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Lu C, Chen M, Zhao Y, Zhan Y, Wei X, Lu L, Yang M, Gong X. A Co-MOF encapsulated microneedle patch activates hypoxia induction factor-1 to pre-protect transplanted flaps from distal ischemic necrosis. Acta Biomater 2024:S1742-7061(24)00312-X. [PMID: 38871202 DOI: 10.1016/j.actbio.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 05/25/2024] [Accepted: 06/06/2024] [Indexed: 06/15/2024]
Abstract
Avoiding ischemic necrosis after flap transplantation remains a significant clinical challenge. Developing an effective pretreatment method to promote flap survival postoperatively is crucial. Cobalt chloride (CoCl2) can increase cell tolerance to ischemia and hypoxia condition by stimulating hypoxia-inducible factor-1 (HIF-1) expression. However, the considerable toxic effects severely limit the clinical application of CoCl2. In this study, cobalt-based metal-organic frameworks (Co-MOF) encapsulated in a microneedle patch (Co-MOF@MN) was developed to facilitate the transdermal sustained release of Co2+ for rapid, minimally invasive rapid pretreatment of flap transplantation. The MN patch was composed of a fully methanol-based two-component cross-linked polymer formula, with a pyramid structure and high mechanical strength, which satisfied the purpose of penetrating the skin stratum corneum of rat back to achieve subcutaneous vascular area administration. Benefiting from the water-triggered disintegration of Co-MOF and the transdermal delivery via the MN patch, preoperative damage and side effects were effectively mitigated. Moreover, in both the oxygen-glucose deprivation/recovery (OGD/R) cell model and the rat dorsal perforator flap model, Co-MOF@MN activated the HIF-1α pathway and its associated downstream proteins, which reduced reperfusion oxidative damage, improved blood supply in choke areas, and increased flap survival rates post-transplantation. This preprotection strategy, combining MOF nanoparticles and the MN patch, meets the clinical demands for trauma minimization and uniform administration in flap transplantation. STATEMENT OF SIGNIFICANCE: Cobalt chloride (CoCl2) can stimulate the expression of hypoxia-inducible factor (HIF-1) and improve the tolerance of cells to ischemia and hypoxia conditions. However, the toxicity and narrow therapeutic window of CoCl2 severely limit its clinical application. Herein, we explored the role of Co-MOF as a biocompatible nanocage for sustained release of Co2+, showing the protective effect on vascular endothelial cells in the stress model of oxygen-glucose deprivation. To fit the clinical needs of minimal trauma in flap transplantation, a Co-MOF@MN system was developed to achieve local transdermal delivery at the choke area, significantly improving blood supply opening and flap survival rate. This strategy of two-step delivery of Co2+ realized the enhancement of biological functions while ensuring the biosafety.
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Affiliation(s)
- Cheng Lu
- Department of Hand and Podiatric Surgery, Orthopedics Center, The First Hospital of Jilin University, Jilin University, Changchun 130031, PR China
| | - Miao Chen
- Department of Hand and Podiatric Surgery, Orthopedics Center, The First Hospital of Jilin University, Jilin University, Changchun 130031, PR China
| | - Yuanyuan Zhao
- Department of Hand and Podiatric Surgery, Orthopedics Center, The First Hospital of Jilin University, Jilin University, Changchun 130031, PR China
| | - Yongxin Zhan
- Department of Hand and Podiatric Surgery, Orthopedics Center, The First Hospital of Jilin University, Jilin University, Changchun 130031, PR China
| | - Xin Wei
- Department of Hand and Podiatric Surgery, Orthopedics Center, The First Hospital of Jilin University, Jilin University, Changchun 130031, PR China
| | - Laijin Lu
- Department of Hand and Podiatric Surgery, Orthopedics Center, The First Hospital of Jilin University, Jilin University, Changchun 130031, PR China; Orthopedics Central Laboratory, Institute of Translational Medicine, The First Hospital of Jilin University, Jilin University, Changchun 130021, PR China
| | - Mingxi Yang
- Department of Hand and Podiatric Surgery, Orthopedics Center, The First Hospital of Jilin University, Jilin University, Changchun 130031, PR China; Orthopedics Central Laboratory, Institute of Translational Medicine, The First Hospital of Jilin University, Jilin University, Changchun 130021, PR China.
| | - Xu Gong
- Department of Hand and Podiatric Surgery, Orthopedics Center, The First Hospital of Jilin University, Jilin University, Changchun 130031, PR China; Orthopedics Central Laboratory, Institute of Translational Medicine, The First Hospital of Jilin University, Jilin University, Changchun 130021, PR China.
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Katagiri M, Nakabayashi M, Matsuda Y, Ono Y, Ichinose M. Differential changes in blood flow and oxygen utilization in active muscles between voluntary exercise and electrical muscle stimulation in young adults. J Appl Physiol (1985) 2024; 136:1053-1064. [PMID: 38482573 DOI: 10.1152/japplphysiol.00863.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/22/2024] [Accepted: 03/05/2024] [Indexed: 04/24/2024] Open
Abstract
The physiological effects on blood flow and oxygen utilization in active muscles during and after involuntary contraction triggered by electrical muscle stimulation (EMS) remain unclear, particularly compared with those elicited by voluntary (VOL) contractions. Therefore, we used diffuse correlation and near-infrared spectroscopy (DCS-NIRS) to compare changes in local muscle blood flow and oxygen consumption during and after these two types of muscle contractions in humans. Overall, 24 healthy young adults participated in the study, and data were successfully obtained from 17 of them. Intermittent (2-s contraction, 2-s relaxation) isometric ankle dorsiflexion with a target tension of 20% of maximal VOL contraction was performed by EMS or VOL for 2 min, followed by a 6-min recovery period. DCS-NIRS probes were placed on the tibialis anterior muscle, and relative changes in local tissue blood flow index (rBFI), oxygen extraction fraction (rOEF), and metabolic rate of oxygen (rMRO2) were continuously derived. EMS induced more significant increases in rOEF and rMRO2 than VOL exercise but a comparable increase in rBFI. After EMS, rBFI and rMRO2 decreased more slowly than after VOL and remained significantly higher until the end of the recovery period. We concluded that EMS augments oxygen consumption in contracting muscles by enhancing oxygen extraction while increasing oxygen delivery at a rate similar to the VOL exercise. Under the conditions examined in this study, EMS demonstrated a more pronounced and/or prolonged enhancement in local muscle perfusion and aerobic metabolism compared with VOL exercise in healthy participants.NEW & NOTEWORTHY This is the first study to visualize continuous changes in blood flow and oxygen utilization within contracted muscles during and after electrical muscle stimulation (EMS) using combined diffuse correlation and near-infrared spectroscopy. We found that initiating EMS increases blood flow at a rate comparable to that during voluntary (VOL) exercise but enhances oxygen extraction, resulting in higher oxygen consumption. Furthermore, EMS increased postexercise muscle perfusion and oxygen consumption compared with that after VOL exercise.
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Affiliation(s)
- Makoto Katagiri
- Electrical Engineering Program, Graduate School of Science and Technology, Meiji University, Kanagawa, Japan
| | - Mikie Nakabayashi
- Electrical Engineering Program, Graduate School of Science and Technology, Meiji University, Kanagawa, Japan
| | - Yasuhiro Matsuda
- Faculty of Medical Science, Nippon Sport Science University, Kanagawa, Japan
| | - Yumie Ono
- Department of Electronics and Bioinformatics, School of Science and Technology, Meiji University, Kanagawa, Japan
| | - Masashi Ichinose
- Human Integrative Physiology Laboratory, School of Business Administration, Meiji University, Tokyo, Japan
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Zarzeczny R, Nawrat-Szołtysik A, Polak A. Effects of 12 weeks of neuromuscular electrical stimulation of the quadriceps muscles on the function and physio-biochemical traits in functionally fit female nursing-home residents aged 75 + years: a pilot study. Eur J Appl Physiol 2024; 124:945-962. [PMID: 37750973 PMCID: PMC10879313 DOI: 10.1007/s00421-023-05321-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 09/08/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE Muscular changes induced by neuromuscular electrical stimulation (NMES) are well recognized, but knowledge of how NMES influences the physio-biochemical traits of the oldest old is still limited. This study investigated the effect of NMES applied for 12 weeks to the quadriceps muscles of female nursing-home residents aged 75 + on their functional capability and inflammatory, bone metabolism, and cardiovascular traits. METHODS Nineteen women regularly taking part in two body conditioning sessions per week were randomized into an electrical stimulation group (ES; n = 10; 30 min sessions, 3 times per week) or a control group (CON; n = 9). At baseline and study week 12, all women performed the 30 s chair stand test (30sCST), the 6-minute walk test (6MWT), and the instrumented timed up and go test (iTUG). Resting heart rates, blood pressure, and the blood concentrations of inflammatory and bone metabolism markers were also measured twice. RESULTS NMES increased the strength of participants' quadriceps muscles and their performance on the 30sCST and 6MWT while lowering resting arterial blood pressure and inflammatory marker levels; osteoclast activity showed a tendency to decrease. Changes in the iTUG results were not observed. A multiple regression analysis found that the results of functional tests in the ES group were best correlated with pulse pressure (the 30sCST and iTUG tests) and diastolic blood pressure (the 6MWT test). CONCLUSION Twelve weeks of NMES treatment improved participants' functional capacity and inflammatory, bone metabolism, and cardiovascular traits. The ES group participants' performance on functional tests was best predicted by hemodynamic parameters.
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Affiliation(s)
- Ryszard Zarzeczny
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, 5 Żeromskiego Str., 25-369, Kielce, Poland.
| | - Agnieszka Nawrat-Szołtysik
- Chair of Physiotherapy Basics, Jerzy Kukuczka Academy of Physical Education in Katowice, 72A Mikołowska Str., 40-065, Katowice, Poland
| | - Anna Polak
- Chair of Physiotherapy Basics, Jerzy Kukuczka Academy of Physical Education in Katowice, 72A Mikołowska Str., 40-065, Katowice, Poland
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Viudes-Sarrión N, Aleixandre-Carrera F, Beltrá P, Ortega FJ, Molina-Payá FJ, Velasco E, Delicado-Miralles M. Blood flow effects of percutaneous peripheral nerve stimulation. A blinded, randomized clinical trial. Eur J Clin Invest 2024; 54:e14091. [PMID: 37675595 DOI: 10.1111/eci.14091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/18/2023] [Accepted: 08/23/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND The vasculature function is mainly regulated by the autonomic nervous system. Importantly, the sensory-motor nervous system also innervates peripheral vessels and has the capacity to modulate vascular tone. Here we investigated the effects of electrical stimulation of a mixed nerve trunk on blood flow in deep arteries and muscle perfusion. Our hypothesis is that stimulation of a mixed nerve can modify blood flow. METHODS Twenty-nine healthy participants were included into a randomized-crossover and blinded clinical trial. Each subject received a placebo and two percutaneous peripheral nerve stimulation (pPNS) protocols on the median nerve: Pain Threshold continuous Low Frequency (PT-cLF) and Sensory Threshold burst High Frequency (ST-bHF). Blood flow was then assessed bilaterally using Power Doppler Ultrasonography at the main arteries of the arm, and blood perfusion at the forearm muscles. Afterwards, blood flow was quantified using a semi-automatized software, freely shared here. RESULTS Placebo, consisting in needle insertion, produced an immediate and generalized reduction on peak systolic velocity in all arteries. Although nerve stimulation produced mainly no effects, some significant differences were found: both protocols increased the relative perfusion area of the forearm muscles, the ST-bHF protocol prevented the reduction in peak systolic velocity and TAMEAN of the radial artery produced by the control protocol and PT-cLF produced a TAMEAN reduction of the ulnar artery. CONCLUSIONS Therefore, the arterial blood flow in the arm is mainly impervious to the electrical stimulation of the median nerve, composed by autonomic and sensory-motor axons, although it produces mild modifications in the forearm muscles perfusion.
