases including the Cochrane Library, PubMed, Web of Science, Embase, SinoMed, CNKI, VIP and Wanfang database were searched from inception to May 2021. Randomized controlled trails (RCT) about the influence of NMES of lower limbs in patients with mechanical ventilation in ICU were collected. Routine rehabilitation measures were implemented in the control group, while the combination of routine rehabilitation and NMES on the lower limbs was implemented in the observation group. The literature screening, data extracting, and bias risk assessment of included studies were conducted independently by two reviewers. RevMan 5.3 software was used to perform Meta-analysis. Funnel plot was used to test publication bias.Results:A total of 8 RCT were eventually enrolled. The literature quality evaluation results showed that 1 study was grade A and 7 studies were grade B, suggesting that the quality of the included literature was relatively high. The Meta-analysis results showed that NMES in the lower extremities could effectively shorten the duration of mechanical ventilation in ICU patients [standardized mean difference ( SMD) = -0.51, 95% confidence interval (95% CI) was -0.72 to -0.31, P < 0.000 01], increase the maximum inspiratory pressure [MIP; mean difference ( MD) = 14.19, 95% CI was 9.30 to 19.09, P < 0.000 01], and improve the functional status of critically ill patients [functional status score for ICU (FSS-ICU); MD = 10.44, 95% CI was 3.12 to 17.77, P = 0.005] with statistically significances. However, there were no significant advantages in increasing the Medical Research Council (MRC) score ( MD = 2.13, 95% CI was -1.38 to 5.63, P = 0.23), reducing ICU mortality [relative risk ( RR) = 0.80, 95% CI was 0.51 to 1.24, P = 0.31], shortening length of ICU stay ( MD = -0.54, 95% CI was -3.67 to 2.59, P = 0.74), and the combined effect was not statistically significant. Funnel plot based on the duration of mechanical ventilation showed that the distribution of included articles was basically symmetrical, and no publication bias was detected. Conclusions:NMES of the lower limbs can not only shorten the ventilation duration effectively, but also improve the MIP and functional status of mechanically ventilated patients in ICU. However, it has no significant effect on the MRC score, ICU mortality and length of ICU stay of patients with mechanical ventilation. In the future, high-quality, large sample size and multi-center RCT are needed to verify the effects of NMES.
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Background: Neuromuscular electrical stimulation (NMES) has been noted as an effective pre-conditioning intervention for an increase of the rate of development (RFD). However, it is unknown whether NMES increases muscle flexibility. Therefore, the purpose of this study was to investigate whether neuromuscular electrical stimulation (NMES) at 20% of maximal voluntary isometric contraction (MVIC) torque level for 5 seconds used as a warm-up is effective for improving the range of motion (ROM) following increased tolerance for muscle extensibility with/without alteration of the MTU stiffness. Methods and Results: Maximum ROM and ROM with standardized torque (30N) were measured in both legs in thirteen healthy males before and after NMES intervention at a 20% MVIC level for 5 seconds. The maximum ROM increased after intervention compared with before intervention on the NMES side, while it was not changed on the non-NMES side. In addition, there were no significant differences in the ROM with standardized torque in any measurements. Conclusion: It is concluded that NMES at 20% MVIC for 5 seconds could be effective for improving ROM following an increased tolerance for muscle extensibility without alteration of the MTU stiffness.
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Objective:To observe the effect of pelvic floor neuromuscular electrical stimulation (NMES) and sling exercise training (SET) on diastasis recti abdominis after parturition. Methods:From September to December, 2019, 90 patients with rectus abdominis separation > 2 cm and pelvic floor muscle strength above grade III were randomly divided into three groups, accepting simple pelvic floor NMES (group A), pelvic floor NMES and SET (group B), and simple SET (group C), respectively, for four weeks. The separation distance of rectus abdominis was measured before treatment, two weeks and four weeks after treatment, and four weeks follow-up. Results:The separation distance of rectus abdominis decreased in each group after treatment (F > 8.327, P < 0.01); and it was the least in group B (F > 8.327, P < 0.01), while the multiple comparison results showed that there was no significant difference between group A and group C (P > 0.05). Conclusion:Both pelvic floor NMES and SET can similarly relieve the diastasis recti abdominis after parturition, and it is more effective in combination.
