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Manojlović Ivezić D, Žitnik J, Šarabon N. Feasibility and Safety of an Eight-Week Exercise Program with the Additional Peripheral Magnetic Stimulation of the Abdominal Muscles. Healthcare (Basel) 2024; 12:1434. [PMID: 39057577 PMCID: PMC11276811 DOI: 10.3390/healthcare12141434] [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: 06/21/2024] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
Peripheral magnetic stimulation has recently been introduced as a non-invasive but effective physical agent to improve muscle strength and everyday function. The aim of this study was to evaluate the feasibility and safety of an exercise program focusing on the abdominal muscles in combination with the peripheral magnetic stimulation of the abdominal muscles. Male and female overweight and obese adults (n = 19) participated in an eight-week exercise program with the additional peripheral magnetic stimulation of the abdominal muscles. Outcome measures included changes in abdominal subcutaneous fat thickness, trunk muscle strength, body composition, and self-reported body satisfaction. Subcutaneous fat thickness was significantly reduced after the intervention (p < 0.01-p < 0.001). Trunk flexion and left side flexion strength increased significantly after the intervention, although no significant changes were observed for trunk extension (p = 0.07) and right side flexion strength (p = 0.13). The body satisfaction self-assessment score significantly increased (p < 0.01), while body mass, body mass index, and fat mass significantly decreased after the intervention (p < 0.05). Our findings suggest that an exercise program with the additional peripheral magnetic stimulation is feasible and safe for overweight and obese participants. These results support the use of peripheral magnetic stimulation as a safe adjunct to the voluntary abdominal muscle contraction. Future studies are needed to evaluate the efficacy of the additional peripheral magnetic stimulation of the abdominal muscles compared to the voluntary contraction of the abdominal muscles alone.
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Affiliation(s)
- Denisa Manojlović Ivezić
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia; (D.M.I.); (J.Ž.)
| | - Jure Žitnik
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia; (D.M.I.); (J.Ž.)
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia; (D.M.I.); (J.Ž.)
- Human Health Department, InnoRenew CoE, Livade 6, SI-6310 Izola, Slovenia
- Laboratory for Motor Control and Motor Behavior, S2P, Science to Practice, Ltd., Tehnološki Park 19, SI-1000 Ljubljana, Slovenia
- Ludwig Boltzmann Institute for Rehabilitation Research, Neugebäudeplatz 1, 3100 St. Pölten, Austria
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Liu S, Sun J. Magnetic nanomaterials mediate precise magnetic therapy. Biomed Phys Eng Express 2024; 10:052001. [PMID: 38981447 DOI: 10.1088/2057-1976/ad60cb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 07/09/2024] [Indexed: 07/11/2024]
Abstract
Magnetic nanoparticle (MNP)-mediated precision magnet therapy plays a crucial role in treating various diseases. This therapeutic strategy compensates for the limitations of low spatial resolution and low focusing of magnetic stimulation, and realizes the goal of wireless teletherapy with precise targeting of focal areas. This paper summarizes the preparation methods of magnetic nanomaterials, the properties of magnetic nanoparticles, the biological effects, and the measurement methods for detecting magnetism; discusses the research progress of precision magnetotherapy in the treatment of psychiatric disorders, neurological injuries, metabolic disorders, and bone-related disorders, and looks forward to the future development trend of precision magnet therapy.
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Affiliation(s)
- Sha Liu
- Jiangsu Key Laboratory of Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210009, People's Republic of China
- State Key Laboratory of Bioelectronics, Southeast University, Nanjing, 210096, People's Republic of China
| | - Jianfei Sun
- Jiangsu Key Laboratory of Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210009, People's Republic of China
- State Key Laboratory of Bioelectronics, Southeast University, Nanjing, 210096, People's Republic of China
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Woods S, McKiel A, Herda T, Klentrou P, Holmes M, Gabriel D, Falk B. Developmental changes in motor unit activity patterns: child-adult comparison using discrete motor unit analysis. Appl Physiol Nutr Metab 2024; 49:904-919. [PMID: 38471135 DOI: 10.1139/apnm-2023-0339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Using global surface electromyography (sEMG) and the sEMG threshold it has been suggested that children activate their type-II motor unit (MU) to a lesser extent compared with adults. However, when age-related differences in discrete MU activation are examined using sEMG decomposition this phenomenon is not observed. Furthermore, findings from these studies are inconsistent and conflicting. Therefore, the purpose of this study was to examine differences in discrete MU activation of the vastus lateralis (VL) between boys and men during moderate-intensity knee extensions. Seventeen boys and 20 men completed two laboratory sessions. Following a habituation session, maximal voluntary isometric knee extension (MVIC) torque was determined before completing trapezoidal contractions at 70% MVIC. sEMG of the VL was captured and mathematically decomposed into individual MU action potential trains. Motor unit action potential amplitude (MUAPamp), recruitment threshold (RT), and MU firing rates (MUFR) were calculated. We observed that MUAPamp-RT slope was steeper in men compared with boys (p < 0.05) even after accounting for fat thickness and quadriceps muscle depth. The mean MUFR and y-intercept of the MUFR-RT relationship were significantly (p < 0.001) lower in boys than in men. The slope of the MUFR-RT relationship tended to be steeper in men, but the differences did not reach statistical significance (p = 0.056). Overall, our results suggest that neural strategies used to produce torque are different among boys and men. Such differences may be related, in part, to boys' lower MUFR and lesser ability to activate their higher-threshold MUs. Although, other factors (e.g., muscle composition) likely also play a role.