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Affiliation(s)
- Nuria Viudes-Sarrión
- Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium
- Human Movement Biomechanics Research Group, Deptartment of Movement Sciences, KU Leuven, Leuven, Belgium
- Neuroscience in Physiotherapy (NiP), Independent Research Group, Elche, Spain
| | - Fernando Aleixandre-Carrera
- Neuroscience in Physiotherapy (NiP), Independent Research Group, Elche, Spain
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC, San Juan de Alicante, Spain
| | - Patricia Beltrá
- Neuroscience in Physiotherapy (NiP), Independent Research Group, Elche, Spain
- Physical Therapy Department, Valencia University, Valencia, Spain
| | - Francisco Javier Ortega
- Physical therapy and advanced rehabilitation clinic RehAv Elche, Elche, Spain
- Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Elche, Spain
| | - Francisco Javier Molina-Payá
- Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Elche, Spain
| | - Enrique Velasco
- Neuroscience in Physiotherapy (NiP), Independent Research Group, Elche, Spain
- Laboratory of Ion Channel Research, Department of Cellular and Molecular Medicine, KU Leuven; VIB-KU Leuven Center for Brain & Disease Research, Leuven, Belgium
| | - Miguel Delicado-Miralles
- Neuroscience in Physiotherapy (NiP), Independent Research Group, Elche, Spain
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC, San Juan de Alicante, Spain
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Menezes MA, Menezes DA, Vasconcelos LL, DeSantana JM. Is Electrical Stimulation Effective in Preventing or Treating Delayed-onset Muscle Soreness (DOMS) in Athletes and Untrained Adults? A Systematic Review With Meta-Analysis. THE JOURNAL OF PAIN 2022; 23:2013-2035. [PMID: 35964921 DOI: 10.1016/j.jpain.2022.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 01/04/2023]
Abstract
The effectiveness of electrical stimulation (ES) in preventing or treating delayed-onset muscle soreness (DOMS) and its effects on muscle recovery is unclear. The systematic review investigated the benefits or harms of ES on DOMS and muscle recovery. Databases (PubMed, Medline, CENTRAL, EMBASE, CINAHL, PsycINFO, PEDro, LILACS, SPORTDiscus) were searched up to March, 31st 2021 for randomized controlled trials (RCTs) of athletes or untrained adults with DOMS treated with ES and compared to placebo/sham (simulation or without ES), or control (no intervention). Data were pooled in a meta-analysis. Risk of bias (Cochrane Collaboration tool) and quality of evidence (GRADE) were analyzed. Fourteen trials (n=435) were included in this review and 12 trials (n=389) were pooled in a meta-analysis. Evidence of very low to low quality indicates that ES does not prevent or treat DOMS as well as ES does not help to promote muscle recovery immediately, 24, 48, 72, 96 hours after the intervention. Only one study monitored adverse events. There are no recommendations that support the use of ES in DOMS and muscle recovery. PERSPECTIVES: No recommendations support the use of electrical stimulation in delayed-onset muscle soreness and muscle recovery in athletes and untrained adults. This means that electrical stimulation is not fruitful for this population according those protocols used. Therefore, unlikely that further randomized controlled trials with the same approach will yield promising results.
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Affiliation(s)
- Mayara Alves Menezes
- Health Sciences Graduate Program, Federal University of Sergipe. R. Cláudio Batista - Palestina, nº 676, zip code: 49060-025. Aracaju, SE, Brazil
| | - Danielle Alves Menezes
- Psychology Graduate Program, Federal University of Sergipe. Cidade Universitária Prof. José Aloísio de Campos, Avenida Marechal Rondon, s/n - Jardim Rosa Elze, zip code: 49100-000. São Cristóvão, SE, Brazil
| | - Lucas Lima Vasconcelos
- Department of Psychology, McGill University, 2001 Avenue McGill College, QC, H3A 1G1 Montreal, Canada
| | - Josimari Melo DeSantana
- Department of Physical Therapy, Federal University of Sergipe. Cidade Universitária Prof. José Aloísio de Campos, Avenida Marechal Rondon, s/n - Jardim Rosa Elze, zip code: 49100-000. São Cristóvão, SE, Brazil..
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Using TENS for Pain Control: Update on the State of the Evidence. Medicina (B Aires) 2022; 58:medicina58101332. [PMID: 36295493 PMCID: PMC9611192 DOI: 10.3390/medicina58101332] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 12/03/2022] Open
Abstract
Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological intervention used in the treatment of acute and chronic pain conditions. The first clinical studies on TENS were published over 50 years ago, when effective parameters of stimulation were unclear and clinical trial design was in its infancy. Over the last two decades, a better understanding of the mechanisms underlying TENS efficacy has led to the development of an adequate dose and has improved outcome measure utilization. The continued uncertainty about the clinical efficacy of TENS to alleviate pain, despite years of research, is related to the quality of the clinical trials included in systematic reviews. This summary of the evidence includes only trials with pain as the primary outcome. The outcomes will be rated as positive (+), negative (−), undecided (U), or equivalent to other effective interventions (=). In comparison with our 2014 review, there appears to be improvement in adverse events and parameter reporting. Importantly, stimulation intensity has been documented as critical to therapeutic success. Examinations of the outcomes beyond resting pain, analgesic tolerance, and identification of TENS responders remain less studied areas of research. This literature review supports the conclusion that TENS may have efficacy for a variety of acute and chronic pain conditions, although the magnitude of the effect remains uncertain due to the low quality of existing literature. In order to provide information to individuals with pain and to clinicians treating those with pain, we suggest that resources for research should target larger, high-quality clinical trials including an adequate TENS dose and adequate timing of the outcome and should monitor risks of bias. Systematic reviews and meta-analyses should focus only on areas with sufficiently strong clinical trials that will result in adequate sample size.
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Reduction on Proinflammatory Cytokines after Application of Transcutaneous Electrical Nerve Stimulation (TENS) in Patients with a Breast Cancer: A Nonrandomized, Open, and Single-Arm Study Protocol with Paired Analysis. Mediators Inflamm 2022; 2022:1350813. [PMID: 35241969 PMCID: PMC8886802 DOI: 10.1155/2022/1350813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 12/15/2021] [Accepted: 01/29/2022] [Indexed: 11/17/2022] Open
Abstract
Background. Transcutaneous electrical nerve stimulation (TENS) has been used as analgesic therapy in many diseases. It is already known that studies that have observed the relationship between pain and cytokines have found that patients who report less severe pain have less production of proinflammatory cytokines. However, one another accepted mechanism is that decreasing proinflammatory cytokines results in decreased pain intensity. Analyzing the literature, the authors describe that, in addition to the analgesic effect, TENS has shown systemic effects, and clinically, the reduction of proinflammatory cytokines could be a protective factor against inflammation. To test the inflammatory effect of TENS, we researched the literature for clinical conditions that suggest that proinflammatory cytokines are one of the main mediators of the disease process. Chronic inflammation is one of the risk factors mentioned for the development of a new cancer; at the same time, it is indicated as an indicator of the worst prognosis. Studies also suggest that the worst prognosis of breast cancer, one of the types with the highest incidence in the world, may be related to increased inflammatory activity. Considering that inflammation is increased in breast cancer and that TENS can reduce proinflammatory cytokines even without blocking the pain pathway, our hypothesis is that the anti-inflammatory effect of TENS can bring benefits to these patients. The aim of this study will be to evaluate the effect of TENS on blood reduction of proinflammatory cytokines in breast cancer patients. Methods. This study will evaluate at least 59 patients, over 18 years of age, diagnosed with breast cancer, but who have not yet started any treatment. All patients will be submitted to TENS intervention (Ibramed, Model Neurodyn III, parameters: VIF—turn on, frequency—2-247 Hz, pulse size—50-500 μs, and intensity (mA)—maximum tolerated by the patient), and the data will be analyzed in the pre- and postintervention of each patient. The application has a total duration of 30 minutes, and 8 ml of blood will be collected before and after the intervention. Proinflammatory (IL-1, IL-2, IL-6, IL-7, and TNF-α) and anti-inflammatory (IL-4, IL-10, IL-13, and FTCβ) cytokines will be analyzed. As a primary endpoint, we will analyze the reduction in blood concentration of proinflammatory cytokines, and as secondary endpoints, we will analyze the size of the effect according to each type of proinflammatory cytokine, describe the effect size of the reduction according to the breast cancer immunohistochemistry, and analyze the effect of TENS on anti-inflammatory cytokines. This study is approved by the Research Ethics Committee (Centro Universitário FMABC, Brazil) and registered in the Brazilian Clinical Trials (Search text: RBR-10jbwh47).
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Dolibog P, Pietrzyk B, Kierszniok K, Pawlicki K. Comparative Analysis of Human Body Temperatures Measured with Noncontact and Contact Thermometers. Healthcare (Basel) 2022; 10:healthcare10020331. [PMID: 35206944 PMCID: PMC8871951 DOI: 10.3390/healthcare10020331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/02/2022] [Accepted: 02/07/2022] [Indexed: 12/03/2022] Open
Abstract
Body temperature measurement is one of the basic methods in clinical diagnosis. The problems of thermometry—interpretation of the accuracy and repeatability of various types of thermometers—are still being discussed, especially during the current pandemic in connection with the SARS-CoV-2 virus responsible for causing the COVID-19 disease. The aim of the study was to compare surface temperatures of the human body measured by various techniques, in particular a noncontact thermometer (infrared) and contact thermometers (mercury, mercury-free, electronic). The study included 102 randomly selected healthy women and men (age 18–79 years). The Bland–Altman method was used to estimate the 95% reproducibility coefficient, i.e., to assess the degree of conformity between different attempts. Temperatures measured with contact thermometers in the armpit are higher than temperatures measured without contact at the frontal area of the head. The methods used to measure with contact thermometers and a noncontact infrared thermometer statistically showed high measurement reliability. In order to correctly interpret the result of measuring human body temperature, it is necessary to indicate the place of measurement and the type of thermometer used.
