• 한국전문물리치료학회지
• /
• 제29권4호
• /
• pp.269-273
• /
• 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.

• 한국전문물리치료학회지
• /
• 제29권3호
• /
• pp.187-193
• /
• 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.

• 대한통합의학회지
• /
• 제11권2호
• /
• pp.159-168
• /
• 2023

Purpose : This study aimed to investigate how neuromuscular electrical stimulation (NMES) affects the balance ability of patients who have undergone total knee arthroplasty owing to osteoarthritis. Methods : Thirty patients who had undergone total knee arthroplasty were randomized to an experimental group (n=15) and a control group (n=15). The experimental group received conventional physical therapy for 50 minutes and NMES treatment for 30 minutes, whereas the control group received conventional physical therapy for 50 minutes and active range of motion (AROM) exercises for 30 minutes. Within-group and between-group changes in static and dynamic balance ability before and after the 4-week intervention were analyzed. Results : In the within-group comparison, sway velocity in the center of gravity and total distance were significantly improved in both the experimental and control groups (p<.05), with no significant differences between the groups (p>.05). In the within-group comparison, both the experimental and control groups showed significant improvement in the functional reach test and movement velosity (p<.05). In the between-group comparison, the experimental group showed a significantly better improvement than the control group in the functional reach test (p<.05), but there was no significant difference in the movement velosity test (p>.05). Conclusion : In this study, NMES improved the static and dynamic balance in patients who had undergone total knee arthroplasty. Compared with AROM exercises, there was a greater effect on dynamic balance partially; however, the overall effect was similar. Therefore, NMES may be one option among various interventions to improve the balance ability in patients who have undergone total knee arthroplasty. In particular, this method may be effective when it is difficult to apply balance training for patients with total knee arthroplasty in a clinical setting.

• The Journal of Korean Physical Therapy
• /
• 제36권2호
• /
• pp.71-77
• /
• 2024

Purpose: The prolonged use of digital devices has led to the widespread adoption of poor postures, particularly rounded shoulder posture (RSP), associated with shoulder impingement and pain. This study investigates the effects of neuromuscular electrical stimulation (NMES) on RSP in healthy adults. Methods: Thirty adults with RSP were randomly assigned to NMES only, exercise only, or NMES with exercise groups. NMES was applied to the lower trapezius, which was the target muscle in this study, for a total of 2 weeks, 5 times per week, 20 minutes per session. The exercise program included pectoralis minor stretching, wall-slide exercise, dynamic hug exercise with band, and Brugger stretching for upper body with band, which were performed for a total of 2 weeks, 5 times per week, 20 minutes per session. Outcome measures, including the Supine Method (SM) for posture and surface electromyography (EMG) of the lower trapezius for muscle activity, were assessed before the intervention, after 5 sessions, and after 10 sessions. Results: All the groups showed significant changes in the SM and % maximal voluntary isometric contraction (%MVIC) over time (p<0.05). The NMES group had significantly reduced SM at 1 week, while the exercise and combined groups had reduced SM at 2 weeks (p<0.017). All the groups had increased %MVIC at 2 weeks (p<0.017), with no significant differences observed between groups. Conclusion: NMES alone can be as effective as exercise in improving RSP. NMES combined with exercise also showed positive outcomes, thus offering diverse treatment options for this condition.

• 한국엔터테인먼트산업학회논문지
• /
• 제13권7호
• /
• pp.539-548
• /
• 2019

복합호흡운동과 넙다리네갈래근의 신경근전기자극 치료가 중증 만성폐쇄성폐질환 환자들의 폐기능과 대뇌겉질 활성도에 미치는 효과를 알아보고자 하였다. 60~80세 중증 만성폐쇄성폐질환 환자 20명을 대상으로 실험군은 복합호흡운동과 넙다리네갈래근의 신경근전기자극을, 대조군은 복합호흡운동만을 실시하였다. 사전 검사로 폐기능과 대뇌겉질 활성도를 측정하였고, 중재는 6주 간, 주 4일, 1일 1회, 30분씩 각 집단에 시행한 후, 사후검사를 사전검사와 동일하게 재측정하였다. 그 결과 집단 내 폐기능 변화는 실험군과 대조군 모두 1초간 노력성 날숨량에서 유의한 차이가 있었고(p<.001)(p<.05), 집단 간 폐기능 변화 비교에서 1초간 노력성 날숨량의 변화는 유의한 차이가 있었다(p<.05). 집단 내 대뇌겉질의 영역 별 알파파 변화 비교에서는 Fp1, Fp2, F3, F4 영역에서 대조군과 실험군 모두 유의한 차이가 있었다(p<.01)(p<.05). 따라서 6주 동안의 복합호흡운동과 넙다리네갈래근의 신경근전기자극은 중증 만성폐쇄성폐질환들의 폐기능을 향상시키고, 대뇌겉질 활성도에서 앞이마부 영역의 알파파가 증가되어 긍정적인 호흡의 변화가 나타났음을 알 수 있었다. 따라서 중증의 만성폐쇄성폐질환 환자들에게 복합호흡운동 뿐만 아니라 부가적으로 넙다리네갈래근에 신경근전기자극을 병행하면 보다 좋은 치료적 효과를 볼 수 있을 것으로 생각된다.

