PURPOSE: This study was conducted to investigate the effects of combined Joint Mobilization and Functional Electrical Stimulation on Muscle Activation and Mobility of ankle joints in stroke patients and their Modified Functional Reach Test (MFRT) results. METHODS: A total of 26 patients with stroke were randomly selected for enrollment in this study. (1) Functional Electrical Stimulation (FES) (2) combined Joint Mobilization and FES. An EMG system was used to measure tibialis anterior and gastrocnemius activities. Range Of Motion (ROM) of Ankle Joint and MFRT for Dynamic Balance. Pre and post intervention results were compared by paired-t-tests and differences in changes after intervention between groups were identified by the independent t-test. RESULTS: The muscle activation, ROM, and MFRT differed significantly in the experimental group (p<.05). The ROM was significantly different for the active dorsiflexion pre and post intervention in the group that received FES alone (p<.05). CONCLUSION: The results of this study suggest use of a systematic program of proactive posture control to prevent dysfunction when planning interventions for ankle joints can help stroke patients walk efficiently.
Skeletal muscle injury occurs frequently in sports medicine and is the most general form of injury followed by physical impact. There are growth factors which conduct proliferation, differentiation, and synthesis of myogenic prodromal cells and regulate vascular generation for the continued survival of myocytes. The purpose of the present study was to confirm the effects of electroacupuncture (EA) and electrical stimulation (ES) on muscle recovery processes according to vascular endothelial growth factor (VEGF) expression. Eighteen Sprague-Dawley rats were separated into 2 experimental groups and a controlled group. All animals had suffered from crush damage in the extensor digitorum longus for 30 seconds and were killed 1, 3, and 7 days after injury. 30 Hz and 1 mA impulsion for 15 minutes was applied to the EA experimental groups Zusanli (ST36) and Taichong (LR3) using electroacupuncture and the same stimulation was applied to the ES group using an electrical node. Hematoxyline-Eosin staining and VEGF immunohistochemistry were used to ascertain the resulting muscle recovery. There were few morphological differences between the EA and ES groups, and both groups were observed to have tendencies to decrease atrophy as time passed. In the controlled group, gradually diminishing atrophy could be observed, but their forms were mostly disheveled. There were few differences in VEGF expression between the EA and ES groups, and tendencies to have an increased quantity of VEGF with the lapse of time were observed in both groups. In the controlled group, a little VEGF expression could be observed merely 7 days after injury. In conclusion, EA and ES contributed to muscle recovery processes and could be used for the treatment of muscle injury.
The purpose of this study was to determine the effect of muscle fatigue by neuromuscular electrical stimulation(NMES). Using Biodex System 3PRO(Biodex Medical Systems Inc, USA), experiment was conducted as to the normal group(I) composed of fifteen adults and the patient group(II) composed of fifteen patients with spastic hemiplegia. As to each group, maximal tolerated intensity(MTI) and maximal tolerated isometric contraction(MTIC) in electric currents yielded by low rate(20 pps) and high rate(100 pps) neuromuscular electrical stimulation and the aspects of decrease and restoration of the isometric contraction were examined, and their strength decrement index(SDI) and strength recovery index(SRI) were also calculated. 1. As for MTI in NMES, the MTI of the group II was higher than that of the group I in both low rate and high rate NMES. In comparison within group, MTI of group II was significantly higher in high rate NMES rather than in low rate NMES(p<0.05). 2. In comparison of MTIC between groups, the group I showed higher in both low rate and high rate NMES. In comparison within group, MTIC of group II was significantly higher in high rate NMES rather than in low rate NMES(p<0.01). 3. As for SDI, both groups showed highest SDI in high rate NMES, but no significant differences could be observed. 4. As for SRI, both groups showed significantly low SRI in low rate NMES(p<0.01, p<0.05), and comparison between groups showed no significant differences could be observed. These result lead us to the conclusion that muscle fatigue was influenced by frequency, high rate NMES was lower at SDI and higher at SRI on compare to low rate NMES, therefor, a further studies concerning electrical stimulation should consider differences each frequency in response to treatment.