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ISHIKAWA M, MIURA H, TAMURA Y, MURAKAMI A. Effect of Electrical Muscle Stimulation on Vascular Endothelial Function during Prolonged Sitting. Phys Ther Res 2022; 25:127-133. [PMID: 36819917 PMCID: PMC9910348 DOI: 10.1298/ptr.e10191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 09/07/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE While prolonged sedentary behaviors (SBs) increase cardiovascular disease (CVD) risk, interrupting prolonged sitting (PS) with frequent light exercise reduces arterial functional decline. Skeletal muscle electrical stimulation (EMS) enhances peripheral circulation through passive muscle contraction, suggesting that EMS reduces CVD risk by providing an alternative to active exercise for prolonged SBs. This study aimed to investigate the effects of EMS to skeletal muscles during PS on the endothelial function of the brachial artery (BA). METHODS Study participants included 12 healthy adult men who were subjected to 15 min of supine rest, followed by 1 h of PS only (control [CON] trial), or 20 min of EMS to the lower extremities at 50% of the maximum tolerance intensity during PS (EMS trial). Flow-mediated dilation (FMD) of the BA was measured before and 30 min after PS, and normalized FMD (nFMD) was calculated. RESULTS The nFMD of the CON trial significantly decreased 30 min after PS completion (6.21% ± 1.13%) compared with that before PS (7.26% ± 0.73%), and there was no significant change in the EMS trial before and after PS. The EMS trial showed a significant increase in the nFMD 30 min after PS completion (1.14 ± 0.77) compared with that before PS (0.84 ± 0.43). However, no significant difference was observed in the CON trials. CONCLUSION Passive contraction of the lower extremity muscles by EMS increases BA nFMD, suggesting that prolonged sedentary lower extremity EMS use may reduce the risk of vascular endothelial dysfunction.
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Affiliation(s)
- Mizuki ISHIKAWA
- Department of Physical Therapy, Faculty of Health Science, Osaka Yukioka College of Health Science, Japan
| | - Hajime MIURA
- Laboratory for Applied Physiology, Institutes of Socio-Arts and Sciences, Tokushima University, Japan
| | - Yasuaki TAMURA
- Department of Rehabilitation Medicine, Tokushima Prefecture Naruto Hospital, Japan
| | - Ayako MURAKAMI
- Department of Health and Nutrition, Shikoku University, Japan
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Rajendran SB, Challen K, Wright KL, Hardy JG. Electrical Stimulation to Enhance Wound Healing. J Funct Biomater 2021; 12:40. [PMID: 34205317 PMCID: PMC8293212 DOI: 10.3390/jfb12020040] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 12/11/2022] Open
Abstract
Electrical stimulation (ES) can serve as a therapeutic modality accelerating the healing of wounds, particularly chronic wounds which have impaired healing due to complications from underlying pathology. This review explores how ES affects the cellular mechanisms of wound healing, and its effectiveness in treating acute and chronic wounds. Literature searches with no publication date restrictions were conducted using the Cochrane Library, Medline, Web of Science, Google Scholar and PubMed databases, and 30 full-text articles met the inclusion criteria. In vitro and in vivo experiments investigating the effect of ES on the general mechanisms of healing demonstrated increased epithelialization, fibroblast migration, and vascularity around wounds. Six in vitro studies demonstrated bactericidal effects upon exposure to alternating and pulsed current. Twelve randomized controlled trials (RCTs) investigated the effect of pulsed current on chronic wound healing. All reviewed RCTs demonstrated a larger reduction in wound size and increased healing rate when compared to control groups. In conclusion, ES therapy can contribute to improved chronic wound healing and potentially reduce the financial burden associated with wound management. However, the variations in the wound characteristics, patient demographics, and ES parameters used across studies present opportunities for systematic RCT studies in the future.
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Affiliation(s)
- Saranya B. Rajendran
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, Lancashire LA1 4AT, UK;
| | - Kirsty Challen
- Emergency Department, Lancashire Teaching Hospitals NHS Trust, Royal Preston Hospital, Sharoe Green Lane, Preston, Lancashire PR2 9HT, UK;
| | - Karen L. Wright
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Lancaster, Lancashire LA1 4YG, UK
| | - John G. Hardy
- Department of Chemistry, Faculty of Science and Technology, Lancaster University, Lancaster, Lancashire LA1 4YB, UK
- Materials Science Institute, Lancaster University, Lancaster, Lancashire LA1 4YB, UK
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Casagrande SM, Biondo-Simões MDLP, Ioshii S, Robes RR, Biondo-Simões R, Boeno BRDO. Histological evaluation of the effect of low-frequency electric stimulation on healing Achilles tendons in rats. Acta Cir Bras 2021; 36:e360103. [PMID: 33533827 PMCID: PMC7853699 DOI: 10.1590/acb360103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/11/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Histologically evaluate the effects of low frequency electrical stimulation in the treatment of Achilles tendon injuries in rats. METHODS Thirty-four rats underwent Achilles tendon tenotomy and tenorrhaphy. They were randomly allocated in two groups. Half of the sample constituted the experiment group, whose lesions were stimulated with 2 Hz, nonpolarized current and 1 mA, for 14 days. The other animals formed the control group. They were evaluated at 2, 4 and 6 weeks. The histological study was carried out, the collagen density and the wound maturity index were measured. RESULTS The healing score was higher in the group stimulated at the 6th week (p = 0.018). The density collagen 1 was higher in the group treated at the three times (p = 0.004) and that collagen 3 was higher in the group treated at 6 weeks (p = 0.004). Together, collagen 1 and 3 were higher in the group stimulated at 4 and 6 weeks (p = 0.009, p = 0.004). The maturity index was higher in this group at the three moments (p = 0.017 p = 0.004 and p = 0.009). CONCLUSION Low frequency electric stimulation improved healing and increased the quantity of collagen.
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Casagrande SM, Biondo-Simões MDLP, Berti LF, Robes RR, Biondo-Simões R, Nakadomari TS, Henning Junior L. Tensiometric evaluation of the effect of lowfrequency electric stimulation on healing Achilles tendons in rats. Acta Cir Bras 2020; 35:e351103. [PMID: 33331453 PMCID: PMC7748081 DOI: 10.1590/acb351103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 10/09/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate the effects of low-frequency electric stimulation on biomechanics following surgical treatment of the Achilles tendon in rats. METHODS Forty-two rats were divided into two groups. One was given electric stimulation and the other was not. All were submitted to Achilles tenotomy and tenorrhaphy performed with a modified Kessler stitch. The experiment group underwent electric stimulation with 2 Hz, a nonpolarized current of 1 mA intensity for 14 days. The animals were euthanized at 2, 4 and 6 weeks for the biomechanical study. RESULTS The work performed, that is, the tendon's capacity to absorb energy until rupture, was greater in the electrically stimulated group in the 2nd (p = 0.032) and in the 6th week (p = 0.010). The maximum tension, which is the capacity to support a load, was higher in the treated group in the 2nd (p = 0.030) and the 6th week (p = 024). These results indicate greater resistance of the electrically stimulated tendons. An analysis of the elastic module showed no differences. CONCLUSION Low-frequency electric stimulation increased the resistance of the tendons at 2 and 6 weeks of evolution in rats.
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A test-retest reliability study of assessing small cutaneous fibers by measuring current perception threshold with pin electrodes. PLoS One 2020; 15:e0242490. [PMID: 33201884 PMCID: PMC7671533 DOI: 10.1371/journal.pone.0242490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 11/04/2020] [Indexed: 11/19/2022] Open
Abstract
Background The quantitative measurement of current perception threshold (CPT) has been used as a method to assess the function of nerve fibers in neuropathy diseases. The aim of this study was to assess the test-retest reliability measuring CPT using the circular pin electrodes for assessing the function of cutaneous thin nerve fibers. Methods CPT measurement was repeated on two separate days with at least one-week interval in 55 volunteers. Superficial blood flow (SBF) and skin temperature (ST) were measured on the skin in an around area concentric to the circular pin electrodes after the process of finding CPTs. The coefficient of variation (CV) and intra-class correlation coefficient (ICC) were calculated. The correlation between each two of CPT, SBF increment and ST increment was analyzed. Results No significant differences were found for CPT, SBF and ST between two sessions. SBF was found to be significantly increased after the process of finding CPT. CPT values of males were found to be higher than females. SBF increment was found to be positively correlated with ST increment. The ICC values for CPT, SBF and ST were 0.595, 0.852 and 0.728, respectively. The CV values for CPT, SBF and ST were 25.53%, 12.59% and 1.94%, respectively. Conclusions The reliability of CPT measurement using circular pin electrodes is fair, and need consistence of measurements in longitudinal studies.
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Application of stable continuous external electric field promotes wound healing in pig wound model. Bioelectrochemistry 2020; 135:107578. [DOI: 10.1016/j.bioelechem.2020.107578] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 05/25/2020] [Accepted: 05/31/2020] [Indexed: 12/13/2022]
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Sen CK, Mathew-Steiner SS, Das A, Sundaresan VB, Roy S. Electroceutical Management of Bacterial Biofilms and Surgical Infection. Antioxid Redox Signal 2020; 33:713-724. [PMID: 32466673 PMCID: PMC7475090 DOI: 10.1089/ars.2020.8086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 01/04/2023]
Abstract
Significance: In the host-microbe microenvironment, bioelectrical factors influence microbes and hosts as well as host-microbe interactions. This article discusses relevant mechanistic underpinnings of this novel paradigm. It also addresses how such knowledge may be leveraged to develop novel electroceutical solutions to manage biofilm infection. Recent Advances: Systematic review and meta-analysis of several hundred wound studies reported a 78.2% prevalence of biofilms in chronic wounds. Biofilm infection is a major cause of delayed wound healing. In the host-microbe microenvironment, bioelectrical factors influence interactions between microbes and hosts. Critical Issues: Rapid biological responses are driven by electrical signals generated by ion currents moving across cell membranes. Bacterial life, growth, and function rely on a bioelectrical milieu, which when perturbed impairs their ability to form a biofilm, a major threat to health care. Electrokinetic stability of several viral particles depend on electrostatic forces. Weak electrical field strength, otherwise safe for humans, can be anti-microbial in this context. In the host, the electric field enhanced keratinocyte migration, bolstered immune defenses, improved mitochondrial function, and demonstrated multiple other effects consistent with supporting wound healing. A deeper mechanistic understanding of bioelectrical principles will inform the design of next-generation electroceuticals. Future Directions: This is an opportune moment in time as there is a surge of interest in electroceuticals in medicine. Projected to reach $35.5 billion by 2025, electroceuticals are becoming a cynosure in the global market. The World Health Organization reports that more than 50% of surgical site infections can be antibiotic resistant. Electroceuticals offer a serious alternative.
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Affiliation(s)
- Chandan K. Sen
- Indiana Center for Regenerative Medicine and Engineering, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Shomita S. Mathew-Steiner
- Indiana Center for Regenerative Medicine and Engineering, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Amitava Das
- Indiana Center for Regenerative Medicine and Engineering, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Vishnu Baba Sundaresan
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio, USA
| | - Sashwati Roy
- Indiana Center for Regenerative Medicine and Engineering, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Visconti MJ, Haidari W, Feldman SR. Transcutaneous electrical nerve stimulation (TENS): a review of applications in dermatology. J DERMATOL TREAT 2019; 31:846-849. [PMID: 31418608 DOI: 10.1080/09546634.2019.1657227] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: A transcutaneous electrical nerve stimulation (TENS) unit is an inexpensive, accessible therapeutic device with multiple dermatology-related uses.Objective: This review aims to describe the dermatological applications of TENS.Methods: PubMed was searched for literature related to TENS in dermatology. Articles describing this association were reviewed for evidence.Results: TENS offered pain relief during photodynamic therapy for the treatment of actinic keratoses, with a reduction in visual analog scale (VAS) scores for patients using TENS during photodynamic therapy compared to those using no intervention. In the treatment of refractory postherpetic neuralgia pain, patients received greater pain relief when given pregabalin along with TENS therapy compared to pregabalin and no TENS therapy. TENS was the most effective therapy in reducing the incidence of PHN when compared to antiviral agents or combination therapy. The administration of TENS three times per week for four weeks improved VAS scores for pruritus associated with atopic dermatitis and lichen simplex chronicus. This benefit extended into the treatment of other conditions, resulting in improvement of pruritus measured by VAS and Dermatology Life Quality Index scores for macular amyloidosis and lichen planus.Conclusions: TENS is beneficial in the field of dermatology, particularly involving the relief of chronic pruritus.
