Objective: The aim of this review is to explore the latest intervention trends and effects of EMG-triggered functional electrical stimulation on the upper extremity functions in stroke patients. Design: Systematic review on clinical trials. Methods: A systematic literature search was performed to identify clinical trials evaluating the effects of EMG-triggered functional electrical stimulation (EMG-FES) and task-oriented EMG-triggered FES on the hand functions in stroke patients. Literature review was conducted with the following key words: hand function, functional electrical stimulation, task-oriented, stroke. Results: Ten clinical trials were included; 8 of them were randomized controlled trial, 1 was block-randomized, and 1 was a pre-post comparison study. A positive effect of electrical stimulation was reported in the patient groups that were treated with functional electrical stimulation combined with specific tasks, and volitional muscle contraction-triggered stimulation that was synchronized with tasks. Motor capabilities of the hand and arm were improved after the rehabilitation. Conclusions: EMG-triggered electrical stimulation may be more effective than non-triggered electrical stimulation in facilitating the hand functions in stroke patients in terms of muscle strength and voluntary muscle contraction of the paretic hand and arm. Triggered electrical stimulation can be even more effective when it is combined with specific tasks.
This study was carried out to determine the influencing of electrical stimulation to cervicothoracic sympathetic ganglion(CTSG; stellate ganglion) u the sympathetic tone. For the purpose of this study. the stimulation was given to both the interferential current stimulation(ICS: AMF 100Hz) group consisting of 10 person(males 8, females 2) and the transcutaneous nerve electrical stimulation(TENS: 100 Hz) group of 10(males 7, females 3) in the right side of the trachea with probe electrodes. Then. the temperature changes on the surfaces of the forehead. cheek, neck and internal ear of cephalocervix, which is subject to the influence of the cervicothoracic sympathetic ganglion, and the palm. which is the end of the upper limbs. measured before. immediately alter. 10 minutes after and 20 minutes after experiment. The results are summarized as follows. 1. The emergence of remarkable Horner's symptoms which appear due to the changes of the tone of cervicothoracic sympathetic ganglion was not seen. However, in the interferential current stimulation group there were two felt the sense of warmth in the facial region and one person who felt it in the upper limbs, and in the transcutaneous nerve electrical stimulation group there was each one person who felt the sense of warmth in the facial region and in the upper limbs, respectively. Both groups have each one person who felt the sense of oppression in the eyelids. Three persons of the interferential current stimulation group and two persons of the transcutaneous nerve electrical stimulation group have the sense of hoarse voice or numbness in the neck. These are the symptoms that appeared during stimulation, so it is difficult for them to be considered as the direct effects of the changes of the tone of cervicothoracic sympathetic ganglion. 2. The t-test was performed to determine the significance between the right, which is the experimental side, and the left, which is the non-experimental side. Significance between the right, which is the experimental side, and the left, which is the non-experimental side. Significant changes were seen in the necks of the interferential current stimulation group and in the cheeks and internal ears of the transcutaneous nerve electrical stimulation immediately after experiment(P<.05). And the interferential current stimulation group showed a very high significance in the cheeks immediately after experiment and in the necks ten minutes after experiment(p<.01). Therefore, it could be seen that the electrical stimulation had an influencing on the changes of body temperature of the cephalocervix. 3. In both the interferential current stimulation group and the transcutaneous nerve electrical stimulation group, the forecheads, checks and necks of the cephalocervix in the experimental side(right) rather than the non-experimental side(left) had mostly a statistically significant rise in temperature immediately after experiment. The one-way ANOVA was carried out to determine the temperature change of on the surface of the body with the lapse of time; before, immediately after, ten minutes after and tewenty minutes after experiment. But no statistical significance was found from both the right and left sides.
