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Zhou S, Zhang SS, Crowley-McHattan ZJ. A scoping review of the contralateral effects of unilateral peripheral stimulation on neuromuscular function. PLoS One 2022; 17:e0263662. [PMID: 35139128 PMCID: PMC8827438 DOI: 10.1371/journal.pone.0263662] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 01/21/2022] [Indexed: 12/28/2022] Open
Abstract
It is known that resistance exercise using one limb can affect motor function of both the exercised limb and the unexercised contralateral limb, a phenomenon termed cross-education. It has been suggested that cross-education has clinical implications, e.g. in rehabilitation for orthopaedic conditions or post-stroke paresis. Much of the research on the contralateral effect of unilateral intervention on motor output is based on voluntary exercise. This scoping review aimed to map the characteristics of current literature on the cross-education caused by three most frequently utilised peripheral neuromuscular stimulation modalities in this context: electrical stimulation, mechanical vibration and percutaneous needling, that may direct future research and translate to clinical practice. A systematic search of relevant databases (Ebsco, ProQuest, PubMed, Scopus, Web of Science) through to the end of 2020 was conducted following the PRISMA Extension for Scoping Review. Empirical studies on human participants that applied a unilateral peripheral neuromuscular stimulation and assessed neuromuscular function of the stimulated and/or the unstimulated side were selected. By reading the full text, the demographic characteristics, context, design, methods and major findings of the studies were synthesised. The results found that 83 studies were eligible for the review, with the majority (53) utilised electrical stimulation whilst those applied vibration (18) or needling (12) were emerging. Although the contralateral effects appeared to be robust, only 31 studies claimed to be in the context of cross-education, and 25 investigated on clinical patients. The underlying mechanism for the contralateral effects induced by unilateral peripheral stimulation remains unclear. The findings suggest a need to enhance the awareness of cross-education caused by peripheral stimulation, to help improve the translation of theoretical concepts to clinical practice, and aid in developing well-designed clinical trials to determine the efficacy of cross-education therapies.
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Affiliation(s)
- Shi Zhou
- Discipline of Sport and Exercise Science, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
- * E-mail:
| | - Shuang-Shuang Zhang
- Discipline of Sport and Exercise Science, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Zachary J. Crowley-McHattan
- Discipline of Sport and Exercise Science, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
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Giannasi LC, Dutra MTS, Tenguan VLS, Mancilha GP, Silva GRC, Fillietaz-Bacigalupo E, da Silva DB, Politti F, Nacif SR, de Oliveira EF, da Rocha JC, Rocha CT, Romero MM, de Oliveira CS, de Oliveira LVF, de Mello Rode S, Koga-Ito CY, Amorim JBO, Salgado MAC, Gomes MF. Evaluation of the masticatory muscle function, physiological sleep variables, and salivary parameters after electromechanical therapeutic approaches in adult patients with Down syndrome: a randomized controlled clinical trial. Trials 2019; 20:215. [PMID: 30975204 PMCID: PMC6460660 DOI: 10.1186/s13063-019-3300-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 03/18/2019] [Indexed: 01/12/2023] Open
Abstract
Background There are many comorbidities associated with Down syndrome (DS), including obstructive sleep apnea (OSA) and masticatory muscle alteration. Muscular hypotonia, in particular, of the masticatory and oropharyngeal muscles is one of the main characteristics of individuals with DS, resulting in impairments of speech, swallowing, and mastication in these individuals. In addition, total or partial obstruction of the airways during sleep can occur due to pharyngeal hypotonia, leading to snoring and to OSA. This progressive respiratory disorder is associated with a high risk of morbidity and mortality in individuals with DS. The aim of this research is to assess the therapeutic effects of surface neuromuscular electrical stimulation (NMES), the mastication apparatus (MA), and a mandibular advancement oral appliance (OAm) with an embedded thermosensitive microchip on the functions of masticatory muscles (bilateral masseter and temporal muscles), physiological sleep variables, and salivary parameters in adult patients with DS. Methods The patients with DS will be randomly selected and divided into three groups (DS-NMES, DS-MA, and DS-OAm) with a minimum of 10 patients in each group. A thermosensitive microchip will be embedded in the OAm to record its compliance. The therapeutic effects on masticatory muscle function will be investigated through electromyography, a caliper, and a force-transducer device; the sleep variables, in turn, will be evaluated by means of polysomnography. The physicochemical and microbiological properties of the saliva will also be analyzed, including the salivary flow, viscosity, buffer capacity, cortisol levels (susceptibility to psychological and/or physical stress), and Pseudomonas aeruginosa levels (risk of aspiration pneumonia) in these patients. The methods determined for this study will be carried out prior to and after 2 months of the recommended therapies. Discussion The primary outcomes would be the improvement and/or reestablishment of the function of masticatory muscles and the physiological sleep variables in this target public since individuals with DS commonly present generalized muscular hypotonia and dysfunction of the oropharyngeal musculature. As a secondary outcome indicator, the impact of the applied therapies (NMES, MA, and OAm) on the salivary microbiological and physicochemical properties in DS individuals will also be assessed. Furthermore, the compliance of OAm usage will be measured through a thermosensitive microchip. Trial registration Registro Brasileiro de Ensaios Clínicos, RBR-3qp5np. Registered on 20 February 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3300-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lilian Chrystiane Giannasi
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, R: Esperança 265, São Paulo, SP, Brazil. .,Metropolitan University of Santos, Santos, Brazil. .,University Center of Anápolis-UniEvangélica, Anápolis, Brazil.
