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El Semary MM, Elrewainy RM, Nagaty A, Maged M, Abdelhakiem NM. Effect of magnetic therapy in bladder dysfunction and quality of life in paraplegic patients. NeuroRehabilitation 2024; 54:611-618. [PMID: 38875052 DOI: 10.3233/nre-240060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
BACKGROUND Urinary dysfunction is linked to spinal cord injury (SCI). The quality of life (QoL) declines in both neurogenic bladder impairment and non-disordered patients. OBJECTIVE To ascertain the effectiveness of pulsed magnetic therapy on urinary impairment and QoL in individuals with traumatic incomplete SCI. METHODS This study included forty male paraplegic subjects with neurogenic detrusor overactivity (NDO) for more than one year following incomplete SCI between T6-T12. Their ages ranged from 20 to 35 and they engaged in therapy for three months. The subjects were divided into two groups of equal size. Individuals in Group I were managed via pulsed magnetic therapy once per week plus pelvic floor training three times a week. Individuals in Group II were managed with only three times a week for pelvic floor training. All patients were examined for bladder cystometric investigations, pelvic-floor electromyography (EMG), and SF-Qualiveen questionnaire. RESULTS There was a noteworthy increment in individuals in Group I in volume of bladder at first desire to void and maximum cystometric capacity, detrusor pressure at Qmax, and maximum flow rate. There was a momentous increment in Group I in measures of evaluation of EMG biofeedback. There was a notable rise in Group I in SF-Qualiveen questionnaire. CONCLUSION Magnetic stimulation should be favored as beneficial adjunct to traditional therapy in the management of bladder impairment and enhancing QoL in individuals with SCI.
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Affiliation(s)
- Moataz Mohamed El Semary
- Department of Physical Therapy for Neurology and Neurosurgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences (CAMS), Jouf University, Al Jawf, Saudi Arabia
| | - Rasha Mohamed Elrewainy
- Department of Physical Therapy for Neurology and Neurosurgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Ahmed Nagaty
- Department of Neurosurgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mai Maged
- Egyptian Clinical Neurophysiology Society, Cairo, Egypt
| | - Nadia Mohamed Abdelhakiem
- Department of Physical Therapy for Neuromuscular Disorders and its Surgery, Faculty of Physical Therapy, Deraya University, Minya, Egypt
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Laskin JJ, Waheed Z, Thorogood NP, Nightingale TE, Noonan VK. Spinal cord stimulation research in the restoration of motor, sensory and autonomic function for individuals living with spinal cord injuries: A scoping review. Arch Phys Med Rehabil 2022; 103:1387-1397. [PMID: 35202581 DOI: 10.1016/j.apmr.2022.01.161] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To describe the status of spinal cord stimulation (SCS) research for the improvement of motor, sensory and autonomic function for individuals living with a spinal cord injury (SCI). DATA SOURCES This scoping review identified original research published prior to March 31, 2021, via literature searches using Medline, EMBASE, PubMed, Science Direct, CINAHL, Sport Discus, Web of Science, as well as a targeted search for well-known principal investigators. Search terms included permutations of "spinal cord stimulation", "epidural spinal cord stimulation", "transcutaneous spinal cord stimulation", "magnetic spinal cord stimulation" and "neuromodulation". STUDY SELECTION Studies were included if they: 1) were in English, 2) presented original research on humans living with a SCI, and 3) investigated at least one of the three forms of SCS. DATA EXTRACTION Extracted data included: authors, publication year, participant characteristics, purpose, study design, stimulation (device, location, parameters,) primary outcomes, and adverse events. DATA SYNTHESIS As a scoping review the extracted data was tabulated and presented descriptively. Themes and gaps in the literature were identified and reported. Of the 5,754 articles screened, 103 articles were included (55 epidural, 36 transcutaneous and 12 magnetic). The primary research design was a case study or series with only a single randomized clinical trial. Motor recovery was the most common primary outcome for epidural and transcutaneous SCS studies whereas bowel and bladder outcomes were most common for magnetic. Seventy percent of the studies included 10 or fewer participants, and 18 articles documented at least one adverse event. Incomplete stimulation parameter descriptions were noted across many studies. No articles mentioned direct engagement of consumers or advocacy groups. CONCLUSION This review identified a need for more robust study designs, larger sample sizes, comparative studies, improved reporting of stimulation parameters, adverse event data, and alignment of outcomes with the priorities of the SCI community.