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Affiliation(s)
- Stacey Woods
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Andrew McKiel
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
- Centre for Bone and Muscle Health, Brock University, St. Catharines, ON, Canada
| | - Trent Herda
- School of Education and Human Sciences, University of Kansas, Lawrence, KS, USA
| | - Panagiota Klentrou
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
- Centre for Bone and Muscle Health, Brock University, St. Catharines, ON, Canada
| | - Michael Holmes
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
- Centre for Bone and Muscle Health, Brock University, St. Catharines, ON, Canada
| | - David Gabriel
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Bareket Falk
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
- Centre for Bone and Muscle Health, Brock University, St. Catharines, ON, Canada
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Kamiue M, Tsubahara A, Ito T, Koike Y. Measurement of Knee Extensor Torque During Repetitive Peripheral Magnetic Stimulation: Comparison of the Forces Induced by Different Stimulators. Ann Rehabil Med 2024; 48:203-210. [PMID: 38714208 PMCID: PMC11217762 DOI: 10.5535/arm.230025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/09/2024] [Accepted: 04/11/2024] [Indexed: 05/09/2024] Open
Abstract
OBJECTIVE To investigate the factors that induce strong contractions during repetitive peripheral magnetic stimulation (rPMS) and compare the muscle torque induced by two stimulators (Stim A and Stim B) with different coil properties. METHODS rPMS was applied to the right vastus lateralis of 30 healthy young adults. Stim A contained a 10.1 cm2 rectangular iron core coil, while Stim B contained a 191 cm2 round coil. The knee extensor torque (KET) induced by rPMS at 30 Hz was measured isometrically and divided by the maximum voluntary contraction (MVC) to obtain a relative value of MVC (%MVC). KET at 100% intensity of Stim A (A100%, 1.08 T) was compared to those at 100% or 70% intensity of Stim B (B100%, 1.47 T vs. B70%, 1.07 T). Additionally, we conducted a comprehensive literature search for studies that measured the KET during rPMS. RESULTS Both the mean values of %MVC using B100% and B70% were significantly greater than that using A100%. Furthermore, the KET induced by Stim B was found to be larger than that described in previous reports, unless booster units were used to directly stimulate the main trunk of the femoral nerve. CONCLUSION Stim B induced a stronger muscle contraction force than Stim A did. This may be because the larger the coil area, the wider the area that can be stimulated. Additionally, a circular coil allows for deeper stimulation.
