• Journal of Biomedical Engineering Research
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• v.28 no.1
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• pp.29-35
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• 2007

This study was designed to investigate the feasibility to utilize the electromyogram (EMG) for estimating the muscle torque. The muscle torque estimation plays an important role in functional electrical stimulation because electrical stimulation causes muscles to fatigue much faster than voluntary contraction, and the stimulation intensity should then be modified to keep the muscle torque within the desired range. We employed the neural network method which was trained using the major EMG parameters and the corresponding knee extensor torque measured and extracted during isometric contractions. The experimental results suggested that (1) our neural network algorithm and protocol was feasible to be adopted in a real-time feedback control of the stimulation intensity, (2) the training data needed to cover the entire range of the measured value, (3) different amplitudes and frequencies made little difference to the estimation quality, and (4) a single input to the neural network led to a better estimation rather than a combination of two or three. Since this study was done under a limited contraction condition, the results need more experiments under many different contraction conditions, such as during walking, for justification.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.5 no.1
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• pp.33-43
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• 2007

This study divided 35 hemiplegia patients into control group having standard physical therapy and gait training and functional electrical stimulation(FES) group using FES during gait training in order to examine the effects of applying FES to ankle joint dorsiflexor on motor unit action potential. Stimulation conditions of FES were pulse rate 35 pps, pulse width $250{\mu}s$, and on-time 0.3 second, treatment hour was 30 min. and treatment period was once a day for five days a week through six weeks. For functional evaluations before and after treatment, root mean square(RMS) were measured and the following conclusions were obtained. : In RMS analysis of motor unit action potential, gastrocnemius was significantly reduced in both weight bearing(p<.001) and bearing condition (p<.05). In conclusion, application of FES to hemiplegia patients in recovery stage during gait training decreased RMS and it was interpreted that it was caused by mitigation of muscular spasticity by reduction of motor unit.

• Physical Therapy Rehabilitation Science
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• v.3 no.2
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• pp.112-118
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• 2014

Objective: The purpose of this study was to investigate the effects of an exercise with and without neuromuscular electrical stimulation (NMES) of the quadriceps femoris muscle, on strength, pain, and weight distribution in patients with knee instability post surgery. Design: Randomized controlled trial. Methods: Twenty patients in the early stage of rehabilitation after knee surgery were recruited as subjects and were randomly divided into either experimental group (exercise combined with NMES) (n=10) or control group (n=10). Both groups received strength training of the lower limb for 20 min/day, 5 days/week for 4 weeks. The experimental group used NMES for unilateral quadriceps femoris training with incremental increases in the intensity of isometric contraction over 4 weeks. Outcome measurements were assessed using the digital manual muscle testing, 30-chair stand test (30CST), numeric pain rating scale (NPRS) and weight distribution using the foot analyzer before and after 4 weeks of training. Results: After the 4-week intervention, knee extensor strength increased significantly in the experimental group post intervention (p<0.05), and there was a significant improvement in the experimental group compared with the control group (p<0.05). The 30CST and NPRS scores improved significantly in the experimental group compared to the control group (p<0.05), and there was a significant difference between the two groups (p<0.05). Weight distribution was significantly improved in the experimental group compared with the control group, (p<0.05), but there was no significant difference in improvement between the two groups. Conclusions: This study showed that NMES combined with strengthening exercises of the lower limbs is effective in improving lower limb pain and strength in patients with instability after knee surgery.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.125-135
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• 2019