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Affiliation(s)
- Michael J Visconti
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Wasim Haidari
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Souza AK, Souza TR, Siqueira das Neves LM, de Paula Marcondes Ferreira Leite G, Garcia SB, Roberto de Jesus Guirro R, Barbosa RI, Caldeira de Oliveira Guirro E. Effect of High Voltage Pulsed Current on the integration of total skin grafts in rats submitted to nicotine action. J Tissue Viability 2019; 28:161-166. [DOI: 10.1016/j.jtv.2019.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/14/2019] [Accepted: 05/19/2019] [Indexed: 10/26/2022]
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Effectiveness of Transcutaneous Electrical Nerve Stimulation Energy in Older Adults: A Pilot Clinical Trial. Adv Skin Wound Care 2018; 31:462-469. [PMID: 30234576 DOI: 10.1097/01.asw.0000544614.18501.b4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of a transcutaneous electric nerve stimulation (TENS) device typically used for pain suppression (analgesia) during pressure injury (PI) healing, peripheral vascularization, and secondary pain in older adults with chronic PIs and cognitive impairment. DESIGN AND SETTING This pilot clinical trial followed patients from 6 nursing homes. PATIENTS AND INTERVENTION Twenty-two patients with PIs in the distal third of their lower limbs (7 men, 15 women) were included in this study. The control group completed standard wound care (SWC), whereas the experimental group received SWC and TENS. A total of 20 sessions were conducted for each group over 2 months, 3 times a week. MAIN OUTCOME MEASURE PI area, PI healing rate, blood flow, skin temperature, oxygen saturation, and level of pain at baseline and posttreatment. MAIN RESULTS Significant improvements were achieved in PI area (mean difference, 0.92; 95% confidence interval [CI], 0.15-1.67; P =.024), healing rate (3; 95% CI, 1-4.99; P =.009), skin temperature (1.82; 95% CI, 0.35-3.28; P =.021), and pain (1.44; 95% CI, 0.49-2.39; P =.008) in the experimental group, whereas none of the variables revealed a significant change in the control group. CONCLUSIONS The effect of local and spinal TENS combined with the SWC for PI produced a significant improvement in size, healing, skin temperature, and pain levels.
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Effects of Transcutaneous Electrical Nerve Stimulation on Proinflammatory Cytokines: Systematic Review and Meta-Analysis. Mediators Inflamm 2018; 2018:1094352. [PMID: 29805310 PMCID: PMC5901481 DOI: 10.1155/2018/1094352] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 03/01/2018] [Indexed: 11/29/2022] Open
Abstract
The mechanism of pain reduction involves bidirectional processes of pain blocking (nociception) and reductions in the levels of proinflammatory cytokines in the blood. Does transcutaneous electrical nerve stimulation (TENS) reduce blood levels of proinflammatory cytokines? For this systematic review, we searched in six databases to identify randomized controlled trials with the criteria: humans older than 18 years (adults), use of TENS in the experimental group, and having at least one pre- and postintervention blood level of at least one proinflammatory cytokine. The risk of bias and the level of evidence were assessed. Five studies were included involving 240 participants. The heterogeneity of the studies was high (I2: 85%); therefore, we used a random-effects meta-analysis. It was observed through the meta-analysis synthesis measures that there were statistically significant differences following the use of TENS to reduce the general group of cytokines. When grouped by chronic disease, by postoperative settings, or by individual studies in the case of IL-6, it was observed that the significant reduction of cytokines related to the use of TENS was maintained. The use of TENS reduced the blood levels of proinflammatory cytokines (we observed a protective factor of TENS in relation to inflammation). The protocol of the systematic review was registered in PROSPERO, CRD42017060379.
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20
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Does transcutaneous nerve stimulation have effect on sympathetic skin response? J Clin Neurosci 2017; 47:160-162. [PMID: 29017745 DOI: 10.1016/j.jocn.2017.08.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 08/10/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study examined the effects of transcutaneous electrical nerve stimulation (TENS) on the sympathetic nerve system by sympathetic skin response test. METHODS Fifty-five healthy volunteers received either: (i) 30minutes TENS (25 participants) (ii) 30minutes sham TENS (30 participants) and SSR test was performed pre- and post-TENS. The mean values of latency and peak-to-peak amplitude of five consecutive SSRs were calculated. RESULTS A significant amplitude difference was found between TENS and sham TENS group both in right and left hand (p=0.04, p=0.01, respectively). However there was no significant latancy difference between two groups (p>0.05 ). CONCLUSION TENS has an inhibitory effect on elicited SNS responses when compared with sham TENS control group.
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Besnier F, Sénard JM, Grémeaux V, Riédel M, Garrigues D, Guiraud T, Labrunée M. The efficacy of transcutaneous electrical nerve stimulation on the improvement of walking distance in patients with peripheral arterial disease with intermittent claudication: study protocol for a randomised controlled trial: the TENS-PAD study. Trials 2017; 18:373. [PMID: 28797281 PMCID: PMC5553808 DOI: 10.1186/s13063-017-1997-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 05/19/2017] [Indexed: 01/01/2023] Open
Abstract
Background In patients with peripheral arterial disease (PAD), walking improvements are often limited by early pain onset due to vascular claudication. It would thus appear interesting to develop noninvasive therapeutic strategies, such as transcutaneous electrical nerve stimulation (TENS), to improve the participation of PAD patients in rehabilitation programmes, and thus improve their quality of life. Our team recently tested the efficacy of a single 45-min session of 10-Hz TENS prior to walking. TENS significantly delayed pain onset and increased the pain-free walking distance in patients with class-II PAD. We now seek to assess the efficacy of a chronic intervention that includes the daily use of TENS for 3 weeks (5 days a week) on walking distance in Leriche-Fontaine stage-II PAD patients. Methods/design This is a prospective, double-blind, multicentre, randomised, placebo-controlled trial. One hundred subjects with unilateral PAD (Leriche-Fontaine stage II) will be randomised into two groups (1:1). For the experimental group (TENS group): the treatment will consist of stimulation of the affected leg (at a biphasic frequency of 10 Hz, with a pulse width of 200 μs, maximal intensity below the motor threshold) for 45 min per day, in the morning before the exercise rehabilitation programme, for 3 weeks, 5 days per week. For the control group (SHAM group): the placebo stimulation will be delivered according to the same modalities as for the TENS group but with a voltage level automatically falling to zero after 10 s of stimulation. First outcome: walking distance without pain. Secondary outcomes: transcutaneous oxygen pressure (TcPO2) measured during a Strandness exercise test, peak oxygen uptake (VO2 peak), endothelial function (EndoPAT®), Ankle-brachial Pressure Index, Body Mass Index, lipid profile (LDL-C, HDL-C, triglycerides), fasting glycaemia, HbA1c level, and the WELCH questionnaire. Discussion TENS-PAD is the first randomised controlled trial that uses transcutaneous electrical therapy as an adjuvant technique to improve vascular function in the treatment of PAD. If the results are confirmed, this technique could be incorporated into the routine care in cardiovascular rehabilitation centers and used in the long term by patients to improve their walking capacity. Trial registration ClinicalTrials.gov, ID: NCT02678403. Registered on 9 February 2016. Sponsor: Toulouse University Hospital. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1997-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Florent Besnier
- Institute of Metabolic and Cardiovascular Diseases (I2MC) team 8, Université de Toulouse National Institute of Health and Medical Research (INSERM), Toulouse, France.,Clinic of Saint-Orens, Cardiovascular and Pulmonary Rehabilitation Centre, Saint-Orens-de-Gameville, France
| | - Jean-Michel Sénard
- Institute of Metabolic and Cardiovascular Diseases (I2MC) team 8, Université de Toulouse National Institute of Health and Medical Research (INSERM), Toulouse, France.,Department of Clinical Pharmacology, Toulouse University Hospital, Toulouse, France
| | - Vincent Grémeaux
- Pôle Rééducation-Réadaptation and Plateforme d'Investigation Technologique INSERM CIC 1432, Dijon University Hospital, Dijon, France
| | - Mélanie Riédel
- Department of Cardiovascular Rehabilitation, Reunion University Hospital, Réunion Island, France
| | - Damien Garrigues
- Clinic of Saint-Orens, Cardiovascular and Pulmonary Rehabilitation Centre, Saint-Orens-de-Gameville, France
| | - Thibaut Guiraud
- Institute of Metabolic and Cardiovascular Diseases (I2MC) team 8, Université de Toulouse National Institute of Health and Medical Research (INSERM), Toulouse, France.,Clinic of Saint-Orens, Cardiovascular and Pulmonary Rehabilitation Centre, Saint-Orens-de-Gameville, France
| | - Marc Labrunée
- Institute of Metabolic and Cardiovascular Diseases (I2MC) team 8, Université de Toulouse National Institute of Health and Medical Research (INSERM), Toulouse, France. .,Department of Cardiovascular Rehabilitation, Toulouse University Hospital, Toulouse, France.
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22
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Almeida TCDC, Figueiredo FWDS, Barbosa Filho VC, de Abreu LC, Fonseca FLA, Adami F. Effects of transcutaneous electrical nerve stimulation (TENS) on proinflammatory cytokines: protocol for systematic review. Syst Rev 2017; 6:139. [PMID: 28697739 PMCID: PMC5505047 DOI: 10.1186/s13643-017-0532-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 06/22/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Pain reduction can be achieved by lowering proinflammatory cytokine levels in the blood. Transcutaneous electrical nerve stimulation (TENS) is a non-invasive physiotherapeutic resource for pain management, but evidence on the effectiveness of this device at reducing proinflammatory cytokines in the blood is unclear. This study systematically reviews the literature on the effect of TENS on proinflammatory cytokines. METHODS A systematic review protocol was developed based on searches of articles in six electronic databases and references of retrieved articles, contact with authors, and repositories of clinical trials. Eligibility criteria: publication in peer-reviewed journals, randomized clinical trials, use of TENS in the experimental group, and pre- and post-measurements of proinflammatory cytokines in the blood. Selection of the studies and extraction of the data will be carried out by two reviewers independently. Characteristics of the study, participants, interventions and outcomes were extracted and described. Assessments were performed on the risk of bias, level of evidence and the size of the intervention effect in the studies, according to GRADE guidelines and the Cochrane Handbook for Systematic Reviews. Clinical and statistical assessments compared the effects of the interventions (meta-analysis), taking into consideration any influencing characteristics of the studies (e.g., methods and application sites). DISCUSSION We anticipate that this review will strengthen evidence-based knowledge of the effect of TENS on proinflammatory cytokines and, as a result, direct new studies to benefit patients with specific pathologies. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42017060379 .