| | - Marignês T S Dutra
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, R: Esperança 265, São Paulo, SP, Brazil
| | - Vera L S Tenguan
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, R: Esperança 265, São Paulo, SP, Brazil
| | - Gabriela P Mancilha
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, R: Esperança 265, São Paulo, SP, Brazil
| | - Gabriela R C Silva
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, R: Esperança 265, São Paulo, SP, Brazil
| | - Elaine Fillietaz-Bacigalupo
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, R: Esperança 265, São Paulo, SP, Brazil
| | - Daniel B da Silva
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, R: Esperança 265, São Paulo, SP, Brazil
| | | | - Sergio R Nacif
- Hospital do Servidor Público Estadual de São Paulo (IAMSPE-HSPE), São Paulo, Brazil
| | | | - João C da Rocha
- Discipline of Pediatric Dentistry Institute of Science and Technology, São Paulo, Brazil
| | - Carolina T Rocha
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, R: Esperança 265, São Paulo, SP, Brazil
| | - Mateus M Romero
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, R: Esperança 265, São Paulo, SP, Brazil
| | | | | | - Sigmar de Mello Rode
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, R: Esperança 265, São Paulo, SP, Brazil
| | - Cristiane Yumi Koga-Ito
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, R: Esperança 265, São Paulo, SP, Brazil
| | - Jose B O Amorim
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, R: Esperança 265, São Paulo, SP, Brazil
| | - Miguel A C Salgado
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, R: Esperança 265, São Paulo, SP, Brazil
| | - Mônica F Gomes
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, R: Esperança 265, São Paulo, SP, Brazil
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Alon G, Kantor G, Smith GV. Peripheral nerve excitation and plantar flexion force elicited by electrical stimulation in males and females. J Orthop Sports Phys Ther 1999; 29:208-14; discussion 215-7. [PMID: 10322593 DOI: 10.2519/jospt.1999.29.4.208] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Two-group (gender) posttest only using a sample of convenience. OBJECTIVES Our study examined the effect of gender on selected stimulus properties, perceived pain thresholds, and maximally tolerated level of contraction of the plantar flexor muscle group. BACKGROUND There is a dearth of literature regarding gender as a factor that may influence the outcome following the application of neuromuscular electrical stimulation. Data from other disciplines suggest that males and females may not have similar tolerance to electrical stimulation. METHODS AND MEASURES Eleven women (mean age, 28.3 years +/- 5.6 years) and 9 men (mean age, 33.2 years +/- 6 years) participated in a single session of electrical stimulation. A pair of 4.5 x 4.5 cm, self-adhesive, synthetic, polymer electrodes was placed over the medial and lateral heads of the gastrocsoleus muscle group. Electrical stimulation was provided by a battery-powered pulsatile stimulator generating a symmetric biphasic waveform, 200-mu second phase duration, and pulse rate of 50 pulses per second. During testing, the subjects were seated on a specially constructed chair that incorporated a foot pedal attached to a piezoelectric force transducer to measure plantar flexion force. Stimulation amplitude was increased slowly until 4 thresholds (sensory, motor, pain, and maximal pain) were sequentially achieved. At each threshold, stimulus peak voltage, peak current, and phase charge used to elicit that threshold were recorded. Plantar flexion force was also recorded when stimulation was sufficient to achieve pain and maximal pain thresholds. RESULTS The peak voltage, peak current, and phase charge needed to elicit the 4 thresholds did not differ between women and men at any threshold examined (2-factor ANOVA; Newman-Keuls post hoc tests). However, significantly higher stimulus peak voltage, peak current, and phase charge were recorded for each of the 4 thresholds (sensory, motor, pain, and maximal pain tolerance) for both groups. The plantar flexion force elicited by electrical stimulation was significantly lower in female subjects than in male subjects at both pain threshold and maximally tolerated stimulation levels. CONCLUSIONS Gender can influence the magnitude of electrically induced plantar flexion contraction force. We hypothesize that females may require longer conditioning periods to achieve therapeutic levels of muscle contraction.
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Affiliation(s)
- G Alon
- Department of Physical Therapy, University of Maryland, Baltimore 21201, USA.
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