Purpose: The purpose of this study is to compare the kinematic motion of the first metatarsophalangeal (MTP) joint during an electrical stimulation of abductor hallucis (AbdH) muscle, between the normal group and the hallux valgus (HV) group. Methods: A total of twenty subjects (normal group=10 and HV group=10) participated in this study. The kinematic motions of first MTP joint was measured by using 3-dimensional motion analysis during an electrical stimulation in the sitting position. The intensity of an electrical stimulation was set to be tolerated in each subject, and the data of kinematic motions were collected in three trials of 5 seconds. An independent t-test was used to compare the angle of flexion and abduction of the first MTP joint and proximal phalanx in frontal plane, between the normal and HV groups. Results: Participants showed that the angle of flexion was significantly greater in the HV group ($13.12{\pm}10.61^{\circ}$), compared to that of the normal group ($10.17{\pm}2.31^{\circ}$); and the angle of abduction was significantly smaller in the HV group ($10.61{\pm}4.99^{\circ}$) than that of the normal group. Also, the angle of the proximal phalanx in frontal plane was significantly smaller, compared to the normal group ($53.42{\pm}10.70^{\circ}$) (p<0.05). Conclusion: These findings suggest that dysfunction of AbdH muscle is apparent in HV deformity and provide insight into potential risk factors for the development of HV deformity.
PURPOSE: This study examined the effects of integrating transcutaneous electrical nerve stimulation into treadmill gait training by applying functional electrical stimulation on the spasticity, balance, and gait ability of chronic stroke patients METHODS: Twenty participants were assigned randomly to two groups: the treadmill gait training group with applied functional electrical stimulation (FES) with integrated transcutaneous electricalstimulation (TENS) (experimental group, EG, n = 10) and the treadmill gait training group with FES (control group, CG, n = 10). Both groups received treadmill gait training with FES for 30 minutes a time, four times a week, during five weeks. The experimental group received additional TENS on their L3, L5, and S2 dermatome for 30 minutes before the interventions. The spasticity, balance, and gait ability were evaluated before and after the training to compare the intergroup and intragroup changes. RESULTS: Both groups showed significant improvements in the static, dynamic balance, and gait ability (p < .05), but did not show any significant changes in the muscle tone. The EG showed significant improvements in the static balance ability and gait cycle compared to the CG (p < .05). CONCLUSION: Treadmill gait training combined with FES with integrated TENS is an effective method for improving the static balance and gait cycle. On the other hand, the effects of treadmill gait training with FES on spasticity need to be studied further.
Low power laser and neuromuscular electrical stimulation have been utilized in many clinical applications for the treatment of musculoskeletal lesion. This study was to investigate the effects of low power He-Ne IR laser and neuromuscular electrical stimulation on the change of the serum biochemical components in experimentally induced muscle injured rats. The twenty Sprague-Dawley male rats were randomly assigned to the 4 groups: the normal group (n=5), the control group (n=5), the low power laser irradiation group (LLI) (n=5) and the neuromuscular electrical stimulation group (NMES) (n=5). The experimentally induced muscle injury was induced by the subcutaneous injection of a 0.1 ml Freund's Complete Adjuvant into the right hind paw and calf muscles in control, LLI and NMES groups. The LLI group was irradiated with He-Ne IR laser for 5 minutes every day during 10 days. Also, the NMES group was electrically stimulated 15 minutes every day during 10 days. The normal and control groups were not received with any therapeutic intervention. The authors performed tests which were the concentration of the serum biochemical components to detect the effects of therapeutic interventions. The results were as follows: 1. The level of the aspartate aminotransferase (AST) was significantly decreased in the LLI and NMES groups compare to the control group. 2. The level of the serum lactate dehydrogenase (LDH) was significantly decreased in the LLI and NMES groups compare to the control group. 3. The level of the serum creatine kinase (CK) was significantly decreased in the LLI and NMES groups compare to the control group. From the results, we could come to the conclusion that low power laser and neuromuscular electrical stimulation could be accelerating healing processes of skeletal muscle injury and further clinical work will be required.
