• The Journal of Korean Physical Therapy
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• v.33 no.1
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• pp.28-33
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• 2021

Purpose: This study examined the effects of heel raise exercises combined with neuromuscular electrical stimulation (NMES) on the muscle strength and postural control ability of subjects with functional ankle instability (FAI). Methods: Twenty-two subjects with FAI participated in this study. They were assigned randomly to two groups: 11 each in the NMES and the sham-NMES groups. Heel raise exercise was applied, and NMES electrodes were attached to the peroneus longus muscles. The NMES group applied NMES during the heel raise exercise. NMES was applied for 20 minutes during the heel raise exercise. The heel raise exercise was performed four times a week for five weeks. The muscle strength and balance error scoring system (BESS) were measured before and after the intervention. Results: A comparison of before and after the intervention within the groups revealed improved muscle strength in the NMES and Sham-NMES groups, but the BESS was improved under all conditions only in the NMES group. The Sham-NMES group showed no improvement in the unstable support surface. Furthermore, when comparing the amount of change before and after the intervention between the groups, there were significant differences in the total score and unstable support in the BESS and muscle strength. Conclusion: NMES had a positive effect on the functional activities of the functional ankle instability subjects, such as balancing on an unstable support surface during postural control and increasing muscle strength.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.2 no.2
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• pp.1-12
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• 2004

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.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.2 no.3
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• pp.25-35
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• 2004

The purpose of this study was compared to MTICs(maximal tolerated isometric contraction), decrement and recovery. For this, using isokinetic exercise analysis device(Biodex Medical Systems Inc., Biodex System 3PRO, USA), low rate(20 Hz) and high rate(100 Hz) NMES(neuromuscular electrical stimulation) were applied to the quadriceps muscles of fifteen patients with spastic hemiplegia caused by lesions in the central nervous system. The results were as follows: 1. It was shown to fast decrement in the middle of phase at low rate NMES and to slow decrement of MTIC response at high rate NMES(p<.01). 2. It was shown to fast recovery at high rate NMES and to slow recovery at low rate NMES in recovery tendency of MTIC(p<.01). These conclusions suggest that NMES of high rate caused to slow fatigue and fast recovery different from low rate NMES.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.1 no.1
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• pp.31-43
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• 2003

The present studies are designed to determine whether the NMES can affect the muscle atrophy in rats following administration of steroid. Rats were divided into four groups: 1) Control group treated with administration of distilled water. 2) The group treated with administration of steroid. 3) The group treated with NMES once a day after adminstration of steroid. 4) The group treated with NMES twice a day after administration of steroid. The muscle atrophy was induced by one week administration of dexamethasone once a day by 3 mg/kg. The change in the structure of muscle fiber and the amount. of myofibril protein and gastrocnemius were determined after every week dissection of the tissues. The results were as follows; 1. The administration of steroid significantly affected the decrease in the weight, but NMES did not affect the inhibition of decrease in the weight. 2. The weight of gastrocnemius in the group once treated with NMES was changed two weeks later; similarly in the group twice treated with NMES significantly did two or three weeks later. These indicated that NMES affected the muscular activation of gastrocnemius(p<.05). 3. The changes in the amount of gastrocnemius protein by NMES might, indicate that NMES activated the capacity of synthesis of muscle fiber protein(p<.05).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.2
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• pp.120-127
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• 2011

Purpose: This study was designed to examine whether the use of neuromuscular electrical stimulation (NMES) after mandibular distraction osteogenesis accelerated bone formation and consolidation. Methods: Eight adult dogs underwent mandibular left body osteotomy. After a 3 day latency period, a distraction rod device was activated at a rate of 1.0 mm once per day for 10 days. After the completion of mandibular lengthening, NMES group was treated twice daily with 2 hours of NMES for 14, and 28 days, while non-NMES group did not receive NMES. The distracted segment was evaluated radiolgraphically histologically and than immunohistochemically for osteopontin (OPN) to evaluate new bone formation and consolidation. Results: Radiography, did not demonstrate significantly different images between the group and the NMES group. Histological examination however, showed that the new bone formation 14 and 28 days after distraction was better in the NMES group when compared to non-NMES group. Immunohistochemical analysis demonstrated that the staining intensity of OPN increased more in the NMES group than in non-NMES group during early consolidation. Conclusion: The results of this study demonstrated that the use of NMES can promote bone formation and consolidation.