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Affiliation(s)
- James J Laskin
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada; School of Physical Therapy and Rehabilitation Science, University of Montana, Missoula, Montana.
| | - Zeina Waheed
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | | | - Tom E Nightingale
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada; School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom; Centre for Trauma Sciences Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Vanessa K Noonan
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
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Steadman CJ, Grill WM. Spinal cord stimulation for the restoration of bladder function after spinal cord injury. Healthc Technol Lett 2020; 7:87-92. [PMID: 32754343 PMCID: PMC7353924 DOI: 10.1049/htl.2020.0026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/15/2020] [Accepted: 05/15/2020] [Indexed: 12/20/2022] Open
Abstract
Spinal cord injury (SCI) results in the inability to empty the bladder voluntarily, and neurogenic detrusor overactivity (NDO) and detrusor sphincter dyssynergia (DSD) negatively impact both the health and quality of life of persons with SCI. Current approaches to treat bladder dysfunction in persons with SCI, including self-catheterisation and anticholinergic medications, are inadequate, and novel approaches are required to restore continence with increased bladder capacity, as well as to provide predictable and efficient on-demand voiding. Improvements in bladder function following SCI have been documented using a number of different modalities of spinal cord stimulation (SCS) in both persons with SCI and animal models, including SCS alone or SCS with concomitant activity-based training. Improvements include increased volitional voiding, voided volumes, bladder capacity, and quality of life, as well as decreases in NDO and DSD. Further, SCS is a well-developed therapy for chronic pain, and existing Food And Drug Administration (FDA)-approved devices provide a clear pathway to sustainable commercial availability and impact. However, the effective stimulation parameters and the appropriate timing and location of stimulation for SCS-mediated restoration of bladder function require further study, and studies are needed to determine underlying mechanisms of action.
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Affiliation(s)
- Casey J Steadman
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Warren M Grill
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA.,Department of Electrical and Computer Engineering, Duke University, Durham, NC 27708, USA.,Department of Neurobiology, Duke University, Durham, NC 27708, USA.,Department of Neurosurgery, Duke University, Durham, NC 27708, USA
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Chen X, Liu X, Cui Y, Xu G, Liu L, Zhang X, Jiang K, Li Z. Efficacy of functional magnetic stimulation in improving upper extremity function after stroke: a randomized, single-blind, controlled study. J Int Med Res 2020; 48:300060520927881. [PMID: 32495667 PMCID: PMC7273768 DOI: 10.1177/0300060520927881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective To clarify the efficacy of functional magnetic stimulation (FMS) in improving hemiplegic upper extremity function in patients with sub-acute stroke. Methods In this randomized controlled trial, 40 sub-acute stroke patients with hemiplegia were recruited from inpatient wards in the Department of Rehabilitation and randomly assigned to two groups. In the FMS group, magnetic stimulation was applied to extensor muscle groups of the affected upper extremity. In the low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) group, stimulation was applied to the contralesional primary motor cortex. All patients received occupational therapy. Hand and upper extremity motor function was evaluated using the Fugl–Meyer Assessment for upper extremity (FMA-UE), and the Barthel Index (BI) evaluated daily living abilities. Results The FMA-UE and BI scores were significantly increased in both groups following stimulation. Furthermore, a significant between-group difference was observed in both FMA-UE and BI scores after 2 weeks of therapy. In the FMS group, 6 of 19 patients regained wrist and finger extension abilities, but only 2 patients regained equivalent motor skills in the LF-rTMS group Conclusions FMS improves paretic upper extremity function and leads to better recovery of motor activity than LF-rTMS. FMS may be a novel modality to improve motor function.