PURPOSE: This study examined the effects of low frequency neuromuscular electrical stimulation (NMES) training on abdominal obesity in middle-aged women through electromyography and ultrasound. METHODS: Twenty-two middle aged women with abdominal obesity participated in the study. A low-frequency NMES device was used on the abdomen and waist of each subject for 20 minutes each (a total of 40 minutes) three times a week for eight weeks. The waist-hip ratio (WHR), weight and BMI (Body Mass Index) were measured. Electromyography (EMG) and ultrasound measurements were performed three times in total (pre-intervention, four weeks into the intervention, and eight weeks post-intervention) to examine the effects of low-frequency NMES on the abdominal muscle activity, muscle thickness, and subcutaneous fat. RESULTS: The results indicated a difference in the WHR and waist circumference before and after intervention (p<.05). The external oblique muscle (EO) showed a significant increase in muscle activity during all measurements taken post-intervention (p<.05). The abdominal subcutaneous fat thickness also showed a significant decrease between each measurement (p<.05). The test results showed that the abdominal subcutaneous fat thickness values taken eight weeks post-intervention were significantly lower than those taken pre-intervention and four weeks into the intervention (p<.05). CONCLUSION: These findings show that low-frequency NMES device training can be applied to middle-aged women with abdominal obesity to improve their body shape and exercise performance.

• Physical Therapy Korea
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• v.29 no.4
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• pp.269-273
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• 2022

Background: Neuromuscular electrical stimulation (NMES) is used for muscle strengthening. While voluntary muscle contraction follows Henneman et al.'s size principle, the NMES-induced muscle training disrespects the neurophysiology, which may lead to unwanted changes (i.e., declined balance ability). Objects: We examined how the balance was affected by abdominal muscle training with the NMES. Methods: Fifteen young adults (10 males and 5 females) aged between 21 and 30 received abdominal muscle strengthening with NMES for 23 minutes. Before and after the training, participants' balance was measured through one leg standing on a force plate with eyes open or closed. Outcome variables included mean distance (MDIST), root mean square distance (RDIST), total excursion (TOTEX), mean velocity (MVELO), and 95% confidence circle area (AREA) of center of pressure data. Two-way repeated measures analysis of variance was used to test if these outcome variables were associated with time (pre and post) and vision. Results: All outcome variables were not associated with time (p > 0.05). However, all outcome variables were associated with vision (p = 0.0001), and MVELO and TOTEX were 52.4% (45.5 mm/s versus 95.6 mm/s) and 52.4% (364.1 mm versus 764.5 mm) smaller, respectively, in eyes open than eyes closed (F = 55.8, p = 0.0005; F = 55.8, p = 0.0005). Furthermore, there was no interaction between time and vision (F = 0.024, p = 0.877). Conclusion: Despite the different neurophysiology of muscle contraction, abdominal muscle strengthening with NMES did not affect balance.

• The Journal of Korean Physical Therapy
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• v.24 no.6
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• pp.409-413
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• 2012

Purpose: Rehabilitative devices are used to enhance sensorimotor training protocols, for improvement of motor function in the hemiplegic limb of patients who have suffered a stroke. Sensorimotor integration feedback systems, included with these devices, are very good therapeutic frameworks. We applied this approach using electrical stimulation in stroke patients and examined whether a functional electric stimulation-assisted biofeedback therapy system could improve function of the upper extremity in chronic hemiplegia. Methods: A prototype biofeedback system was used by six subjects to perform a set of tasks with their affected upper extremity during a 30-minute session for 20 consecutive working days. When needed for a grasping or releasing movement of objects, the functional electrical stimulation (FES) stimulated the wrist and finger flexor or extensor and assisted the patients in grasping or releasing the objects. Kinematic data provided by the biofeedback system were acquired. In addition, clinical performance scales and activity of daily living skills were evaluated before and after application of a prototype biofeedback system. Results: Our findings revealed statistically significant gradual improvement in patients with stroke, in terms of kinematic and clinical performance during the treatment sessions, in terms of manual function test and the Purdue pegboard. However, no significant difference of the motor activity log was found. Conclusion: Hemiplegic upper extremity function of a small group of patients with chronic hemiparesis was improved through two weeks of training using the FES-assisted biofeedback system. Further research into the use of biofeedback systems for long-term clinical improvement will be needed.