• Journal of Acupuncture Research
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• v.17 no.2
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• pp.209-220
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• 2000

Spasticity, an abnormal increase in resting muscle tone, is one of the most common symptoms of stroke, and its management is becoming a major issue in rehabilitation. The aims of this study are to determine the effects of electroacupuncture(EA), TENS and neuromuscular electric stimulation(NMES) on spasticity, as well as the possibility of tissue comliance method as a spasticity scale. 45 stroke patients participated in a study of the effects on hemiplegic spasticity of EA, TENS and NMES. Spasticity was measured by modified Ashworth scale on the upper extremity and tissue compliance measurement, penetration mm/kg, on Susamni(LI10) area at just before and after stimulation, and 30 minutes, 1 hour, 2 hours and 24 hours after stimulation. The acupuncture points were applied to Kokchi(LI11), Susamni(LI10), Hapkok(LI4) and Oegwan(TE5) of the affected limb. The electrodes were placed unilaterally on LI11 to LI10 and TE5 to LI4. EA with biphasic wave, 60Hz, 0.4 msec pulse duration and low intensity was applied continuously for 20 minutes. TENS with high frequency, low intensity was applied. NMES was applied with spasticity program for 20 minutes. Each electric stimulation was done on extensor muscles group of forearm for 20 minutes. EA and NMES groups were found to produce a statistically significant decrease(p〈0.05) of spasticity and these effects lasted up to 30 minutes after stimulation. There was no definite correlation between the modified Ashworth scale and tissue compliance measurement. But tissure compliance method was found to be possible as a quantitative measurement on spasticity. There was no significant correlation between the effects of EA and NMES and the characteristics of patient, but significant correlation between the effects of EA and NMES and the modified Ashworth scale.

• Journal of Preventive Medicine and Public Health
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• v.52 no.4
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• pp.250-257
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• 2019

Objectives: Flatfoot, or low medial longitudinal arch, contributes to back and lower extremity injuries and is caused by weak abductor hallucis (AbdH) muscles. The purpose of this study was to investigate the effects of short foot exercise (SFE) alone or with neuromuscular electrical stimulation (NMES) on navicular height, the cross-sectional area (CSA) of the AbdH muscle, and AbdH muscle activity in flexible flatfoot. Methods: Thirty-six otherwise healthy people with flexible flatfoot were randomly assigned to a group that received SFE with placebo NMES treatment (the control group) or a group that received both SFE and NMES treatment (the experimental group). Each group received 4 weeks of treatment (SFE alone or SFE with NMES). Navicular height, the CSA of the AbdH muscle, and AbdH muscle activity were assessed before and after the intervention. Results: No significant differences were found in navicular height or the CSA of the AbdH muscle between the control and experimental groups, while AbdH muscle activity showed a statistically significant difference between the groups ($SFE=73.9{\pm}11.0%$ of maximal voluntary isometric contraction [MVIC]; SFE with $NMES=81.4{\pm}8.3%$ of MVIC; p<0.05). Moreover, the CSA of the AbdH muscle showed a statistically significant increase after treatment in the SFE with NMES group ($pre-treatment=218.6{\pm}53.2mm^2$ ; $post-treatment=256.9{\pm}70.5mm^2$ ; p<0.05). Conclusions: SFE with NMES was more effective than SFE alone in increasing AbdH muscle activity. Therefore, SFE with NMES should be recommended to correct or prevent abnormalities in people with flexible flatfoot by a physiotherapist or medical care team.