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Affiliation(s)
- Tábata Cristina do Carmo Almeida
- Faculdade de Medicina do ABC (FMABC), Laboratório de Epidemiologia e Análise de dados (ABC Medical School), Av. Lauro Gomes, 2000, Vila Sacadura Cabral, CEP: 09060-870 Santo André, SP Brazil
| | - Francisco Winter dos Santos Figueiredo
- Faculdade de Medicina do ABC (FMABC), Laboratório de Epidemiologia e Análise de dados (ABC Medical School), Av. Lauro Gomes, 2000, Vila Sacadura Cabral, CEP: 09060-870 Santo André, SP Brazil
| | - Valter Cordeiro Barbosa Filho
- Centre in Physical Activity and Health. Department of Physical Education, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Luiz Carlos de Abreu
- Faculdade de Medicina do ABC (FMABC), Laboratório de Delineamento de Estudos e Escrita Científica (ABC Medical School), Av. Lauro Gomes, 2000, Vila Sacadura Cabral, CEP: 09060-870 Santo André, SP Brazil
| | - Fernando Luiz Affonso Fonseca
- Faculdade de Medicina do ABC (FMABC), Laboratório de Análises Clínicas (ABC Medical School), Av. Lauro Gomes, 2000, Vila Sacadura Cabral, CEP: 09060-870 Santo André, SP Brazil
| | - Fernando Adami
- Faculdade de Medicina do ABC (FMABC), Laboratório de Epidemiologia e Análise de dados (ABC Medical School), Av. Lauro Gomes, 2000, Vila Sacadura Cabral, CEP: 09060-870 Santo André, SP Brazil
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Huang CS, Sun YH, Wang YT, Pan YH, Wang SF, Tsai YF. Asymmetrical responses of skin blood flow in ischemic hindlimbs to electrical stimulation of the unilateral forelimb. Microvasc Res 2017; 113:71-77. [PMID: 28549566 DOI: 10.1016/j.mvr.2017.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 05/19/2017] [Accepted: 05/22/2017] [Indexed: 12/24/2022]
Abstract
The regulation of skin blood flow (SBF) is primarily mediated by the sympathetic nervous system, but the effects of electrical stimulation (ES) of one limb on SBF in the other limbs remain unknown. The present study investigated the effects of unilateral forelimb ES on SBF in the bilateral hindlimbs in anesthetized rats. Bilateral hindlimb ischemia was induced by tourniquet application for 60min. After reperfusion for 24h, ES (3 or 125Hz) was applied to the upper one-fourth of the triceps brachii muscle of the left or right forelimb for 30min. Rats that did not receive ES were used as the controls. Bilateral hindlimb SBF was measured by a laser Doppler line scanner for 20min before ES, 30min during ES, and 9min after ES. The results showed significant differences in SBF in the right but not left hindlimb between the control group and experimental group that received 125-Hz ES of the right forelimb. Right hindlimb SBF significantly increased within 3min following the application of 125-Hz ES to the right forelimb. No significant changes in SBF were observed in the left or right hindlimb when 125-Hz ES was applied to the left forelimb. Moreover, 3-Hz ES of the left or right forelimb did not significantly change SBF in either hindlimb compared with the control group. These results indicate that unilateral forelimb ES causes a differential SBF response in the hindlimb via a specific somatosympathetic reflex, and ES-induced SBF improvements in the ischemic hindlimb are frequency-dependent.
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Affiliation(s)
- Chung-Shin Huang
- Department of Research, Raphael Humanistic Clinic, 11 F, No. 49 Guan-Chien Road, Taipei 100, Taiwan, ROC
| | - Ya-Hui Sun
- Department of Research, Raphael Humanistic Clinic, 11 F, No. 49 Guan-Chien Road, Taipei 100, Taiwan, ROC
| | - Yi-Ting Wang
- Department of Research, Raphael Humanistic Clinic, 11 F, No. 49 Guan-Chien Road, Taipei 100, Taiwan, ROC
| | - Yu-Hung Pan
- Department of Research, Raphael Humanistic Clinic, 11 F, No. 49 Guan-Chien Road, Taipei 100, Taiwan, ROC
| | - Shwu-Fen Wang
- Department of Physical Therapy, College of Medicine, National Taiwan University, No. 17 Xu-Zhou Road, Taipei 100, Taiwan, ROC
| | - Yuan-Feen Tsai
- Department of Research, Raphael Humanistic Clinic, 11 F, No. 49 Guan-Chien Road, Taipei 100, Taiwan, ROC; Department of Physiology, College of Medicine, National Taiwan University, No. 1 Jen-Ai Road, Section 1, Taipei 100, Taiwan, ROC.
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Kamali F, Mirkhani H, Nematollahi A, Heidari S, Moosavi E, Mohamadi M. The Effect of Transcutaneous Electrical Nerve Stimulation of Sympathetic Ganglions and Acupuncture Points on Distal Blood Flow. J Acupunct Meridian Stud 2017; 10:120-124. [PMID: 28483183 DOI: 10.1016/j.jams.2017.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 12/21/2016] [Accepted: 01/06/2017] [Indexed: 10/20/2022] Open
Abstract
Transcutaneous electrical nerve stimulation (TENS) is a widely-practiced method to increase blood flow in clinical practice. The best location for stimulation to achieve optimal blood flow has not yet been determined. We compared the effect of TENS application at sympathetic ganglions and acupuncture points on blood flow in the foot of healthy individuals. Seventy-five healthy individuals were randomly assigned to three groups. The first group received cutaneous electrical stimulation at the thoracolumbar sympathetic ganglions. The second group received stimulation at acupuncture points. The third group received stimulation in the mid-calf area as a control group. Blood flow was recorded at time zero as baseline and every 3 minutes after baseline during stimulation, with a laser Doppler flow-meter. Individuals who received sympathetic ganglion stimulation showed significantly greater blood flow than those receiving acupuncture point stimulation or those in the control group (p<0.001). Data analysis revealed that blood flow at different times during stimulation increased significantly from time zero in each group. Therefore, the application of low-frequency TENS at the thoracolumbar sympathetic ganglions was more effective in increasing peripheral blood circulation than stimulation at acupuncture points.
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Affiliation(s)
- Fahimeh Kamali
- Rehabilitation Science Research Center, Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Mirkhani
- Department of Pharmacology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Medical and Natural Products Chemistry Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Ahmadreza Nematollahi
- Rehabilitation Science Research Center, Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeed Heidari
- Student Research Committee, Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elahesadat Moosavi
- Student Research Committee, Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Mohamadi
- Student Research Committee, Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Abstract
New developments in accelerating wound healing can have immense beneficial socioeconomic impact. The wound healing process is a highly orchestrated series of mechanisms where a multitude of cells and biological cascades are involved. The skin battery and current of injury mechanisms have become topics of interest for their influence in chronic wounds. Electrostimulation therapy of wounds has shown to be a promising treatment option with no-device-related adverse effects. This review presents an overview of the understanding and use of applied electrical current in various aspects of wound healing. Rapid clinical translation of the evolving understanding of biomolecular mechanisms underlying the effects of electrical simulation on wound healing would positively impact upon enhancing patient’s quality of life.
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Affiliation(s)
- Jerome Hunckler
- UCL Division of Surgery and Interventional Sciences, Faculty of Medical Sciences, University College London, London, UK
| | - Achala de Mel
- UCL Division of Surgery and Interventional Sciences, Faculty of Medical Sciences, University College London, London, UK
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Khadka N, Zannou AL, Zunara F, Truong DQ, Dmochowski J, Bikson M. Minimal Heating at the Skin Surface During Transcranial Direct Current Stimulation. Neuromodulation 2017; 21:334-339. [PMID: 28111832 DOI: 10.1111/ner.12554] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 10/11/2016] [Accepted: 10/28/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess if transcranial direct current stimulation (tDCS) produces a temperature change at the skin surface, if any change is stimulation polarity (anode or cathode) specific, and the contribution of passive heating (joule heat) or blood flow on such change. MATERIAL AND METHODS Temperature differences (ΔTs) in an agar phantom study and an in vivo study (forearm stimulation) including 20 volunteers with both experimental measures and finite element method (FEM) multiphysics prediction (current flow and bioheat) models of skin comprising three tissue layers (epidermis, dermis, and subcutaneous layer with blood perfusion) or of the phantom for active stimulation and control cases were compared. Temperature was measured during pre, post, and stimulation phases for both phantom and subject's forearms using thermocouples. RESULTS In the phantom, ΔT under both anode and cathode, compared to control, was not significantly different and less than 0.1°C. Stimulation of subjects resulted in a gradual increase in temperature under both anode and cathode electrodes, compared to control (at t = 20 min: ΔTanode = 0.9°C, ΔTcathode = 1.1°C, ΔTcontrol = 0.05°C). The FEM phantom model predicted comparable maximum ΔT of 0.27°C and 0.28°C (at t = 20 min) for the control and anode/cathode cases, respectively. The FEM skin model predicted a maximum ΔT at t = 20 min of 0.98°C for control and 1.36°C under anode/cathode electrodes. CONCLUSIONS Taken together, our results indicate a moderate and nonhazardous increase in temperature at the skin surface during 2 mA tDCS that is independent of polarity, and results from stimulation induced blood flow rather than joule heat.
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Affiliation(s)
- Niranjan Khadka
- Department of Biomedical Engineering, The City College of New York, CUNY, New York, NY, USA
| | - Adantchede L Zannou
- Department of Biomedical Engineering, The City College of New York, CUNY, New York, NY, USA
| | - Fatima Zunara
- Department of Biomedical Engineering, The City College of New York, CUNY, New York, NY, USA
| | - Dennis Q Truong
- Department of Biomedical Engineering, The City College of New York, CUNY, New York, NY, USA
| | - Jacek Dmochowski
- Department of Biomedical Engineering, The City College of New York, CUNY, New York, NY, USA
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York, CUNY, New York, NY, USA
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Yamabata S, Shiraishi H, Munechika M, Fukushima H, Fukuoka Y, Hojo T, Shirayama T, Horii M, Matoba S, Kubo T. Effects of electrical stimulation therapy on the blood flow in chronic critical limb ischemia patients following regenerative therapy. SAGE Open Med 2016; 4:2050312116660723. [PMID: 27504185 PMCID: PMC4962517 DOI: 10.1177/2050312116660723] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 06/19/2016] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES We investigated the effects of electrical stimulation therapy on cutaneous and muscle blood flow in critical limb ischemia patients following regenerative therapy. METHODS Three groups were studied: 10 healthy young subjects, 10 elderly subjects, and 7 critical limb ischemia patients after regenerative therapy. After 5 min rest, electrical stimulation was applied at 5 Hz on the tibialis anterior muscle for 10 min. We estimated the relative changes in oxyhemoglobin and total hemoglobin compared to the basal values at rest (Δ[HbO2], Δ[Hbtot]), which reflected the blood flow in the skin and muscle layer, and we simultaneously measured the tissue O2 saturation (StO2) throughout the electrical stimulation and recovery phase by near-infrared spectroscopy. RESULTS The Δ[HbO2] and Δ[Hbtot] values of the muscle layer in critical limb ischemia patients increased gradually and remained significantly higher at the 5-min and 10-min recovery periods after the electrical stimulation without reducing the StO2, but there is no significant change in the other two groups. Skin blood flow was not influenced by electrical stimulation in three groups. CONCLUSION This improvement of the peripheral circulation by electrical stimulation would be beneficial as the adjunctive therapy after regenerative cell therapy.