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Background: Deep Venous Thrombosis (DVT) and subsequent Pulmonary Embolism (PE) are one of the mosteminent causes of preventable deaths in nosocomial settings. The prevalence is increasing and they have variableclinical presentations encountered in community settings as well as hospitalized patients requiring timely andobligatory prophylaxis. Objective: This study aims to review prophylactic measures for deep venousthrombosis/pulmonary embolism highlighting implemented pharmacologic and mechanical interventions, newerand yet investigational techniques such as neuromuscular electrical stimulation towards reducing prevalence ofvenous thromboembolism. Materials and Methods: A review of relevant articles published between the years of2000 to 2019 in English language was done using the databases of PubMed Pico, Google Scholar and Google,using the predetermined keywords. Conclusion: Venous thromboembolism prevalence is increasing and amongthe various available methods for thromboprophylaxis, pharmacologic approach is the most superior whichinvolves making use of either unfractioned or low molecular weight heparin although the most efficacious is lowmolecular weight heparin as evidenced by several meta-analyses. Anticoagulants have numerous side effectsleading to limitations of their use and in such situations, mechanical methods such as intermittent pneumaticcompression (most effective), graduated compression stockings, and venous foot pump scan can be used. Incircumstances where both medicines and mechanical approach become impractical, neuromuscular electricalstimulation can be implemented even though additional research is required to further elucidate its efficacy andimplications.
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OBJECTIVE: To study the efficacy of the neuromuscular electrical stimulation combined with swallowing training on the patients with swallowing dysfunction following acute cerebral infarction.Method Totally 100 patients with swallowing dysfunction following acute cerebral infarction were randomly divided into the experimental group(50 patients)and the control group(50 patients).The patients in the experimental group were treated with neuromuscular electrical stimulation combined with swallowing training,while the patients in the control group were treated with routine care and swallowing training.The improvement in swallowing function,complications,quality of life and prognosis were compared between the two groups after treatment.RESULTS: After treatment,the evaluation of drinking water test,SSA score and GUSS score in the experimental group and the control group were significantly improved compared with those before treatment(P<0.05),and the improvement of the experimental group was significantly better than that of the control group(P<0.05).The white blood cell count,CRP value,mRS score at 90 days,and the incidence of aspiration pneumonia and malnutrition in the experimental group were significantly lower than those in the control group(P<0.05),and the albumin,pre-albumin,total lymphocyte count and SWAL-QOL score at the time of discharge were significantly higher than those in the control group(P<0.05).CONCLUSION: Neuromuscular electrical stimulation combined with swallowing training has better effect than pure swallowing training in the patients with swallowing dysfunction due to acute cerebral infarction;the complication incidence is lower,the quality of life is higher,and the prognosis is better.
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Objective To explore the effect of applying surface neuromuscular electrical stimulation (NMES) on the functioning of the upper esophageal sphincter (UES) using the high-resolution solid-state manometry.Methods Seventeen healthy volunteers were selected and given sham stimulation (SS),superior and inferior hyoid stimulation (SIHS),superior hyoid stimulation (SHS) or inferior hyoid stimulation (IHS) at a frequency of 80 Hz and the maximum tolerated level before swallowing.Any changes in the kinematics or biomechanics during swallowing and at rest were recorded using high-resolution solid-state manometry.One-factor repeated analysis of the measurement variance was used.Results A significant decrease in the duration of UES relaxation was observed in response to the electrical stimulation (compared with the sham stimulation).The UES's residual pressure showed a rising trend during electrical stimulation,especially in response to IHS,but the difference compared with SS was not significant.The UES's resting pressure during SIHS increased significantly compared with SS,but there was no significant difference between SHS and IHS in this respect.Conclusions Surface neuromuscular electrical stimulation applied to the neck can immediately change the functioning of the UES.NMES at the maximum tolerated intensity can reduce the duration of UES relaxation,which is important for dysphagia therapy and research.
