Effects of a full-body electrostimulation garment application in a cohort of subjects with cerebral palsy, multiple sclerosis, and stroke on upper motor neuron syndrome symptoms.

OBJECTIVES: Dysfunction of the central nervous system may inflict spastic movement disorder (SMD). Electrical stimuli were identified as promising therapeutic option. Electrical stimulation provided by a 58-electrode full body garment was investigated based on data from regular trial fittings. METHODS: Data from 72 testees were investigated. Age averages 36.6 (19.8) ys with 44 females. The cohort spans infantile cerebral paresis (CP) (n=29), multiple sclerosis (MS) (n=23) and stroke (n=20). Data were stratified by etiology and an entry BBS Score<45. RESULTS: Effect sizes (Cohen`s d) related BBS, TUG, FGA, 10mWT, WMFT, EQ5D5L and Pain. Significance levels are indicated by *: p<0.05, **: p<0.01, ***: p<0.001, (t): p<0.1: CP: 1.64***, 0.29*, 1.59***, 0.76(t), 1.00***, 0.5*, 1.28***; MS: 1.83***, 0.83***, 1.28**, 1.07***, 0.93*, 1,11**, 0.78*; Stroke: 1.28**, 0.78**, 0.89, 0.92**, 0.71, 1.26*, 0.78*. CONCLUSIONS: Multi-site transcutaneous electrical stimulation may increase ambulation related skills in subjects with SMD stemming from CP, MS and stroke. The results indicate effects on static and dynamic balance, fall risk, mobility, upper extremity improvement and an overall increase in health utility and a reduction in spasticity related pain. Effects are immediate as well as sustained. These results may inspire individual trial fittings and inform further controlled trials.

MRI findings of knee abnormalities in adolescent and adult volleyball players.

BACKGROUND: To longitudinally and cross-sectionally evaluate knee abnormalities by sex and age in adolescent and adult volleyball athletes over 2 years using magnetic resonance imaging (MRI). METHODS: Thirty-six high-level volleyball athletes (18 adolescents: 56% female, mean age 16.0 ± 0.8 years; and 18 adults: 50% female, mean age 46.8 ± 5.1 years) were imaged by MRI at BL and at 2-year follow-up (FU). Prevalence and severity of cartilage lesions, subarticular bone marrow lesions (BMLs), subarticular cysts, osteophytes, and ligament and meniscus integrity were evaluated by sex and by age cohort (adolescents and adults) using the whole-organ MRI score (WORMS). RESULTS: There were no significant longitudinal changes in any of the features within any of the sex or age groups. No significant differences were found in overall prevalence or severity of any of the features between males and females, although at FU, males had a significantly higher prevalence of osteophytes in the medial femorotibial joint (MFTJ) than females (p=0.044). Compared to adolescents, adult volleyball players had a significantly greater prevalence and severity of cartilage lesions (p<0.001 for both), BMLs (p=0.0153 and p=0.005), and osteophytes (p≤0.003 and p<0.001), and more severe meniscal lesions (p≤0.021). CONCLUSION: We found significant differences in the prevalence and severity of knee abnormalities between adolescent and adult volleyball players, but no overall differences by sex. These findings lay the groundwork for further investigations with larger cohorts and longer FU times to determine whether or not these knee abnormalities are associated with the development of OA.