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Affiliation(s)
- Shiho Yamabata
- Rehabilitation Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hirokazu Shiraishi
- Rehabilitation Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Mai Munechika
- Rehabilitation Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hideki Fukushima
- Rehabilitation Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiyuki Fukuoka
- Graduate School of Health and Sports Science, Doshisha University, Kyoto, Japan
| | - Tatsuya Hojo
- Graduate School of Health and Sports Science, Doshisha University, Kyoto, Japan
| | - Takeshi Shirayama
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Motoyuki Horii
- Rehabilitation Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toshikazu Kubo
- Rehabilitation Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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The Effect of Electrical Stimulation Combined with Foam Dressing on Ulcer Healing in Rats with Spinal Cord Injury. Adv Skin Wound Care 2015; 28:495-502. [DOI: 10.1097/01.asw.0000470553.85257.84] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Campos FV, Neves LM, Da Silva VZ, Cipriano GF, Chiappa GR, Cahalin L, Arena R, Cipriano G. Hemodynamic Effects Induced by Transcutaneous Electrical Nerve Stimulation in Apparently Healthy Individuals: A Systematic Review With Meta-Analysis. Arch Phys Med Rehabil 2015; 97:826-35. [PMID: 26384939 DOI: 10.1016/j.apmr.2015.08.433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 08/13/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the immediate effects of transcutaneous electrical nerve stimulation (TENS) on heart rate, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in apparently healthy adults (age ≥18y). DATA SOURCES The Cochrane Library (online version 2014), PubMed (1962-2014), EMBASE (1980-2014), and LILACS (1980-2014) electronic databases were searched. STUDY SELECTION Randomized controlled trials were included when TENS was administered noninvasively with surface electrodes during rest, and the effect of TENS was compared with that of control or placebo TENS. A sensitive search strategy for identifying randomized controlled trials was used by 2 independent reviewers. The initial search led to the identification of 432 studies, of which 5 articles met the eligibility criteria. DATA EXTRACTION Two independent reviewers extracted data from the selected studies. Quality was evaluated using the PEDro scale. Mean differences or standardized mean differences in outcomes were calculated. DATA SYNTHESIS Five eligible articles involved a total of 142 apparently healthy individuals. Four studies used high-frequency TENS and 3 used low-frequency TENS and evaluated the effect on SBP. Three studies using high-frequency TENS and 2 using low-frequency TENS evaluated the effect on DBP. Three studies using high-frequency TENS and 1 study using low-frequency TENS evaluated the effect on heart rate. A statistically significant reduction in SBP (-3.00mmHg; 95% confidence interval [CI], -5.02 to -0.98; P=.004) was found using low-frequency TENS. A statistically significant reduction in DBP (-1.04mmHg; 95% CI, -2.77 to -0.03; I(2)=61%; P=.04) and in heart rate (-2.55beats/min; 95% CI, -4.31 to -0.78; I(2)=86%; P=.005]) was found using both frequencies. The median value on the PEDro scale was 7 (range, 4-8). CONCLUSIONS TENS seems to promote a discrete reduction in SBP, DBP, and heart rate in apparently healthy individuals.
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Affiliation(s)
- Filippe V Campos
- Health Sciences and Technologies PhD Program, Department of Physical Therapy, University of Brasilia, Brasilia, Brazil; Cardiac Rehabilitation Ambulatory, Armed Forces Hospital, Brasilia, Brazil
| | - Laura M Neves
- Health Sciences and Technologies PhD Program, Department of Physical Therapy, University of Brasilia, Brasilia, Brazil; University of Para, Belém, Brazil
| | - Vinicius Z Da Silva
- Health Sciences and Technologies PhD Program, Department of Physical Therapy, University of Brasilia, Brasilia, Brazil
| | - Graziella F Cipriano
- Health Sciences and Technologies PhD Program, Department of Physical Therapy, University of Brasilia, Brasilia, Brazil
| | - Gaspar R Chiappa
- Exercise Pathophysiology Research Laboratory, Cardiology Division, Porto Alegre Hospital, Porto Alegre, Brazil
| | - Lawrence Cahalin
- Department of Physical Therapy, Leonard M. Miller School of Medicine, University of Miami, Miami, FL
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, Chicago, IL; Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
| | - Gerson Cipriano
- Health Sciences and Technologies PhD Program, Department of Physical Therapy, University of Brasilia, Brasilia, Brazil.
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Folha RAC, Pinfildi CE, Liebano RE, Rampazo ÉP, Pereira RN, Ferreira LM. Can transcutaneous electrical nerve stimulation improve achilles tendon healing in rats? Braz J Phys Ther 2015; 19:433-40. [PMID: 26647744 PMCID: PMC4668336 DOI: 10.1590/bjpt-rbf.2014.0107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 05/18/2015] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND: Tendon injury is one of the most frequent injuries in sports activities. TENS is
a physical agent used in the treatment of pain but its influence on the tendon's
healing process is unclear. OBJECTIVE: To evaluate the influence of TENS on the healing of partial rupture of the
Achilles tendon in rats. METHOD: Sixty Wistar rats were submitted to a partial rupture of the Achilles tendon by
direct trauma and randomized into six groups (TENS or Sham stimulation) and the
time of evaluation (7, 14, and 21 days post-injury). Burst TENS was applied for 30
minutes, 6 days, 100 Hz frequency, 2 Hz burst frequency, 200 µs pulse duration,
and 300 ms pulse train duration. Microscopic analyses were performed to quantify
the blood vessels and mast cells, birefringence to quantify collagen fiber
alignment, and immunohistochemistry to quantify types I and III collagen fibers.
RESULTS: A significant interaction was observed for collagen type I (p=0.020) where the
TENS group presented lower percentage in 14 days after the lesion (p=0.33). The
main group effect showed that the TENS group presented worse collagen fiber
alignment (p=0.001) and lower percentage of collagen III (p=0.001) and the main
time effect (p=0.001) showed decreased percentage of collagen III at 7 days
(p=0.001) and 14 days (p=0.001) after lesion when compared to 21 days. CONCLUSIONS: Burst TENS inhibited collagen I and III production and impaired its alignment
during healing of partial rupture of the Achilles tendon in rats.
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Affiliation(s)
- Roberta A C Folha
- Departamento de Cirurgia Plástica, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Carlos E Pinfildi
- Departamento de Ciências do Movimento Humano, UNIFESP, Santos, SP, Brazil
| | - Richard E Liebano
- Departamento de Fisioterapia, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - Érika P Rampazo
- Departamento de Cirurgia Plástica, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | - Lydia M Ferreira
- Departamento de Cirurgia Plástica, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Vance CGT, Dailey DL, Rakel BA, Sluka KA. Using TENS for pain control: the state of the evidence. Pain Manag 2015; 4:197-209. [PMID: 24953072 DOI: 10.2217/pmt.14.13] [Citation(s) in RCA: 212] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacological intervention that activates a complex neuronal network to reduce pain by activating descending inhibitory systems in the central nervous system to reduce hyperalgesia. The evidence for TENS efficacy is conflicting and requires not only description but also critique. Population-specific systemic reviews and meta-analyses are emerging, indicating both HF and LF TENS being shown to provide analgesia, specifically when applied at a strong, nonpainful intensity. The purpose of this article is to provide a critical review of the latest basic science and clinical evidence for TENS. Additional research is necessary to determine if TENS has effects specific to mechanical stimuli and/or beyond reduction of pain and will improve activity levels, function and quality of life.
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Affiliation(s)
- Carol G T Vance
- The University of Iowa Physical Therapy & Rehabilitation Science Department, IA, USA
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Calvey C, Zhou W, Stakleff KS, Sendelbach-Sloan P, Harkins AB, Lanzinger W, Willits RK. Short-term electrical stimulation to promote nerve repair and functional recovery in a rat model. J Hand Surg Am 2015; 40:314-22. [PMID: 25459379 DOI: 10.1016/j.jhsa.2014.10.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 09/29/2014] [Accepted: 10/02/2014] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the effect of duration of electrical stimulation on peripheral nerve regeneration and functional recovery. Based on previous work, we hypothesized that applying 10 minutes of electrical stimulation to a 10-mm rat sciatic nerve defect would significantly improve nerve regeneration and functional recovery compared with the non-electrical stimulation group. METHODS A silicone tube filled with a collagen gel was used to bridge a 10-mm nerve defect in rats, and either 10 minutes or 60 minutes of electrical stimulation was applied to the nerve during surgery. Controls consisted of a silicone tube with collagen gel and no electrical stimulation or an isograft. We analyzed recovery over a 12-week period, measuring sciatic functional index and extensor postural thrust scores and concluding with histological examination of the nerve. RESULTS Functional assessment scores at week 12 increased 24% in the 10-minute group as compared to the no stimulation control group. Electrical stimulation of either 10 or 60 minutes improved the number of nerve fibers over no stimulation. Additionally, the electrical stimulation group's histomorphometric analysis was not different from the isograft group. CONCLUSIONS Several previous studies have demonstrated the effectiveness of 60-minute stimulations on peripheral nerve regeneration. This study demonstrated that an electrical stimulation of 10 minutes enhanced several functional and histomorphometric outcomes of nerve regeneration and was overall similar to a 60-minute stimulation over 12 weeks. CLINICAL RELEVANCE Decreasing the electrical stimulation time from 60 minutes to 10 minutes provided a potential clinically feasible and safe method to enhance nerve regeneration and functional recovery.
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Affiliation(s)
- Colleen Calvey
- Department of Orthopaedic Surgery and the Kenneth Calhoun Research Laboratory, Akron General Medical Center, Akron, OH; Department of Biomedical Engineering, The University of Akron, Akron, OH; Department of Pharmacological and Physiological Science, Saint Louis University, St. Louis, MO
| | - Wenda Zhou
- Department of Orthopaedic Surgery and the Kenneth Calhoun Research Laboratory, Akron General Medical Center, Akron, OH; Department of Biomedical Engineering, The University of Akron, Akron, OH; Department of Pharmacological and Physiological Science, Saint Louis University, St. Louis, MO
| | - Kimberly Sloan Stakleff
- Department of Orthopaedic Surgery and the Kenneth Calhoun Research Laboratory, Akron General Medical Center, Akron, OH; Department of Biomedical Engineering, The University of Akron, Akron, OH; Department of Pharmacological and Physiological Science, Saint Louis University, St. Louis, MO
| | - Patricia Sendelbach-Sloan
- Department of Orthopaedic Surgery and the Kenneth Calhoun Research Laboratory, Akron General Medical Center, Akron, OH; Department of Biomedical Engineering, The University of Akron, Akron, OH; Department of Pharmacological and Physiological Science, Saint Louis University, St. Louis, MO
| | - Amy B Harkins
- Department of Orthopaedic Surgery and the Kenneth Calhoun Research Laboratory, Akron General Medical Center, Akron, OH; Department of Biomedical Engineering, The University of Akron, Akron, OH; Department of Pharmacological and Physiological Science, Saint Louis University, St. Louis, MO
| | - William Lanzinger
- Department of Orthopaedic Surgery and the Kenneth Calhoun Research Laboratory, Akron General Medical Center, Akron, OH; Department of Biomedical Engineering, The University of Akron, Akron, OH; Department of Pharmacological and Physiological Science, Saint Louis University, St. Louis, MO
| | - Rebecca Kuntz Willits
- Department of Orthopaedic Surgery and the Kenneth Calhoun Research Laboratory, Akron General Medical Center, Akron, OH; Department of Biomedical Engineering, The University of Akron, Akron, OH; Department of Pharmacological and Physiological Science, Saint Louis University, St. Louis, MO.