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Affiliation(s)
- Masanori Kamiue
- Doctoral Program in Rehabilitation, Graduate School of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Akio Tsubahara
- Department of Physical Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Tomotaka Ito
- Department of Physical Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Yasuhiro Koike
- Department of Occupational Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Japan
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Fujimura K, Kagaya H, Itoh R, Endo C, Tanikawa H, Maeda H. Repetitive peripheral magnetic stimulation for preventing shoulder subluxation after stroke: a randomized controlled trial. Eur J Phys Rehabil Med 2024; 60:216-224. [PMID: 38483332 PMCID: PMC11114152 DOI: 10.23736/s1973-9087.24.08264-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/15/2024] [Accepted: 02/14/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Shoulder subluxation caused by paralysis after stroke is a serious issue affecting shoulder pain and functional prognosis. However, its preventive treatment has not been fully investigated. AIM To investigate the effects of repetitive peripheral magnetic stimulation (rPMS) on the prevention of shoulder subluxation. DESIGN A single-center, parallel-group, prospective randomized, open-blinded, end-point study. SETTING Convalescent rehabilitation ward. POPULATION We included 50 inpatients in the convalescent rehabilitation ward with post-stroke, having upper limb paralysis, and the acromio-humeral interval (AHI) was within 1/2 finger-breadth. METHODS A blinded computer-based allocation system was used to randomly assign patients into two groups: 1) conventional rehabilitation plus rPMS therapy (rPMS group, N=25); and 2) conventional rehabilitation alone (control group, N=25). Blinded assessors evaluated the patients before the intervention (T0), 6 weeks after (T1), and 12 weeks after (T2). The primary outcome was the change in AHIs from T0 to T1 between the groups. In contrast, the secondary outcomes were shoulder pain, spasticity, active range of motion, and Fugl-Meyer Assessment upper extremity (FMA-UE) score. RESULTS Twenty-two patients in the rPMS group and 24 in the control group completed T1, whereas 16 in the rPMS group and 11 in the control group completed T2. The change in AHI was significantly lower in the rPMS group than in the control group ([95% CI, -5.15 to -0.390], P=0.023). Within-group analysis showed that AHI in the rPMS group did not change significantly, whereas it increased in the control group (P=0.004). There were no significant differences between T1 and T2 within or between the groups. Moreover, AHI did not show differences in patients with severe impairment but decreased in the rPMS group in patients with mild impairment (P=0.001). CONCLUSIONS The rPMS may be a new modality for preventing shoulder subluxation. The association between motor impairment and the sustained effect needs to be further examined. CLINICAL REHABILITATION IMPACT Applying rPMS to the muscles of the paralyzed shoulder after a stroke may prevent shoulder subluxation.
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Affiliation(s)
- Kenta Fujimura
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan -
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Ryoka Itoh
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Chiharu Endo
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Hiroki Tanikawa
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Hirofumi Maeda
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
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Jiménez-García AM, Bonnel G, Álvarez-Mota A, Arias N. Current perspectives on neuromodulation in ALS patients: A systematic review and meta-analysis. PLoS One 2024; 19:e0300671. [PMID: 38551974 PMCID: PMC10980254 DOI: 10.1371/journal.pone.0300671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/01/2024] [Indexed: 04/01/2024] Open
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease that affects motor neurons, resulting in muscle weakness, paralysis, and eventually patient mortality. In recent years, neuromodulation techniques have emerged as promising potential therapeutic approaches to slow disease progression and improve the quality of life of ALS patients. A systematic review was conducted until August 8, 2023, to evaluate the neuromodulation methods used and their potential in the treatment of ALS. The search strategy was applied in the Cochrane Central database, incorporating results from other databases such as PubMed, Embase, CTgov, CINAHL, and ICTRP. Following the exclusion of papers that did not fulfil the inclusion criteria, a total of 2090 records were found, leaving a total of 10 studies. R software was used to conduct meta-analyses based on the effect sizes between the experimental and control groups. This revealed differences in muscle stretch measures with manual muscle testing (p = 0.012) and resting motor threshold (p = 0.0457), but not with voluntary isometric contraction (p = 0.1883). The functionality of ALS was also different (p = 0.007), but not the quality of life. Although intracortical facilitation was not seen in motor cortex 1 (M1) (p = 0.1338), short-interval intracortical inhibition of M1 was significant (p = 0.0001). BDNF showed no differences that were statistically significant (p = 0.2297). Neuromodulation-based treatments are proposed as a promising therapeutic approach for ALS that can produce effects on muscle function, spasticity, and intracortical connections through electrical, magnetic, and photonic stimulation. Photobiomodulation stands out as an innovative approach that uses specific wavelengths to influence mitochondria, with the aim of improving mitochondrial function and reducing excitotoxicity. The lack of reliable placebo controls and the variation in stimulation frequency are some of the drawbacks of neuromodulation.