Objective: The purpose of this study was determine the effect of Balance Trainer training with Transcutaneous Electrical Nerve Stimulation (TENS) on spasticity and balance in persons with chronic stroke. Design: Randomized controlled trial. Methods: A total of 30 subjects with hemiparetic stroke were recruited and randomly divided into the Balance Trainer training with TENS group (n=15) and Balance Trainer training with placebo TENS group (n=15). The Balance Trainer training with TENS group practiced additional Balance Trainer training with TENS for 30 minutes a day, 5 days per a week during 4 weeks and the Balance Trainer training with placebo TENS group practiced additional Balance Trainer training with placebo TENS for the same period. Spasticity and balance were assessed by ability (static balance, dynamic balance) and were measured before and after the 4-week programs. Results: The result of spasticity and dynamic balance were improved significantly in both groups (p<0.05). The Balance Trainer training with TENS group showed significantly greater improvement in spasticity of the gastrocnemius & dynamic balance, compared to the Balance Trainer training with placebo TENS group (p<0.05). The Balance trainer training with TENS group showed a significant improvement in static balance, especially during the eye-closed condition (p<0.05). Conclusions: The Balance Trainer training with TENS was effective in improving spasticity and balance in subjects with chronic stroke. Based on these results, it is suggested that Balance Trainer training with TENS could clinically be used more actively in conjunction with conventional physical therapy.
Objective: This study was conducted to investigate the effect of high-intensity laser therapy(HILT), transcutaneous electrical nerve stimulation(TENS), and ultrasound(US) treatment on pain, grip strength, and hand function in patients who had undergone carpal tunnel syndrome surgery. Design: A randomized controlled trial. Methods: Thirty patients who had undergone carpal tunnel syndrome surgery were randomly assigned to receive either TENS combined with HILT, US combined with HILT, or only HILT as the control group. Treatments were applied around the surgical site, and pre- and post-treatment changes were evaluated. Pain was assessed using NPRS, hand symptoms using CTS-6 and BCTQ-SSS, grip strength with an electronic dynamometer, and hand function using BCTQ-FSS. Treatments were administered seven times over two weeks. Results: The pain and symptoms were significantly reduced(p<0.05) and grip strength and hand function were significantly increased(p<0.05) after treatment compared to before treatment for all subjects. Pain was significantly reduced(p<0.05) and grip strength was significantly increased(p<0.05) in the TESN+HILT group and US+HILT group compared to the Control group. Hand symptoms were significantly reduced(p<0.05) and hand function significantly increased(p<0.05) in the TENS+HILT group compared to the Control group. Conclusions: TENS combined with HILT was found to be more effective than US combined with HILT in reducing pain and symptoms and improving grip strength and hand function in patients following carpal tunnel syndrome surgery. These findings suggest that these treatment modalities can be beneficially applied in clinical practice.
In human body, catecholamines, such as epinephrine and norepinephrine, can be increased anxiety, blood pressure and pain etc. The inhibitory effects of TENS, electroacupuncture and massage on the release of epinephrine, norepinephrine from sympathetic nerve endings has already been known. However, the effects of silver spike point stimulation on the catecholamines was not well understood. Therefore, the purpose of this study was to characterize the SSP-induced inhibitory effects of catecholamines. The following results were obtained. (1) The studies on urinary catecholamines released that the levels of epinephrine and norepinephrine of continue type SSP stimulation group were significantly lower than those in the control group in human in vivo. (2) The dose-response curves of epinephrine and norepinephrine in rat aortic smooth muscle strips were increased dose dependent manner respectively. However, the contractile response of norepinephrine in rat aortic smooth muscle strips were slightly differentiated. It is concluded that the SSP stimulation reflects to the inhibitory effects of epinephrine and norepinephrine in men. Especially, we believe that the amplitude-frequency modulation, such as continue type a)1d frequency modulation type, of SSP stimulation plays a role in regulating catecholamines.
Purpose: The purpose of this study was to investigate the therapeutic effect of non-invasive vagus nerve stimulation by transcutaneous electrical nerve stimulation application on the autonomic nervous system of human body. Methods: Participants were seventeen healthy adults. Standard deviation of all normal N-N intervals(SDNN), root mean square of successive differences(RMSSD), low frequency(LF), high frequency(HF) were compared in pre and post Mean values after intervention. Data were analyzed in Wilcoxon's signed-ranks test. Results: The results of this study is that sistolic blood pressure and pulse rate decreased mean value after non-invasive vagus nerve stimulation by transcutaneous electrical nerve stimulation. High frequency, low frequency, SDNN, RMSSD increased mean value in heart rate variability after intervention. But that is not significant except for SDNN. Conclusion: Non-invasive vagus stimulation by transcutaneous electrical nerve stimulation effect on parasympathetic nerve stimulation, and then it might be effective method for autonomic nerve balance control.
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