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Ud-Din S, Bayat A. Electrical Stimulation and Cutaneous Wound Healing: A Review of Clinical Evidence. Healthcare (Basel) 2014; 2:445-67. [PMID: 27429287 PMCID: PMC4934569 DOI: 10.3390/healthcare2040445] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 09/18/2014] [Accepted: 09/30/2014] [Indexed: 12/26/2022] Open
Abstract
Electrical stimulation (ES) has been shown to have beneficial effects in wound healing. It is important to assess the effects of ES on cutaneous wound healing in order to ensure optimization for clinical practice. Several different applications as well as modalities of ES have been described, including direct current (DC), alternating current (AC), high-voltage pulsed current (HVPC), low-intensity direct current (LIDC) and electrobiofeedback ES. However, no one method has been advocated as the most optimal for the treatment of cutaneous wound healing. Therefore, this review aims to examine the level of evidence (LOE) for the application of different types of ES to enhance cutaneous wound healing in the skin. An extensive search was conducted to identify relevant clinical studies utilising ES for cutaneous wound healing since 1980 using PubMed, Medline and EMBASE. A total of 48 studies were evaluated and assigned LOE. All types of ES demonstrated positive effects on cutaneous wound healing in the majority of studies. However, the reported studies demonstrate contrasting differences in the parameters and types of ES application, leading to an inability to generate sufficient evidence to support any one standard therapeutic approach. Despite variations in the type of current, duration, and dosing of ES, the majority of studies showed a significant improvement in wound area reduction or accelerated wound healing compared to the standard of care or sham therapy as well as improved local perfusion. The limited number of LOE-1 trials for investigating the effects of ES in wound healing make critical evaluation and assessment somewhat difficult. Further, better-designed clinical trials are needed to improve our understanding of the optimal dosing, timing and type of ES to be used.
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Affiliation(s)
- Sara Ud-Din
- Plastic and Reconstructive Surgery Research, Manchester Institute of Biotechnology, University of Manchester, Manchester M1 7DN, UK.
- University Hospital of South Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, Manchester M1 7DN, UK.
| | - Ardeshir Bayat
- Plastic and Reconstructive Surgery Research, Manchester Institute of Biotechnology, University of Manchester, Manchester M1 7DN, UK.
- University Hospital of South Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, Manchester M1 7DN, UK.
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Franco OS, Paulitsch FS, Pereira APC, Teixeira AO, Martins CN, Silva AMV, Plentz RDM, Irigoyen MC, Signori LU. Effects of different frequencies of transcutaneous electrical nerve stimulation on venous vascular reactivity. ACTA ACUST UNITED AC 2014; 47:411-8. [PMID: 24820225 PMCID: PMC4075310 DOI: 10.1590/1414-431x20143767] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 02/10/2014] [Indexed: 12/22/2022]
Abstract
Transcutaneous electrical nerve stimulation (TENS) is a type of therapy used
primarily for analgesia, but also presents changes in the cardiovascular system
responses; its effects are dependent upon application parameters. Alterations to the
cardiovascular system suggest that TENS may modify venous vascular response. The
objective of this study was to evaluate the effects of TENS at different frequencies
(10 and 100 Hz) on venous vascular reactivity in healthy subjects. Twenty-nine
healthy male volunteers were randomized into three groups: placebo (n=10),
low-frequency TENS (10 Hz, n=9) and high-frequency TENS (100 Hz, n=10). TENS was
applied for 30 min in the nervous plexus trajectory from the superior member (from
cervical to dorsal region of the fist) at low (10 Hz/200 μs) and high frequency (100
Hz/200 μs) with its intensity adjusted below the motor threshold and intensified
every 5 min, intending to avoid accommodation. Venous vascular reactivity in response
to phenylephrine, acetylcholine (endothelium-dependent) and sodium nitroprusside
(endothelium-independent) was assessed by the dorsal hand vein technique. The
phenylephrine effective dose to achieve 70% vasoconstriction was reduced 53%
(P<0.01) using low-frequency TENS (10 Hz), while in high-frequency stimulation
(100 Hz), a 47% increased dose was needed (P<0.01). The endothelium-dependent
(acetylcholine) and independent (sodium nitroprusside) responses were not modified by
TENS, which modifies venous responsiveness, and increases the low-frequency
sensitivity of α1-adrenergic receptors and shows high-frequency opposite effects.
These changes represent an important vascular effect caused by TENS with implications
for hemodynamics, inflammation and analgesia.
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Affiliation(s)
- O S Franco
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil
| | - F S Paulitsch
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil
| | - A P C Pereira
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil
| | - A O Teixeira
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil
| | - C N Martins
- Programa de Pós-Graduação em Fisiologia Animal Comparada, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil
| | - A M V Silva
- Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - R D M Plentz
- Programa de Pós-Graduação em Ciências da Saúde, Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil
| | - M C Irigoyen
- Unidade de Hipertensão, Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - L U Signori
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil
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Torkaman G. Electrical Stimulation of Wound Healing: A Review of Animal Experimental Evidence. Adv Wound Care (New Rochelle) 2014; 3:202-218. [PMID: 24761359 DOI: 10.1089/wound.2012.0409] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 04/14/2013] [Indexed: 11/12/2022] Open
Abstract
Significance: Electrical stimulation (ES) is a therapeutic intervention that may help specialists facilitate wound healing rates. The purpose of this section is to compile the available animal research regarding the effectiveness of ES on the injury potential, healing rate, cellular and molecular proliferation, mechanical properties, and survival rate of skin flaps. Recent Advances: Regardless of the type of ES current and polarity used, most of the animal experimental evidence suggests that application of ES can facilitate wound healing. However, treatment time should be sufficiently long to attain good mechanical strength of regenerated tissue, because tensile strength is not consistent with augmented collagen deposition. ES improves the survival rate and skin blood flow of animal flaps, but clinical studies are needed to substantiate the findings from these animal experiments. Critical Issues: Impaired or delayed healing is a major clinical problem that can lead to wound chronicity. ES with various strategies has been used to facilitate the healing process, but many aspects remain controversial. Despite much research, no consensus exists regarding the detailed effects of ES on wound healing. Nevertheless, ES has been approved by the Center for Medicare and Medicine Services for reimbursement of the treatment of some chronic ulcers. Future Directions: Exogenous ES may promote the directional migration of cells and signaling molecules via electrotaxis; however, its underlying mechanism is still poorly understood. Future studies that further elucidate the mechanisms regulating electrotaxis will be necessary to optimize the use of ES in different wound states.
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Affiliation(s)
- Giti Torkaman
- Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Wong YM. Electrical Property of Acupoints. J Altern Complement Med 2014; 20:145-6. [DOI: 10.1089/acm.2013.0169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Yiu Ming Wong
- Health Science Unit (PEC), Hong Kong Physically Handicapped & Able Bodied Association, Hong Kong
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Gürgen SG, Sayın O, Çetin F, Tuç Yücel A. Transcutaneous Electrical Nerve Stimulation (TENS) Accelerates Cutaneous Wound Healing and Inhibits Pro-inflammatory Cytokines. Inflammation 2013; 37:775-84. [DOI: 10.1007/s10753-013-9796-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Thakral G, LaFontaine J, Najafi B, Talal TK, Kim P, Lavery LA. Electrical stimulation to accelerate wound healing. Diabet Foot Ankle 2013; 4:22081. [PMID: 24049559 PMCID: PMC3776323 DOI: 10.3402/dfa.v4i0.22081] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 08/11/2013] [Accepted: 08/21/2013] [Indexed: 04/12/2023]
Abstract
BACKGROUND There are several applications of electrical stimulation described in medical literature to accelerate wound healing and improve cutaneous perfusion. This is a simple technique that could be incorporated as an adjunctive therapy in plastic surgery. The objective of this review was to evaluate the results of randomized clinical trials that use electrical stimulation for wound healing. METHOD We identified 21 randomized clinical trials that used electrical stimulation for wound healing. We did not include five studies with treatment groups with less than eight subjects. RESULTS Electrical stimulation was associated with faster wound area reduction or a higher proportion of wounds that healed in 14 out of 16 wound randomized clinical trials. The type of electrical stimulation, waveform, and duration of therapy vary in the literature. CONCLUSION Electrical stimulation has been shown to accelerate wound healing and increase cutaneous perfusion in human studies. Electrical stimulation is an adjunctive therapy that is underutilized in plastic surgery and could improve flap and graft survival, accelerate postoperative recovery, and decrease necrosis following foot reconstruction.
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Affiliation(s)
- Gaurav Thakral
- Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Javier LaFontaine
- Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bijan Najafi
- Department of Surgery, University of Arizona, Tucson, AZ, USA
| | - Talal K. Talal
- Department of Medicine, Diabetic Foot and Wound Center, Hamad Medical Corporation, Doha, Qatar
| | - Paul Kim
- Department of Plastic Surgery, Georgetown University, Washington, DC, USA
| | - Lawrence A. Lavery
- Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA
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Thakral G, Kim PJ, LaFontaine J, Menzies R, Najafi B, Lavery LA. Electrical stimulation as an adjunctive treatment of painful and sensory diabetic neuropathy. J Diabetes Sci Technol 2013; 7:1202-9. [PMID: 24124947 PMCID: PMC3876364 DOI: 10.1177/193229681300700510] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND The objective of this review is to evaluate the use of electrical stimulation to treat diabetic neuropathy. Application of electrical stimulation may provide a novel treatment option for large and small fiber neuropathy in persons with diabetes. Large and small nerve neuropathy alters pain, proprioception, touch perception, and motor function, which cause burning foot pain and serve as protective mechanisms from ulcerations. METHODS A content search for clinical trials involving electrical stimulation, neuropathy, and diabetes was conducted through PubMed. Randomized clinical trials and prospective studies with outcome measures affecting the lower extremity function were selected for review. RESULTS We identified eight studies in which electrical stimulation was used to treat diabetic neuropathy. Six studies evaluated small fiber neuropathy. Two studies evaluated patients with both small and large fiber neuropathy and reported significant improvement in vibration and monofilament testing and reduction in symptoms in the electrical stimulation treatment group. Six of the eight painful neuropathy studies identified significant improvement in symptoms. There were no studies that evaluated electrical stimulation to treated diabetic motor neuropathy, fall prevention or postural instability. CONCLUSIONS Electrical stimulation may be an effective alternative and adjunctive therapy to current interventions for diabetic peripheral neuropathy.