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Affiliation(s)
- Ana M. Jiménez-García
- BRABE Group, Department of Psychology, Faculty of Life and Natural Sciences, University of Nebrija, Madrid, Spain
| | - Gaspard Bonnel
- BRABE Group, Department of Psychology, Faculty of Life and Natural Sciences, University of Nebrija, Madrid, Spain
| | - Alicia Álvarez-Mota
- BRABE Group, Department of Psychology, Faculty of Life and Natural Sciences, University of Nebrija, Madrid, Spain
| | - Natalia Arias
- BRABE Group, Department of Psychology, Faculty of Life and Natural Sciences, University of Nebrija, Madrid, Spain
- Health Research Institute of the Principality of Asturias (Instituto de Investigación Universitaria del Principado de Asturias), Oviedo, Spain
- INEUROPA, Instituto de Neurociencias del Principado de Asturias, Plaza Feijoo, Oviedo, Spain
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Kamiue M, Ito T, Tsubahara A, Kishimoto T. Factors Involved in Higher Knee Extension Torque Induced by Repetitive Peripheral Magnetic Stimulation. Am J Phys Med Rehabil 2024; 103:24-30. [PMID: 37549355 DOI: 10.1097/phm.0000000000002299] [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: 08/09/2023]
Abstract
OBJECTIVE The study aimed to determine the relationship between knee extension torque induced by repetitive peripheral magnetic stimulation and the characteristics of the participants. DESIGN This was a basic study with noninvasive intervention. Knee extension torque induced by repetitive peripheral magnetic stimulation (repetitive peripheral magnetic stimulation-induced torque) and maximum voluntary contraction were measured. Stepwise method of multiple regression was performed to determine the factors affecting repetitive peripheral magnetic stimulation-induced torque at 100% intensity and repetitive peripheral magnetic stimulation-induced torque divided by maximum voluntary contraction (percent maximum voluntary contraction). Subcutaneous fat thickness, vastus lateralis muscle thickness measured by ultrasound, maximum voluntary contraction, and mean power frequency of electromyography during maximum voluntary contraction were selected as independent variables. RESULTS Repetitive peripheral magnetic stimulation was applied to the right vastus lateralis of 30 young healthy adults (average age, 21.1 ± 0.3 yrs). In the multiple regression analysis, repetitive peripheral magnetic stimulation-induced torque ( P < 0.001) was shown to be independently and significantly associated with maximum voluntary contraction (β = 0.510), subcutaneous fat thickness (β = -0.358), and vastus lateralis muscle thickness (β = 0.208), while percent maximum voluntary contraction value ( P < 0.05) was independently and significantly associated with vastus lateralis muscle thickness (β = 1.059). CONCLUSIONS Repetitive peripheral magnetic stimulation-induced torque decreases with thicker subcutaneous fat and increases with stronger maximum voluntary contraction or with thicker muscle.
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Affiliation(s)
- Masanori Kamiue
- From the Doctoral Program in Rehabilitation, Graduate School of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Japan (MK); Department of Physical Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Japan (TI, AT); and Department of Rehabilitation, Yamamoto Orthopedic Clinic, Kurashiki, Japan (TK)
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He J, Luo A, Yu J, Qian C, Liu D, Hou M, Ma Y. Quantitative assessment of spasticity: a narrative review of novel approaches and technologies. Front Neurol 2023; 14:1121323. [PMID: 37475737 PMCID: PMC10354649 DOI: 10.3389/fneur.2023.1121323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/19/2023] [Indexed: 07/22/2023] Open
Abstract
Spasticity is a complex neurological disorder, causing significant physical disabilities and affecting patients' independence and quality of daily lives. Current spasticity assessment methods are questioned for their non-standardized measurement protocols, limited reliabilities, and capabilities in distinguishing neuron or non-neuron factors in upper motor neuron lesion. A series of new approaches are developed for improving the effectiveness of current clinical used spasticity assessment methods with the developing technology in biosensors, robotics, medical imaging, biomechanics, telemedicine, and artificial intelligence. We investigated the reliabilities and effectiveness of current spasticity measures employed in clinical environments and the newly developed approaches, published from 2016 to date, which have the potential to be used in clinical environments. The new spasticity scales, taking advantage of quantified information such as torque, or echo intensity, the velocity-dependent feature and patients' self-reported information, grade spasticity semi-quantitatively, have competitive or better reliability than previous spasticity scales. Medical imaging technologies, including near-infrared spectroscopy, magnetic resonance imaging, ultrasound and thermography, can measure muscle hemodynamics and metabolism, muscle tissue properties, or temperature of tissue. Medical imaging-based methods are feasible to provide quantitative information in assessing and monitoring muscle spasticity. Portable devices, robotic based equipment or myotonometry, using information from angular, inertial, torque or surface EMG sensors, can quantify spasticity with the help of machine learning algorithms. However, spasticity measures using those devices are normally not physiological sound. Repetitive peripheral magnetic stimulation can assess patients with severe spasticity, which lost voluntary contractions. Neuromusculoskeletal modeling evaluates the neural and non-neural properties and may gain insights into the underlying pathology of spasticity muscles. Telemedicine technology enables outpatient spasticity assessment. The newly developed spasticity methods aim to standardize experimental protocols and outcome measures and enable quantified, accurate, and intelligent assessment. However, more work is needed to investigate and improve the effectiveness and accuracy of spasticity assessment.