Prior studies have revealed that several stimulation to the muscle have released serum myoglobin into the blood vessel and increased aldolase activity. The present authors carried out a study which effect of electrical stimulation treatment (induced a isotonic wrist exerceise) on serum myoglobin(Mb) levels and aldolase(Al) activity were investigated in 6 healthy female. There were four groups of female: 1. no electrical stimulation control: 2. electrical stimulation 10min (EST10'); 3. electrical stimulation 20 min (EST20'); 4. electrical stimulation 30min (EST30'). Each groups is all the same one. Radioimmunoassay and Ultraviolet Spectrophotometry were performed to increased or decreased of serum myoglobin and aldolase. Serum myoglobin significantly increased in electrical stimulated groups[EST10' $(30.20{\pm}5.27ng/ml)$, EST20'$(31.65{\pm}3.96ng/ml)$, EST30'$(31.95{\pm}2.0ng/ml)$] to be compared with control group$(24.43{\pm}2.20ng/ml)$. Aldolase significantly increased in electrical stimulated groups [EST10' ($6.85{\pm}1.17$ Sigma U/mL), EST20'($6.70{\pm}1.46$ Sigma U/mL), EST30'($6.56{\pm}1.01$ Sigma U/mL)) to be compared with control group($5.03{\pm}1.86$ Sigma U/mL). The results of this study show that isotonic exercise result in electrical stimulation treatment increased serum myoglobin content and aldolase activity. In conclusion, our results support that stimulation release serum myoglobin and increase aldolase activity.
This study was designed to evaluate the analgesic effect of low power GaAsAl laser on the pain threshold of mechanical stimulation using different treatment points, acupuncture point (zusanli) and non-acupuncture points(back). Furthermore, we investigated the analgesic effect of low power GaAsAl laser using the different duration and intensity of laser in mechanical stimulation induced pain behavior. The results were summarized as follows: 1. The threshold of mechanical stimulation was significantly increased by GaAsAl laser stimulation into zusanli point after 15 and 30 min after laser stimulation(P<05). However, the laser stimulation into non-acupoint did not affect the pain threshold of mechanical stimulation. with dose dependent manner. 2. In order to investigate the analgesic effects of BV depending upon different intensities of laser stimulation, the experimental animals were divided into three groups: 3 mW treated group, 6 mW treated group and 10 mW treated group. The low power GaAsAl laser stimulation was applied into zusanli acupoint for 30 min with different intensity of laser stimulation. Six and ten mW of laser stimulation significantly increased the pain threshold of mechanical stimulation at 15 min after laser stimulation as compared to that of control group(P<.05). Moreover, the analgesic effect of 10 mW laser stimulation was maintained for 30 min after laser stimulation (P<.05). 3. Finally, we tested the analgesic effect of 10 mW laser stimulation using different duration such as 10 min, 30 min or 1 hr after application of mechanical stimulation. In 30 min treatment group, the pain threshold of mechanical stimulation was increased at 15min and 30min after laser stimulation(P<.05). However, laser stimulation for 60 min dramatically increased the pain threshold of mechanical stimulation at 0 min after laser stimulation and the analgesic effect of laser stimulation was observed until 1 hr after laser stimulation. In conclusion, these data apparently demonstrate that low power GaAsAl laser has analgesic effect on mechanical induced pain model in rats. In addition, the treated point, intensity and duration of laser stimulation should be concerned before clinical application for pain management purpose.
The experiments were designated to evaluate the anti-nociceptive effect of low power laser stimulation on acupoint or non-acupoint using arthrogenic solution induced poly arthritis animal model. Evaluation of potential antinociceptive effect of low power laser on arthritis has employed measurements of the foot bending test, the development of either thermal or mechanical hyperalgesia following the arthritis induction. The analysis of thermal hyperalgesia includes Hargreaves's method. Randall-Sellitto test was utilized for evaluating mechanical hyperalgesia. In addition, the antinociceptive effect of low power laser stimulation on arthritis induced spinal Fos expression was analyzed using a computerized image analysis system. The results were summerized as follows: 1. In laser stimulation on acupoint treated animal, laser stimulation dramatically inhibited the development of pain in foot bending test as compared to those of non acupoint treated animal group and non treated animal group. 2. The threshold of thermal stimulation was significantly increased by low power laser stimulation on acupoint as compared to that of non treated control group. 3. Laser stimulation on acupoint dramatically attenuated the development of mechanical hyperalgesia as compared to that of non treated group. 4. Low power laser stimulation on acupoint significantly suppressed arthritis induced Fos expression in the lumbar spinal cord at 3 week post arthritis induction. In conclusion, the results of the present study demonstrated that low power laser stimulation on acupoint has potent anti-nociceptive effect on arthritis. Additional supporting data for an antinociceptive effect of laser stimulation was obtained using Fos immunohistochemical analysis on spinal cord section. Those data indicated that laser stimulation induced antinociception was mediated by suppression of spinal neuron activity in pain sensation.