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Affiliation(s)
- Gaurav Thakral
- Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Paul J. Kim
- Department of Plastic Surgery, Georgetown University, Washington DC
| | - Javier LaFontaine
- Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Robert Menzies
- Diabetic Foot and Wound Center, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Bijan Najafi
- Department of Surgery, University of Arizona, Tucson, Arizona
| | - Lawrence A. Lavery
- Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas
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Martínez-Rodríguez A, Bello O, Fraiz M, Martinez-Bustelo S. The effect of alternating and biphasic currents on humans' wound healing: a literature review. Int J Dermatol 2013; 52:1053-62. [DOI: 10.1111/j.1365-4632.2012.05836.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Olalla Bello
- Faculty of Physiotherapy; A Coruña University; A Coruña; Spain
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de Oliveira Guimarães CS, Santos Tavares FC, Santos MN, Guimarães GC, Pacheco Olegário JG, Rocha LP, Reis LC, Dos Reis MA, da Cunha Castro EC, Miranda Corrêa RR. Transcutaneous electrical nerve stimulation and placental vascularization in cases of uterine blood flow restriction. Fetal Pediatr Pathol 2013; 32:88-96. [PMID: 22515506 DOI: 10.3109/15513815.2012.671648] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Studies report transcutaneous electrical nerve stimulation (TENS) as a treatment for placental insufficiency. To induce utero-placental insufficiency in rats, the uterine artery was ligated. Transcutaneous electrical nerve stimulation was applied with a frequency of 80 Hz, pulse duration of 200 μs, and low intensity. Placental blood vessels were analyzed after immunohistochemistry. The number, caliber and area occupied by placental vessels, fetal weight and length, and placental volume were lower in cases stimulated by TENS. The interaction between ligation and stimulation by TENS was associated with reduction of all these measurements, suggesting that TENS use during pregnancy may have harmful effects on intra-uterine development.
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Najafi B, Crews RT, Wrobel JS. A Novel Plantar Stimulation Technology for Improving Protective Sensation and Postural Control in Patients with Diabetic Peripheral Neuropathy: A Double-Blinded, Randomized Study. Gerontology 2013; 59:473-80. [DOI: 10.1159/000352072] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 05/16/2013] [Indexed: 11/19/2022] Open
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Perez Machado AF, Santana EF, Tacani PM, Liebano RE. The effects of transcutaneous electrical nerve stimulation on tissue repair: A literature review. THE CANADIAN JOURNAL OF PLASTIC SURGERY = JOURNAL CANADIEN DE CHIRURGIE PLASTIQUE 2012. [DOI: 10.1177/229255031202000415] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Transcutaneous electrical nerve stimulation (TENS) consists of a generic application of low-frequency, pulsed electrical currents transmitted by electrodes through the skin surface. It is a therapeutic modality that is nonpharmacological, noninvasive, inexpensive, easy to use and widely applied in clinical practice. Objective To narratively review the scientific evidence of the effects of TENS on tissue repair with respect to wound healing, skin flap viability and tendinous repair. Methods The study was conducted using the MEDLINE, Lilacs and Scielo databases, without limit to the period of publication, and was completed in November 2011. Inclusion criteria were randomized or nonrandomized, controlled or noncontrolled clinical trials, and experimental trials involving rats subjected to TENS for tissue repair. Results Thirty articles on tissue repair were found and, among these, 14 reported on wound healing, 14 reported on skin flaps and two analyzed tedinous repair. Discussion It was suggested that TENS stimulates skin wound healing and tendon repair, as well as the viability of random skin flaps. Such effects may be due to the release of substance P and calcitonin gene-related peptide, which would increase blood flow and, consequently, hasten the events leading to tissue repair. Conclusions Based on the scientific evidence regarding the effects of TENS on tissue repair, the findings of the present literature review were inconclusive because data from the randomized controlled clinical trials were insufficient to confirm such effects.
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Ud-Din S, Perry D, Giddings P, Colthurst J, Zaman K, Cotton S, Whiteside S, Morris J, Bayat A. Electrical stimulation increases blood flow and haemoglobin levels in acute cutaneous wounds without affecting wound closure time: evidenced by non-invasive assessment of temporal biopsy wounds in human volunteers. Exp Dermatol 2012; 21:758-64. [DOI: 10.1111/exd.12005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Sara Ud-Din
- Plastic & Reconstructive Surgery Research, Manchester Institute of Biotechnology; University of Manchester; Manchester UK
- Faculty of Medical and Human Sciences; University Hospital of South Manchester NHS Foundation Trust; Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre; Manchester UK
| | - Donna Perry
- Plastic & Reconstructive Surgery Research, Manchester Institute of Biotechnology; University of Manchester; Manchester UK
- Faculty of Medical and Human Sciences; University Hospital of South Manchester NHS Foundation Trust; Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre; Manchester UK
| | | | | | - Karen Zaman
- Plastic & Reconstructive Surgery Research, Manchester Institute of Biotechnology; University of Manchester; Manchester UK
- Faculty of Medical and Human Sciences; University Hospital of South Manchester NHS Foundation Trust; Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre; Manchester UK
| | | | - Sigrid Whiteside
- Faculty of Medical and Human Sciences; University Hospital of South Manchester NHS Foundation Trust; Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre; Manchester UK
- Medical Statistics; University Hospital South Manchester NHS Foundation Trust; Manchester UK
| | - Julie Morris
- Faculty of Medical and Human Sciences; University Hospital of South Manchester NHS Foundation Trust; Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre; Manchester UK
- Medical Statistics; University Hospital South Manchester NHS Foundation Trust; Manchester UK
| | - Ardeshir Bayat
- Plastic & Reconstructive Surgery Research, Manchester Institute of Biotechnology; University of Manchester; Manchester UK
- Faculty of Medical and Human Sciences; University Hospital of South Manchester NHS Foundation Trust; Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre; Manchester UK
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Silverdal J, Mourtzinis G, Stener-Victorin E, Mannheimer C, Manhem K. Antihypertensive effect of low-frequency transcutaneous electrical nerve stimulation (TENS) in comparison with drug treatment. Blood Press 2012; 21:306-10. [PMID: 22563948 DOI: 10.3109/08037051.2012.680737] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Hypertension is a major risk factor for vascular disease, yet blood pressure (BP) control is unsatisfactory low, partly due to side-effects. Transcutaneous electrical nerve stimulation (TENS) is well tolerated and studies have demonstrated BP reduction. In this study, we compared the BP lowering effect of 2.5 mg felodipin once daily with 30 min of bidaily low-frequency TENS in 32 adult hypertensive subjects (mean office BP 152.7/90.0 mmHg) in a randomized, crossover design. Office BP and 24-h ambulatory BP monitoring (ABPM) were performed at baseline and at the end of each 4-week treatment and washout period. Felodipin reduced office BP by 10/6 mmHg (p <0.001 respectively) and after washout BP rose to a level still significantly lower than at baseline. TENS reduced office BP by 5/1.5 mmHg (p <0.01, ns). After TENS washout, BP was further reduced and significantly lower than at baseline, but at levels similar to BP after felodipin washout and therefore reasonably caused by factors other than the treatment per se. ABPM revealed a significant systolic reduction of 3 mmHg by felodipin, but no significant changes were noted after TENS. We conclude that our study does not present any solid evidence of BP reduction of TENS.
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Affiliation(s)
- Jonas Silverdal
- Department of Internal Medicine and Geriatrics, Sahlgrenska University Hospital/Östra, SE-416 85 Gothenburg, Sweden.
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Mutlu B, Paker N, Bugdayci D, Tekdos D, Kesiktas N. Efficacy of supervised exercise combined with transcutaneous electrical nerve stimulation in women with fibromyalgia: a prospective controlled study. Rheumatol Int 2012; 33:649-55. [PMID: 22527135 DOI: 10.1007/s00296-012-2390-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 03/11/2012] [Indexed: 10/28/2022]
Abstract
The aim of this study was to investigate the results of a supervised exercise with transcutaneous electrical nerve stimulation (TENS) in an exercise controlled study in women with fibromyalgia. Sixty-six women with fibromyalgia who admitted to the outpatient clinic of our hospital were randomized into two treatment groups. The patients in both groups participated in a supervised combined exercise program for 12 weeks. The women in first group had additional TENS in the first 3 weeks of the study. All subjects were analyzed at the baseline, at the end of the 3rd and 12th weeks. Outcome measures were tender point count (TPC), myalgic pain score (MPS), Fibromyalgia Impact Questionnaire (FIQ) and Short Form-36 (SF-36) Health Survey. Sixty women with fibromyalgia completed the study. The patients in both groups showed improvement in terms of TPC, MPS, FIQ, physical and mental summary scores and total scores of SF-36 at the end of the 3rd and 12th weeks. The improvement in MPS at the third week was higher in the first group (p = 0.01). But there was no difference in terms of the improvement in MPS between the groups at the end of the 12th week control (p = 0.87). There was no significant difference between the improvement in the other outcome parameters of the two groups. As a result, supervised exercise program was successful to improve the myalgic pain, functional status and quality of life in women with fibromyalgia. Exercises combined with TENS might be useful due to quick myalgic pain relief in the treatment of fibromyalgia in everyday practice.
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Affiliation(s)
- B Mutlu
- Istanbul Physical Medicine and Rehabilitation Training Hospital, Bahçelievler, Istanbul, Turkey.
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Transcutaneous electrical nerve stimulation at different frequencies on heart rate variability in healthy subjects. Auton Neurosci 2011; 165:205-8. [DOI: 10.1016/j.autneu.2011.07.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 06/15/2011] [Accepted: 07/10/2011] [Indexed: 11/19/2022]
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Does electrical stimulation enhance post-exercise performance recovery? Eur J Appl Physiol 2011; 111:2501-7. [DOI: 10.1007/s00421-011-2117-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2011] [Accepted: 08/03/2011] [Indexed: 10/17/2022]
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Mahbub MH, Harada N. Review of Different Quantification Methods for the Diagnosis of Digital Vascular Abnormalities in Hand‐arm Vibration Syndrome. J Occup Health 2011; 53:241-9. [PMID: 21597234 DOI: 10.1539/joh.10-0030-ra] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- MH Mahbub
- Department of HygieneYamaguchi University Graduate School of MedicineJapan
| | - Noriaki Harada
- Department of HygieneYamaguchi University Graduate School of MedicineJapan
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Salsabili N, Ansari NN, Berjis K, Sedighi A, Salsabili H. Effects of physiotherapeutic TENS in a woman with unexplained infertility. Physiother Theory Pract 2011; 27:155-9. [PMID: 20690870 DOI: 10.3109/09593981003777356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Unexplained infertility (UI) is a difficult diagnosis in the field of obstetrics and gynaecology. This report describes TENS treatment as an adjunct therapy for a 30-year-old woman with long-standing UI who was scheduled to undergo ovarian stimulation for in vitro fertilization (IVF) and embryo transfer. She had three unsuccessful intrauterine insemination treatments. Her last IVF treatment also failed. The treatment consisted of burst-TENS for seven sessions, which was applied daily from the second day of induction of ovulation (IO) to hCG administration. The transvaginal ultrasonography with pulsed Doppler curves was performed to measure the uterine artery impedance indices of Pulsatility Index (PI) and Resistance Index (RI). Before TENS application, on the first day of IO, the PI and RI for right side uterine artery were 3.96 and 0.96, respectively. For left uterine artery, the PI and RI were 6.92 and 1, respectively. After treatment with TENS, on the day of hCG administration, the PI and RI for right side uterine artery were 3.39 and 0.90, respectively. On the left side, they were PI=2.62 and RI=0.86. IVF was performed and on the day of oocytes collection, 22 oocytes were collected and inseminated. Fertilization was confirmed 16 hours after insemination by visualization of 2 pronuclei. A singleton pregnancy was achieved by the presence of a fetal sac during an ultrasound examination. It is concluded that the addition of TENS resulted in remarkable reduction of uterine artery PI and RI and a successful pregnancy after IVF for this woman with UI.
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Affiliation(s)
- Nasser Salsabili
- Faculty of Rehabilitation, Tehran University of Medical Sciences, Iran.
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