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Affiliation(s)
- Xiaowei Chen
- Department of Physical Medicine and Rehabilitation, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xuncan Liu
- Department of Physical Medicine and Rehabilitation, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yinxing Cui
- Department of Physical Medicine and Rehabilitation, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Guoxing Xu
- Department of Physical Medicine and Rehabilitation, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Lu Liu
- Department of Physical Medicine and Rehabilitation, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xueru Zhang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Kun Jiang
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Zhenlan Li
- Department of Physical Medicine and Rehabilitation, The First Hospital of Jilin University, Changchun, Jilin, China
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Walter JS, Posluszny J, Dieter R, Dieter RS, Sayers S, Iamsakul K, Staunton C, Thomas D, Rabbat M, Singh S. Stimulation of abdominal and upper thoracic muscles with surface electrodes for respiration and cough: Acute studies in adult canines. J Spinal Cord Med 2018; 41:326-336. [PMID: 28614985 PMCID: PMC6055958 DOI: 10.1080/10790268.2017.1335447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To optimize maximal respiratory responses with surface stimulation over abdominal and upper thorax muscles and using a 12-Channel Neuroprosthetic Platform. METHODS Following instrumentation, six anesthetized adult canines were hyperventilated sufficiently to produce respiratory apnea. Six abdominal tests optimized electrode arrangements and stimulation parameters using bipolar sets of 4.5 cm square electrodes. Tests in the upper thorax optimized electrode locations, and forelimb moment was limited to slight-to-moderate. During combined muscle stimulation tests, the upper thoracic was followed immediately by abdominal stimulation. Finally, a model of glottal closure for cough was conducted with the goal of increased peak expiratory flow. RESULTS Optimized stimulation of abdominal muscles included three sets of bilateral surface electrodes located 4.5 cm dorsal to the lateral line and from the 8th intercostal space to caudal to the 13th rib, 80 or 100 mA current, and 50 Hz stimulation frequency. The maximal expired volume was 343 ± 23 ml (n=3). Optimized upper thorax stimulation included a single bilateral set of electrodes located over the 2nd interspace, 60 to 80 mA, and 50 Hz. The maximal inspired volume was 304 ± 54 ml (n=4). Sequential stimulation of the two muscles increased the volume to 600 ± 152 ml (n=2), and the glottal closure maneuver increased the flow. CONCLUSIONS Studies in an adult canine model identified optimal surface stimulation methods for upper thorax and abdominal muscles to induce sufficient volumes for ventilation and cough. Further study with this neuroprosthetic platform is warranted.
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Affiliation(s)
- James S. Walter
- Research Services, Edward Hines Jr. VA Hospital, Hines, Illinois, USA,Urology Departments, Loyola University, Stritch School of Medicine, Maywood, Illinois, USA,Correspondence to: James S. Walter, Edward Hines Jr. VA Hospital (151), 5000 South 5th Avenue, Hines, IL 60141, USA.
| | - Joseph Posluszny
- Research Services, Edward Hines Jr. VA Hospital, Hines, Illinois, USA,Surgery Services, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Raymond Dieter
- Research Services, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Robert S. Dieter
- Cardiology Services, Edward Hines Jr. VA Hospital, Hines, Illinois, USA,Cardiology Departments, Loyola University, Stritch School of Medicine, Maywood, Illinois, USA
| | - Scott Sayers
- Research Services, Edward Hines Jr. VA Hospital, Hines, Illinois, USA,Thoracic and Cardiovascular Surgery Departments, Loyola University, Stritch School of Medicine, Maywood, Illinois, USA
| | | | | | - Donald Thomas
- Research Services, Edward Hines Jr. VA Hospital, Hines, Illinois, USA,Surgery Services, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Mark Rabbat
- Cardiology Services, Edward Hines Jr. VA Hospital, Hines, Illinois, USA,Cardiology Departments, Loyola University, Stritch School of Medicine, Maywood, Illinois, USA
| | - Sanjay Singh
- Research Services, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
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