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Affiliation(s)
- Jian He
- Research Academy of Grand Health, Faculty of Sports Sciences, Ningbo University, Ningbo, China
| | - Anhua Luo
- Research Academy of Grand Health, Faculty of Sports Sciences, Ningbo University, Ningbo, China
| | - Jiajia Yu
- Research Academy of Grand Health, Faculty of Sports Sciences, Ningbo University, Ningbo, China
| | - Chengxi Qian
- Research Academy of Grand Health, Faculty of Sports Sciences, Ningbo University, Ningbo, China
| | - Dongwei Liu
- School of Information Management and Artificial Intelligence, Zhejiang University of Finance and Economics, Hangzhou, China
| | - Meijin Hou
- National Joint Engineering Research Centre of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopaedics and Traumatology of Traditional Chinese Medicine and Rehabilitation (Fujian University of TCM), Ministry of Education, Fuzhou, China
| | - Ye Ma
- Research Academy of Grand Health, Faculty of Sports Sciences, Ningbo University, Ningbo, China
- National Joint Engineering Research Centre of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopaedics and Traumatology of Traditional Chinese Medicine and Rehabilitation (Fujian University of TCM), Ministry of Education, Fuzhou, China
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Colella M, Press DZ, Laher RM, McIlduff CE, Rutkove SB, Cassarà AM, Apollonio F, Pascual-Leone A, Liberti M, Bonmassar G. A study of flex miniaturized coils for focal nerve magnetic stimulation. Med Phys 2023; 50:1779-1792. [PMID: 36502488 PMCID: PMC10033376 DOI: 10.1002/mp.16148] [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: 03/15/2022] [Revised: 09/01/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Peripheral magnetic stimulation (PMS) is emerging as a complement to standard electrical stimulation (ES) of the peripheral nervous system (PNS). PMS may stimulate sensory and motor nerve fibers without the discomfort associated with the ES used for standard nerve conduction studies. The PMS coils are the same ones used in transcranial magnetic stimulation (TMS) and lack focality and selectiveness in the stimulation. PURPOSE This study presents a novel coil for PMS, developed using Flexible technologies, and characterized by reduced dimensions for a precise and controlled targeting of peripheral nerves. METHODS We performed hybrid electromagnetic (EM) and electrophysiological simulations to study the EM exposure induced by a novel miniaturized coil (or mcoil) in and around the radial nerve of the neuro-functionalized virtual human body model Yoon-Sun, and to estimate the current threshold to induce magnetic stimulation (MS) of the radial nerve. Eleven healthy subjects were studied with the mcoil, which consisted of two 15 mm diameter coils in a figure-of-eight configuration, each with a hundred turns of a 25 μm copper-clad four-layer foil. Sensory nerve action potentials (SNAPs) were measured in each subject using two electrodes and compared with those obtained from standard ES. The SNAPs conduction velocities were estimated as a performance metric. RESULTS The induced electric field was estimated numerically to peak at a maximum intensity of 39 V/m underneath the mcoil fed by 70 A currents. In such conditions, the electrophysiological simulations suggested that the mcoil elicits SNAPs originating at 7 mm from the center of the mcoil. Furthermore, the numerically estimated latencies and waveforms agreed with those obtained during the PMS experiments on healthy subjects, confirming the ability of the mcoil to stimulate the radial nerve sensory fibers. CONCLUSION Hybrid EM-electrophysiological simulations assisted the development of a miniaturized coil with a small diameter and a high number of turns using flexible electronics. The numerical dosimetric analysis predicted the threshold current amplitudes required for a suprathreshold peripheral nerve sensory stimulation, which was experimentally confirmed. The developed and now validated computational pipeline will be used to improve the performances (e.g., focality and minimal currents) of new generations of mcoil designs.