• PNF and Movement
• /
• 제20권2호
• /
• pp.147-156
• /
• 2022

Objective: Electrical stimulation is an assistive technology used to aid the recovery of upper limb use after stroke. The purpose of this systematic review was to determine the effects of electrical stimulation on upper extremity function in individuals with hemiparetic stroke and to develop an evidence base that supports the use of electrical stimulation for upper limb recovery after stroke. Design: A systematic review based on randomized controlled trials (RCTs). Methods: Studies published before April 20 2021 were collected for this review by searching PubMed, four other databases, and RCTs that reported the effects of electrical stimulation on upper extremity function in individuals with the characteristic stroke type. Information on the following parameters was extracted from each study: surname of first author, published year, country, participants, intervention, intervention's intensity, comparison, outcomes, additional therapy, and summary of results. This review also evaluated the bias within each study, including any selection bias, performance bias, detection bias, attrition bias, and reporting bias. Results: This review included five RCTs, and 208 stroke patients were included in the analysis. Stroke patients who underwent electrical stimulation showed significantly improved grip and pinch strengths, wrist range of motion, and basic daily living compared to those in the control group; however, there was no improvement in upper extremity function. Of the selected papers, 60% showed a "high risk" of performance bias, and 20% showed a "high risk" of detection bias. Conclusions: The results of this systematic review suggest that electrical stimulation provides some benefits to stroke patients, such as improved hand strength and range of motion. However, future studies are needed to provide clinical evidence of the effects of electrical stimulation on upper extremity function in stroke patients.

• The Korean Journal of Pain
• /
• 제29권2호
• /
• pp.136-140
• /
• 2016

Myofascial pain syndrome (MPS) is one of the common musculoskeletal conditions of the shoulder which may develop sensory-motor and autonomic dysfunctions at the various level of the neuromuscular system. The pain and dysfunction caused by MPS were primarily treated with physical therapy and pharmacological agents in order to achieve painfree movements. However, in recent years intramuscular electrical stimulation (IMES) with conventional electrode placement was used by researchers to maximise therapeutic values. But, in this study an inverse electrode placement was used to deliver electrical impulses intramuscularly to achieve neuro-modulation at the various level of the nervous system. Nine patients with MPS were treated with intramuscular electrode stimulation using inversely placed electrodes for a period of three weeks. All nine subjects recovered from their shoulder pain and disability within the few weeks of intervention. So, this inverse electrode placement may be more appropriate for chronic pain management.

• 대한물리치료과학회지
• /
• 제6권4호
• /
• pp.187-199
• /
• 1999

Functional Electrical Stimulation (FES) is used for muscle reeducation, reduction of spasticity, delay of atrophy, and muscle strengthening. FES stronger stimulation than other forms of electrical stimulation. The efficacy of FES in improving function has been substantiated in the literature. Treatment programs employing FES - activation of muscular tissue through the intact peripheral nervous system - can be broken into five major categories, according to the goal of treatment. These broad areas would include the use of FES to: (1) a direct excitation onto the alpha motoneuron, through peripheral stimulation of the Ia myotatic sensory system and ascending afferent information, which will be integrated at conscious and subconscious level of the CNS. (2) The quality of a stimulated muscle contraction is determined by combination of many parameters, including stimulus amplitude, pulse duration, stimulus frequency, and duty cycle. (3) A unit that has a pulse duration between 200 and $400{\mu}sec$ will be more than adequate for FES applications. (4) The neuromuscular plasticity is critically important to return of function using muscle re-education and facilitation applications. (5) Prior to using FES as an electrical orthosis, the patient should build up endurance in the muscles to be stimu1ated during the gait cycle.

• 한국정밀공학회:학술대회논문집
• /
• 한국정밀공학회 2013년도 춘계학술대회 논문집
• /
• pp.1471-1472
• /
• 2013

• 재활치료과학
• /
• 제11권4호
• /
• pp.69-83
• /
• 2022

목적 : 본 연구는 발렌버그 증후군 환자에게 적용한 구강운동촉진기술(OMFT) 프로토콜과 신경근전기자극 치료(NMES)의 임상 적용 효과의 가능성을 확인하고자 하였다. 연구방법 : 발렌버그 증후군 환자 1명을 대상으로 OMFT와 NMES를 4주 동안 주 5일, 1일 2회로 각각 40회씩 적용하였다. 중재 전·후의 변화를 비교하기 위해 포괄적 구강안면기능척도(COFFS), 한국판 Mann 삼킴 능력 평가(K-MASA), 침습-흡인 척도(PAS)를 사용하여 평가하였다. 자료 분석은 중재 전·후의 점수 변화를 비교하였다. 결과 : 본 연구에 참여한 대상자에게 중재 전·후로 구강안면기능과 삼킴능력이 향상되었다. 구강운동 기능 중 혀 운동에 비교적 많은 기능적 호전이 나타났으며, 인두기 삼킴이 가능해지는 정도로 평가되었 고, VFSS를 통한 PAS 평가에서도 5점으로 증상의 개선이 관찰되었다. 결론 : 체계적인 OMFT와 운동강도의 NMES를 적용한 초기 연하재활치료는 구강 운동 기능과 연하장애 개선에 가능성을 확인하였다. 향후 OMFT와 NMES를 적용한 중재의 효과에 대한 보완 연구가 필요할 것이다.