Beneficial Effects of Pulsed Electromagnetic Field during Cast Immobilization in Patients with Distal Radius Fracture.

To assess whether pulsed electromagnetic field therapy during cast immobilization of distal radius fractures has beneficial effects on pain and limb function, the study included 52 patients (mean age 60.8 ± 15.0 years) with distal radius fractures treated with cast immobilization. Patients were allocated to a pulsed electromagnetic field group (n = 27) or a control group (n = 25). Pain; forearm and arm circumference; range of motion; disabilities of the arm, shoulder, and hand score; and touch sensation were evaluated on the day of the plaster cast dressing and 3 and 6 weeks after. In comparison to the control group, the pulsed electromagnetic field group reported significant changes after 3 and 6 weeks of treatment: lower pain levels (p=0.0052; p < 0.0001, respectively), greater mobility of upper-limb joints, improvement in exteroceptive sensation, and reduction in disability of the upper limb (disabilities of the arm, shoulder, and hand) (p=0.0003; p < 0.0001, respectively). Our results suggest that early addition of pulsed electromagnetic field treatment, during cast immobilization of distal radius fractures, has beneficial effects on the pain, exteroceptive sensation, range of motion, and daily functioning of patients.

Changes of motor unit contractile output during repeated activity.

The aim of the study was to evaluate changes in the motor unit output and to determine changes in the optimal stimulation frequency (i.e., giving the maximal output per one pulse) during prolonged contractile activity when, successively, potentiation of force and fatigue developed. The influence of these phenomena was studied on three types of motor units: fast fatigable (FF), fast resistant (FR) and slow (S) in the rat medial gastrocnemius muscle. The motor units were isolated by a method of splitting of L5 ventral root into very thin bundles of axons which were electrically stimulated 10 times with repeated series of 10 trains of stimuli at duration of 500 ms and progressively increasing (1-150 Hz) frequency. The initial (the first series of stimulating trains), potentiated (the second series), as well as fatigued (the tenths series) force recordings were compared. The motor unit output was expressed as the area under the force-time record in response to one stimulus measured at a plateau phase of the tetanic force. The stimulation frequency when the force-time area per one pulse was maximal was accepted as the optimal frequency. In fast motor units, the maximal contractile output increased with potentiation and was reduced with fatigue, and the optimal frequency decreased and increased, respectively. Nevertheless, the fusion degrees of the optimal tetanic contractions were similar in initial state, potentiation and fatigue independently of the changes in force. The applied stimulation protocol had almost no influence on the mechanical activity of slow motor units. The study highlights the physiological importance of force potentiation induced by preceding contractile activity for the economy of motor performance. The observed changes of the optimal stimulation frequency are consistent with the known changes in the motor unit firing rates during voluntary activity when the two phenomena develop.