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Affiliation(s)
- Micol Colella
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA 02129, USA
- Department of Information Engineering, Electronics and Telecommunications (DIET), Sapienza University of Rome, Rome, Italy
| | - Daniel Z. Press
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Rebecca M. Laher
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Courtney E. McIlduff
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Seward B. Rutkove
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Antonino M. Cassarà
- IT'IS Foundation for Research on Information Technologies in Society, 8004 Zurich, Switzerland
| | - Francesca Apollonio
- Department of Information Engineering, Electronics and Telecommunications (DIET), Sapienza University of Rome, Rome, Italy
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research and Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Guttmann Brain Health Institut, Institut Guttmann, Universitat Autonoma Barcelona, Spain
| | - Micaela Liberti
- Department of Information Engineering, Electronics and Telecommunications (DIET), Sapienza University of Rome, Rome, Italy
| | - Giorgio Bonmassar
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA 02129, USA
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA
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Ye X, Vala D, Walker H, Gaza V, Umali V, Brodoff P, Gockel N, Nakamura M. Effects of Unilateral Neuromuscular Electrical Stimulation with Illusionary Mirror Visual Feedback on the Contralateral Muscle: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3755. [PMID: 36834447 PMCID: PMC9962941 DOI: 10.3390/ijerph20043755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
We aim to examine the cross-education effects of unilateral muscle neuromuscular electrical stimulation (NMES) training combined with illusionary mirror visual feedback (MVF). Fifteen adults (NMES + MVF: 5; NMES: 5, Control: 5) completed this study. The experimental groups completed a 3-week NMES training on their dominant elbow flexor muscle. The NMES + MVF group had a mirror placed in the midsagittal plane between their upper arms, so a visual illusion was created in which their non-dominant arms appeared to be stimulated. Baseline and post-training measurements included both arms' isometric strength, voluntary activation level, and resting twitch. Cross-education effects were not observed from all dependent variables. For the unilateral muscle, both experimental groups showed greater strength increases when compared to the control (isometric strength % changes: NMES + MVF vs. NMES vs. Control = 6.31 ± 4.56% vs. 4.72 ± 8.97% vs. -4.04 ± 3.85%, p < 0.05). Throughout the training, even with the maximally tolerated NMES, the NMES + MVF group had greater perceived exertion and discomfort than the NMES. Additionally, the NMES-evoked force increased throughout the training for both groups. Our data does not support that NMES combined with or without MVF induces cross-education. However, the stimulated muscle becomes more responsive to the NMES and can become stronger following the training.
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Affiliation(s)
- Xin Ye
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Daniel Vala
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Hayden Walker
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Victor Gaza
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Vinz Umali
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Patrick Brodoff
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Nathan Gockel
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT 06117, USA
| | - Masatoshi Nakamura
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata 950-3198, Japan
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Neurorehabilitation in Multiple Sclerosis-A Review of Present Approaches and Future Considerations. J Clin Med 2022; 11:jcm11237003. [PMID: 36498578 PMCID: PMC9739865 DOI: 10.3390/jcm11237003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
Multiple sclerosis is an increasingly prevalent disease, representing the leading cause of non-traumatic neurological disease in Europe and North America. The most common symptoms include gait deficits, balance and coordination impairments, fatigue, spasticity, dysphagia and an overactive bladder. Neurorehabilitation therapeutic approaches aim to alleviate symptoms and improve the quality of life through promoting positive immunological transformations and neuroplasticity. The purpose of this study is to evaluate the current treatments for the most debilitating symptoms in multiple sclerosis, identify areas for future improvement, and provide a reference guide for practitioners in the field. It analyzes the most cited procedures currently in use for the management of a number of symptoms affecting the majority of patients with multiple sclerosis, from different training routines to cognitive rehabilitation and therapies using physical agents, such as electrostimulation, hydrotherapy, cryotherapy and electromagnetic fields. Furthermore, it investigates the quality of evidence for the aforementioned therapies and the different tests applied in practice to assess their utility. Lastly, the study looks at potential future candidates for the treatment and evaluation of patients with multiple sclerosis and the supposed benefits they could bring in clinical settings.