• Journal of Fashion Business
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• v.26 no.4
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• pp.112-122
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• 2022

The purpose of this study is to investigate the effect of using socks combined with EMS on ankle pain reduction and ankle function improvement in home training participants. In this study, the conductive fabric was combined using socks that can properly compress the ankle. First, VAS was measured during EMS training after fatigue was induced and compared with fatigue during rest. It was confirmed that the level of VAS after EMS training was lower than after rest and fatigue. It was also confirmed that EMS training, which combines EMS with socks, was effective in reducing pain. The experimental action is a measurement action of WBLT and lying posture, and the situation before and after EMS training was compared by performing 30 minutes on the treadmill to cause delayed muscle pain during exercise. As a result of this study, it was found that pain reduction and ROM function were improved when electrical stimulation was performed using EMS socks. It was also confirmed that the application of electrical stimulation to EMS socks effected on ankle fatigue and function improvement. From the study results, it is expected that wearing socks equipped with EMS significantly reduces ankle injuries and improves functional recovery for home training participants.

• International Journal of Contents
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• v.7 no.4
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• pp.98-102
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• 2011

In this study, we investigated the effects of neuromuscular electrical stimulation (NMES) on the treatment of 20 acute stroke patients with dysphagia. For both the treated and control groups, the basic facial stimulation training was conducted for 30 minutes, five times a week, for four weeks. NMES was performed on the treated group only, for 30 minutes each time. Both groups were evaluated according to the functional dysphagia scale (FDS) using a videofluoroscopic swallowing study (VFSS). After the treatment was performed for four weeks, the FDS results of the treated group showed a significance difference in oral transit time in the oral phase and in the triggering of pharyngeal swallow fluid, laryngeal elevation and epiglottic closure, nasal penetration, residue in valleculae, coating of pharyngeal wall after swallow fluid, and pharyngeal transit time in the pharyngeal phase. In addition, the treated group showed a significant difference in laryngeal elevation and epiglottic closure, nasal penetration, and pharyngeal transit time in the pharyngeal phase after the treatment compared to the control group. The results of this study showed that neuromuscular electrical stimulation may be an effective method of treating dysphagia in acute phase stroke patients.

• Proceedings of the KOSOMBE Conference
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• v.1997 no.05
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• pp.179-183
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• 1997

The objective of this study was to develop an FES exercise protocol that can enhance muscle force and fatigue resistance and to evaluate the resulting effects. We investigated contraction and fatigue properties of vasti of 10 normal subjects and 4 paraplegics by applying different types of electrical stimulation. Based on the results, we have been training quadriceps of a male paraplegic patient. The results suggested that the exercise be applied 7 days a week, and confirmed that low frequency and intermittent stimulation delays fatigue. After the two-year FES exercise, the patient's knee extensor torque increased by about ten folds and the fatigue index decreased to half of the preFES value.

• Physical Therapy Rehabilitation Science
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• v.6 no.3
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• pp.127-133
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• 2017

Objective: The purpose of this study was to explore the effect of repetitive wrist extension task training with electromyography (EMG)-triggered neuromuscular electrical stimulation (NMES) for wrist extensor muscle recovery in patients with stroke. Design: Randomized controlled trial. Methods: Fifteen subjects who had suffered a stroke were randomly assigned to an EMG-triggered NMES group (n=8) or control group (n=7); subjects in both groups received conventional therapy as usual. Subjects in the experimental group received application of EMG-triggered NMES to the wrist extensor muscles for 20 minutes, twice per day, five days per week, for a period of four weeks, and were given a task to make a touch alarm go off by activity involving extension of their wrist. In the control group, subjects performed wrist self-exercises for the same duration and frequency as those in the experimental group. Outcome measures included muscle reaction time and spectrum analysis. Assessments were performed during the pre- and post-treatment periods. Results: In the EMG-triggered NMES group, faster muscle reaction time was observed, and median frequency also showed improvement, from 68.2 to 75.3 Hz, after training (p<0.05). Muscle reaction time was significantly faster, and median frequency was significantly higher in the experimental group than in the experimental group after training. Conclusions: EMG-triggered NMES is beneficial for patients with hemiparetic stroke in recovery of upper extremity function.