ABSTRACT
COVID-19 produces persistent and prolonged effects, also in the motor function, and its rehabilitation is often complex and challenging. Electrical stimulation (ES) could have an important impact in the rehabilitation of persons with COVID-19. Neuromuscular electrical stimulation (NMES) and functional electrical stimulation (FES) have been proposed as alternatives for motor function rehabilitation in persons with COVID-19. The aim of this study was to systematically review the articles published to date dealing therapeutic effects of NMES and FES in the motor rehabilitation of people with COVID-19. A systematic search of electronic databases was conducted, and articles related to the use of electrical stimulation in persons with COVID-19 for motor recovery were included. A total of 53 citations were found, of which 11 were eligible for inclusion. Considering the action mechanism of ES, and its effectiveness in similar cases, it could be an effective technique for the rehabilitation of motor function in persons with COVID-19. However, it is necessary to carry out clinical trials to confirm this hypothesis. In addition, FES, and more specifically FES cycling, could have additional beneficial effects over NMES.
ABSTRACT
The proceedings contain 53 papers. The topics discussed include: evoked sensations with sinusoidal transcutaneous electrical stimulation at different frequencies;IMU triggered FES for robotic gait training;trans-spinal electrical stimulation for improving trunk and sitting function in tetraplegics with cervical cord injury;a combined approach to CNS excitation for hand rehabilitation: a case study using spinal stimulation and BCI;analysis of the movements generated by a multi-field FES device for upper extremity rehabilitation;and neuromuscular and functional electrical stimulation for motor recovery after COVID-19: systematic review.
ABSTRACT
Heart failure (HF) is a chronic, progressive, and inexorable syndrome affecting worldwide billion of patients (equally distributed among men and women), with prevalence estimate of 1–3% in developed countries. HF leads to enormous direct and indirect costs, and because of ageing population, the total number of HF patients keep rising, approximately 10% in patients >65 years old. Exercise training (ET) is widely recognized as an evidence-based adjunct treatment modality for patients with HF, and growing evidence is emerging among elderly patients with HF. We used relevant data from literature search (PubMed, Medline, EMBASE) highlighting the epidemiology of HF; focusing on central and peripheral mechanisms underlying the beneficial effect of ET in HF patients; and on frail HF elderly patients undergoing ET. Since many Countries ordered a lockdown in early stages pandemic trying to limit infections, COVID-19 pandemic, and its limitation to exercise-based cardiac rehabilitation operativity was also discussed. ET exerts both central and peripheral adaptations that clinically translate into anti-remodeling effects, increased functional capacity and reduced morbidity and mortality. Ideally, ET programs should be prescribed in a patient-tailored approach, particularly in frail elderly patients with HF. In conclusion, given the complexity of HF syndrome, combining, and tailoring different ET modalities is mandatory. A procedural algorithm according to patient’s baseline clinical characteristics [i.e., functional capacity, comorbidity, frailty status (muscle strength, balance, usual daily activities, hearing and vision impairment, sarcopenia, and inability to actively exercise), logistics, individual preferences and goals] has been proposed. Increasing long-term adherence and reaching the frailest patients are challenging goals for future initiatives in the field.
ABSTRACT
The available data from electroneurography (ENG) studies on the transmission of neural impulses in the motor fibers of upper and lower extremity nerves following neuromuscular functional electrical stimulation (NMFES) combined with kinesiotherapy in post-stroke patients during sixty-day observation do not provide convincing results. This study aims to compare the effectiveness of an NMFES of antagonistic muscle groups at the wrist and ankle and kinesiotherapy based mainly on proprioceptive neuromuscular facilitation (PNF). An ENG was performed once in a group of 60 healthy volunteers and three times in 120 patients after stroke (T0, up to 7 days after the incident; T1, after 21 days of treatment; and T2, after 60 days of treatment); 60 subjects received personalized NMFES and PNF treatment (NMFES+K), while the other 60 received only PNF (K). An ENG studied peripheral (M-wave recordings), C8 and L5 ventral root (F-wave recordings) neural impulse transmission in the peroneal and the ulnar nerves on the hemiparetic side. Both groups statistically differed in their amplitudes of M-wave recording parameters after peroneal nerve stimulation performed at T0 and T2 compared with the control group. After 60 days of treatment, only the patients from the NMFES+K group showed significant improvement in M-wave recordings. The application of the proposed NMFES electrostimulation algorithm combined with PNF improved the peripheral neural transmission in peroneal but not ulnar motor nerve fibers in patients after ischemic stroke. Combined kinesiotherapy and safe, personalized, controlled electrotherapy after stroke give better results than kinesiotherapy alone.