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12
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Kamo T, Wada Y, Okamura M, Sakai K, Momosaki R, Taito S. Repetitive peripheral magnetic stimulation for impairment and disability in people after stroke. Cochrane Database Syst Rev 2022; 9:CD011968. [PMID: 36169558 PMCID: PMC9518012 DOI: 10.1002/14651858.cd011968.pub4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Repetitive peripheral magnetic stimulation (rPMS) is a non-invasive treatment method that can penetrate to deeper structures with painless stimulation to improve motor function in people with physical impairment due to brain or nerve disorders. rPMS for people after stroke has proved to be a feasible approach to improving activities of daily living and functional ability. However, the effectiveness and safety of this intervention for people after stroke remain uncertain. This is an update of the review published in 2019. OBJECTIVES To assess the effects of rPMS for improving activities of daily living and functional ability in people after stroke. SEARCH METHODS We searched the Cochrane Stroke Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library; MEDLINE; Embase; the Cumulative Index to Nursing and Allied Health Literature (CINAHL); PsycINFO; the Allied and Complementary Medicine Database (AMED); OTseeker: Occupational Therapy Systematic Evaluation of Evidence; the Physiotherapy Evidence Database (PEDro); Ichushi-Web; and six ongoing trial registries on 5 October 2021. We screened reference lists and contacted experts in the field. We placed no restrictions on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomised controlled trials (RCTs) conducted to assess the therapeutic effect of rPMS for people after stroke. The following comparisons were eligible for inclusion: 1) active rPMS only compared with 'sham' rPMS (a very weak form of stimulation or a sound only); 2) active rPMS only compared with no intervention; 3) active rPMS plus rehabilitation compared with sham rPMS plus rehabilitation; and 4) active rPMS plus rehabilitation compared with rehabilitation only. DATA COLLECTION AND ANALYSIS Two review authors independently assessed studies for inclusion in the review. The same review authors assessed methods and risk of bias, undertook data extraction, and evaluated the certainty of the evidence using the GRADE approach. We contacted trial authors to request unpublished information if necessary. Any disagreements were resolved through discussion. MAIN RESULTS We included four trials (three parallel-group RCTs and one cross-over trial) involving a total of 139 participants. This result was unchanged from the review published in 2019. Blinding of participants and physicians was well reported in three trials, with no information on whether personnel were blinded in one trial. We judged the overall risk of bias across trials as low. Only two trials (with 63 and 18 participants, respectively) provided sufficient information to be included in the meta-analysis. We found no clear effect of rPMS on activities of daily living at the end of treatment (mean difference (MD) -3.00, 95% confidence interval (CI) -16.35 to 10.35; P = 0.66; 1 trial; 63 participants; low-certainty evidence) and at the end of follow-up (MD -2.00, 95% CI -14.86 to 10.86; P = 0.76; 1 trial; 63 participants; low-certainty evidence) when comparing rPMS plus rehabilitation versus sham rPMS plus rehabilitation. We found no statistical difference in improvement of upper limb function at the end of treatment (MD 2.00, 95% CI -4.91 to 8.91; P = 0.57; 1 trial; 63 participants; low-certainty evidence) and at the end of follow-up (MD 4.00, 95% CI -2.92 to 10.92; P = 0.26; 1 trial; 63 participants; low-certainty evidence) when comparing rPMS plus rehabilitation versus sham rPMS plus rehabilitation. We observed a decrease in spasticity of the elbow at the end of follow-up (MD -0.41, 95% CI -0.89 to 0.07; 1 trial; 63 participants; low-certainty evidence) when comparing rPMS plus rehabilitation versus sham rPMS plus rehabilitation. In terms of muscle strength, rPMS treatment was not associated with improved muscle strength of the ankle dorsiflexors at the end of treatment (MD 3.00, 95% CI -2.44 to 8.44; P = 0.28; 1 trial; 18 participants; low-certainty evidence) when compared with sham rPMS. No studies provided information on lower limb function or adverse events, including death. Based on the GRADE approach, we judged the certainty of evidence related to the primary outcome as low, owing to the small sample size of the studies. AUTHORS' CONCLUSIONS There is insufficient evidence to permit the drawing of any conclusions about routine use of rPMS for people after stroke. Additional trials with large sample sizes are needed to provide robust evidence for rPMS after stroke.
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Affiliation(s)
- Tomohiko Kamo
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- Department of Physical Therapy, Faculty of Rehabilitation, Gunma Paz University, Gunma, Japan
| | - Yoshitaka Wada
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- Department of Rehabilitation Medicine I, Fujita Health University, Aichi, Japan
| | - Masatsugu Okamura
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- BIH Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Kotomi Sakai
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- Comprehensive Unit for Health Economic Evidence Review and Decision Support (CHEERS), Research Organization of Science and Technology, Ritsumeikan University, Kyoto city, Japan
| | - Ryo Momosaki
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Mie, Japan
| | - Shunsuke Taito
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
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13
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Hwang NK, Park JS, Choi JB, Jung YJ. Effect of Peripheral Magnetic Stimulation for Dysphagia Rehabilitation: A Systematic Review. Nutrients 2022; 14:3514. [PMID: 36079772 PMCID: PMC9460190 DOI: 10.3390/nu14173514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/25/2022] [Indexed: 11/19/2022] Open
Abstract
Recently, a therapeutic method to stimulate the suprahyoid muscle using peripheral magnetic stimulation for dysphagia rehabilitation has been reported. However, clinical evidence, application protocol, and intervention method remain unclear. Therefore, a systematic review of the published literature is needed. The objective of this study was to systematically review clinical studies of peripheral magnetic stimulation applied for rehabilitation of dysphagia. Issues to be considered in future studies are also suggested. This systematic review performed a literature search of four databases (Medline, Embase, CINAHL, and Web of Science) to identify relevant studies published on the application of repetitive peripheral magnetic stimulation (rPMS) for swallowing-related muscles between 2010 and 2022. Seven studies were reviewed. Randomized controlled trials and one-group pre-post, case study designs were included. In the included studies, rPMS was applied to strengthen the submental suprahyoid muscles. The intervention regime varied. The rPMS was applied at a frequency of 30 Hz for 2 s. Rest time ranged from 8 s to 27-28 s. The number of intervention sessions ranged from 2-3 to 30. The intensity ranged from pain-inducing minimum intensity (90% of maximum stimulus output) to non-painful intensity (70-80% of maximum intensity). The rPMS on the suprahyoid muscles had positive effects on physiological changes in the swallowing function, such as displacement of the hyoid bone, muscle strength (cervical flexor, jaw-opening force), swallowing safety, swallowing performance, and swallowing-related quality of life. Participants also reported little pain and adverse reactions during rPMS. Although rPMS is a therapeutic option that can help improve the swallowing function as a non-invasive stimulation method in the rehabilitation of dysphagia, clinical evidence is needed for the development of clear stimulation protocols and guidelines.