Purpose: This study was conducted to determine how stimulation using Russian current changes isokinetic exercise performance of quadriceps muscle and its antagonist muscles. Methods: Subjects were 20 20-year-old healthy adults who were instructed in the flexion to extension of knees in angular velocity $60^{\circ}/sec$ and $180^{\circ}/sec$ using a Biodex (Biodex system 3). We measured the difference in muscle performance between the Russian current stimulated at the same time during the flexion to extension of knees and not stimulated. Results: The results showed that when Russian current stimulation was applied at the angular velocity $60^{\circ}/sec$, the flexed and extended muscles and the angular velocity $180^{\circ}/sec$ increased significantly, but the peak torque of flexing muscles at the angular velocity $180^{\circ}/sec$ did not increase. Conclusion: These findings suggest that Russian current stimulation with isokinetic exercise of the knee joint could affect the quadriceps muscle and its antagonist muscle performance of muscle strength and endurance.
The purpose of this study was to determine whether vasodilation occurs when interferential current is applied to the cervical sympathetic chain and peripheral sympathetic nerves. A digital thermometer was used to record skin temperature change. The protocols used for interferential stimulation were 90-100 Hz, applied for 20 minutes via two pairs of electrodes 1) to the throat and 2) to the forearm. Forty subjects were stimulated at each of the two sites. There was no significant correlation between inital skin temperature, sex or age and temperature change. Even though there was a statistically significant temperature increase with cervical sympathetic chain stimulation, this had no clinical vasodilatory effect. More research on interferential current stimulation is needed so that the potential benefits to normal subjects and patients is better understood.
Purpose : This study investigated the effects of osteoarthritis therapy using images and histological diagnosis after microcurrents were applied to osteoarthritic rats. Methods : Osteoarthritis was induced with a mixture of 2% carrageenan and 2% kaolin. The mixture (0.1 $m{\ell}$) was injected into the knee joints of rats. Osteoarthritis with articulation received microcurrent stimulation for four weeks (15 min/day, 5 days/week): treated with pulsation frequency of 5 pps and a stimulation intensity of 25 ${\mu}A$. Results : Osteoarthritis of the control group constantly changed. The group with a stimulation intensity of 25 ${\mu}A$ applied to the surface of the articular cartilage experienced near normal recovery according to image diagnosis. The result of histological and immunohistochemistry inspection confirms that microcurrent stimulation had a positive effect on the treatment of osteoarthritis. Conclusion : The differences among images and histological diagnoses show that steoarthritis will experience constant progression from stimulation.
Purpose : The purpose of this study was to analysis the effect of electrical stimulation for dysphagia caused by cerebral infarction. Methods : We recruited nineteen adults after cerebral infarction(14 male, 5 female; mean age, 69y) for our study. Electrical stimulation was used for participants with electrical stimulator connected to two pair of electrodes positioned on the neck for one hour a day and 5 times a week for 4 weeks. Maximum tolerated stimulation levels were applied at rest while participants held their mouth closed. Videofluoroscopic recordings, physical examination of swallowing, and swallow function score were used to evaluate swallowing state of participants. All evaluate items were evaluated before and after treatment. Results : There was no significance difference of swallowing stage. The swallow function score significantly increased from 1.8 to 5.3(p<0.001). Also, cough reflex(p<0.001), laryngeal excursion(p<0.01) were significantly reduced compared to before electrical stimulation. Conclusion : Therefore, electrical stimulation for dysphasia is proved effective as it activates the function of swallowing muscle.
The purpose of this study was to determine whether percutaneous interferential current stimulation on thoracic sympathetic ganglia with amplitude modulated frequency (AMF) $90\~100$ bps and subthreshold of muscle contraction for 10 minutes on peripheral blood flow velocity in healthy subjects. Thirty-seven healthy volunteers were assigned randomly into an experimental group (n=25) and a control group (n=12). the experimental group received interferential current stimulation with subthreshold of the muscle contraction of current at AMF $90\~100$ bps on $1st\~5th$ thoracic sympathetic ganglial region for 10 minutes. The control group received same handling and electode placement, but no current was applied. Using a Doppler blood flow meter, the radial arterial blood flow velocities and the pulse raters were determined for two-way analysis of variance for repeated measures on time and group. There were no significant difference between the two groups with respect to the changes in arterial blood flow velocity and pulse rate over the four measurement times. Interferential current stimulation did not change in mean blood flow velocity and pulse rate. We conclude that interferential current stimulation on the thoracic sympathetic ganglia, as used in this study, did not dilate peripheral artery. This results suggests that interferential current stimulation dose not alter the activtiy of sympathetic nerve.
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