• Physical Therapy Korea
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• v.29 no.3
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• pp.187-193
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• 2022

Background: Neuromuscular electrical stimulation (NMES) is a physical modality used to activate skeletal muscles for strengthening. While voluntary muscle contraction (VMC) follows the progressive recruitment of motor units in order of size from small to large, NMES-induced muscle contraction occurs in a nonselective and synchronous pattern. Therefore, the outcome of muscle strengthening training using NMES-induced versus voluntary contraction might be different, which might affect balance performance. Objects: We examined how the NMES training affected balance and proprioception. Methods: Forty-four young adults were randomly assigned to NMES and VMC group. All participants performed one-leg standing on a force plate and sat on the Biodex (Biodex R Corp.) to measure balance and ankle proprioception, respectively. All measures were conducted before and after a training session. In NMES group, electric pads were placed on the tibialis anterior, gastrocnemius, and soleus muscles for 20 minutes. In VMC group, co-contraction of the three muscles was conducted. Outcome variables included mean distance, root mean square distance, total excursion, mean velocity, 95% confidence circle area acquired from the center of pressure data, and absolute error of dorsi/plantarflexion. Results: None of outcome variables were associated with group (p > 0.35). However, all but plantarflexion error was associated with time (p < 0.02), and the area and mean velocity were 37.0% and 18.6% lower in post than pre in NMES group, respectively, and 48.9% and 16.7% lower in post than pre in VMC group, respectively. Conclusion: Despite different physiology underlying the NMES-induced versus VMC, both training methods improved balance and ankle joint proprioception.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.1 no.1
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• pp.57-72
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• 2003

This study conducts electrical stimulation to male white rat of Spargue-Dawley which is 7 weeks, has the weight of 240 g and is seemingly healthy for one or two weeks by means of neuromuscular electrical stimulator in order to examine the effects of neuromuscular electrical stimulation on its gastrocnemius, measures change of weight of gastrocnemius, serum and enzyme activity and then obtains the following conclusions. There is little difference in AST and CPK of weight and serum of gastrocnemius after one or two weeks of conducting neuromuscular electrical stimulation in all experimental groups. On the one hand, as a result of histochemical observation, NMES I group showed hypertrophy of perimysium and increase of sectional diameter of muscle fiber compared to comparison group, but NMES II group showed a similar result to comparison group. When ultrasubstructure was observed under electron microscope, I-type muscle fiber of NMES I group showed well-arranged mitochondria and it was similar to comparison group. II-type muscle fiber showed a large quantity of glycogen granules within sarcoplasmatic and the extension of luminal of T-tubule. I-type muscle fiber of NMES II group had small mitochondria and showed the vacuolar degeneration of mitochondria and extended T-tubule. II-type muscle fiber showed the extension of agranule cytoplasma reticulum with T-tubule and the reduction of amount of glycogen granule within partial sarcoplasmatic.

• The Journal of Korean Physical Therapy
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• v.30 no.4
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• pp.123-128
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• 2018

Purpose: This study examined the effects of neuromuscular electrical stimulation (NMES) and horseback riding using a robotic device on the trunk muscle activity and gross motor function in children with spastic diplegia. Methods: Children with spastic diplegia were divided into two groups: an experimental group (NMES and horseback riding using a robotic device [n=10]) and a control group (placebo NMES and horseback riding using a robotic device [n=10]). Each group received general physical therapy and occupational therapy. Each intervention involved the administration of NMES for 15 minutes and horseback riding using robotic device therapy for 15 minutes three times a week for 4 weeks. The evaluation included both the rectus abdominis muscles (RA), external oblique muscles (EO), thoracic paraspinal muscles (TP), and lumbar paraspinal muscles (LP) activity and GMFM. Results: The RA, EO, TP, and LP muscle activity, GMFM C, D, and E were increased significantly in the experimental and control groups. A significant increase in both the TP muscle activity and GMFM D was observed in the experimental group compared to the control group. Conclusion: This study showed that horseback riding using a robotic device is an effective intervention for trunk muscle activity and GMFM in children with spastic diplegia. However, if NMES is added to the back muscles, it is possible to further increase the thoracic paraspinal muscle activity and standing ability.