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Objective To evaluate the effect of transcutaneous neuromuscular electrical stimulation on prevention of intensive care unit-acquired weakness (ICU-AW) in chronic obstructive pulmonary disease (COPD) patients with mechanical ventilation. Methods A prospective randomized controlled study was conducted. Sixty COPD patients aged 18-85 years old who were accepted mechanical ventilation therapy admitted to general intensive care unit (ICU) of the First Affiliated Hospital of Hunan University of Medicine from October 2017 to October 2018 were enrolled. Patients were divided into control group (n = 30) and intervention group (n = 30) by random number table method. All patients were accepted routine treatment, and on this basis, the intervention group was applied transcutaneous neuromuscular electrical stimulation on the extremities (twice a day, 30 minutes each time) after 24 hours of admission until ICU discharge. The Medical Research Council muscle strength score (MRC-Score), grip strength, incidence of ICU-AW on the 7th day after admission and on the day of ICU discharge; modified Barthel index score on the day of ICU discharge; and duration of mechanical ventilation, the length of ICU stay, and the length of hospital stay were compared between the two groups. Results Twenty-nine and 27 patients in the control group and the intervention group respectively finally completed the study in dividually. There was no significant difference in gender, age, Barthel index score before 2 weeks of ICU admission, body mass index or acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) in ICU between the two groups. There was no significant difference in the MRC-Score, grip strength or incidence of ICU-AW on the 7th day after ICU admission between the two groups. Compared to the control group, the MRC-Score, grip strength and Barthel index score in the intervention group were significantly increased [MRC-Score: 55.97±8.43 vs. 46.32±7.36, grip strength (kg): 33.46±11.62 vs. 27.42±9.64, Barthel index score:46.04±5.46 vs. 42.13±3.32, all P < 0.05], the incidence rate of ICU-AW was significantly decreased [7.4% (2/27) vs. 31.0% (9/29), P < 0.05], and duration of mechanical ventilation, the length of ICU stay, the length of hospital stay were significantly shortened [duration of mechanical ventilation (days): 5.12±2.01 vs. 7.24±4.35, the length of ICU stay (days): 8.34±2.36 vs. 10.45±2.62, the length of hospital stay (days): 13.21±2.21 vs. 15.38±3.67, all P < 0.05]. Conclusion Transcutaneous neuromuscular electrical stimulation can effectively improve the muscle strength of COPD patients with mechanical ventilation and reduce the incidence of ICU-AW.
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OBJECTIVE: To observe the clinical efficacy of intradermal needle-embedding therapy in the treatment of dysphagia in stroke patients. METHODS: A total of 80 stroke patients with dysphagia were randomly divided into treatment group and control group (n ＝ 40 in each). The control group was treated with conventional medicines, neuromuscular electrical stimulation of the bilateral midlines of the neck and swallowing function training, and the treatment group treated by intradermal needle-embedding at Lianquan (CV 23), Jialianquan-point, Yifeng (TE 17), Ashi-point, etc. (once every other day for 20 days) on the basis of the treatments used in the control group. Swallowing function (0－10 points scaling, the bigger the better)and surface electromyography (sEMG) of the bilateral suprahyoid muscles and infrahyoid muscles in the relaxing, nothing swallowing and water-swallowing conditions were tested before and after the treatment. RESULTS: After treatment, the swallowing scores were significantly increased in both groups compared with those of their individual pre-treatment (P<0.05), suggesting an improvement of swallowing function. During relaxing, nothing swallowing and water-swallowing conditions, the peak amplitudes of sEMG were considerably increased in both groups relevant to those of their individual pre-treatment (P<0.05)．The swallowing function score, and maximum amplitudes of sEMG during relaxing, nothing swallowing and water-swallowing conditions were significantly higher in the treatment group than in the control group (P<0.05), suggesting a better efficacy of intradermal needle-embedding treatment. CONCLUSION: Intradermal needle-embedding can significantly improve the swallowing function of stroke patients with dysphagia.