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Affiliation(s)
- Na-Kyoung Hwang
- Department of Occupational Therapy, Seoul North Municipal Hospital, Seoul 02062, Korea
| | - Ji-Su Park
- Research Institute for Korean Medicine, Pusan National University, Yangsan 50612, Korea
| | - Jong-Bae Choi
- Department of Occupational Therapy, Sangji University, Wonju 26339, Korea
| | - Young-Jin Jung
- School of Healthcare and Biomedical Engineering, Chonnam National University, Yeosu 59626, Korea
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14
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Muscle Stimulation for Aesthetic Body Shaping: A Comprehensive and Critical Review. Dermatol Surg 2022; 48:1076-1082. [PMID: 35985005 DOI: 10.1097/dss.0000000000003550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Aesthetic muscle stimulation (AMS) using high-intensity electromagnetic field (HIFEM) targets skeletal muscle neurons, causing muscle hypertrophy and loss of adipose tissue, thereby cultivating a sculpted physique. Many studies have evaluated AMS for noninvasive body contouring; however, the efficacy, safety, and long-term data remain unclear. OBJECTIVE To critically evaluate the current literature on the use of electromagnetic muscle stimulation for body contouring and provide a consensus on patient selection and long-term efficacy of AMS. MATERIALS AND METHODS PubMed and Embase were searched using the terms: "HIFEM," "Electromagnetic therapy," and "muscle" or "Electrical stimulation muscle treatments" and "aesthetics." Studies involving the use of muscle stimulation for nonaesthetic/dermatologic, in vitro studies or studies involving animals were excluded. RESULTS Twenty studies in total were included [9 moderate-quality, 8 low-quality, and 3 very low‒quality studies] based on the Grading of Recommendations, Assessment, Development, and Evaluation scale, representing 521 patients. Body sites evaluated included the abdomen (378 patients), buttock (156 patients), arms (22 patients), and calves (15 patients). CONCLUSION Electromagnetic muscle stimulation represents an effective therapeutic intervention for abdominal contouring that yields increased muscle thickness, and reduced abdominal fat thickness, for up to 1 year after treatment. Larger, controlled studies are needed to determine the efficacy of electromagnetic muscle stimulation alone for contouring of buttocks, thighs, arms, and calves.
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15
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Negosanti F, Cannarozzo G, Zingoni T, Leone A, Fusco I. Is It Possible to Reshape the Body and Tone It at the Same Time? Schwarzy: The New Technology for Body Sculpting. Bioengineering (Basel) 2022; 9:bioengineering9070284. [PMID: 35877335 PMCID: PMC9311856 DOI: 10.3390/bioengineering9070284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 11/24/2022] Open
Abstract
Background and Objective: In recent years, a strong desire for slimmer and healthier-looking bodies has grown in the population. The aim of this study was to evaluate the effectiveness and safeness of the new technology Flat Magnetic Stimulation for buttock and abdomen remodeling in athletic subjects. Methods: A total of 49 patients (31 females and 18 males) were enrolled. Patients’ digital photos and buttocks/abdomen circumference measurements were taken to assess and monitor the effectiveness of treatment on muscle firming. The level of patient satisfaction was evaluated by a questionnaire based on a seven point Likert scale. Average scores were calculated at a 1-month follow-up (FU). Results: A significant increase in the buttocks’ mean circumference from 85.5 ± 0.7 cm to 88.5 ± 0.7 cm (p < 0.05) and in the abdomens’ mean circumference from 76.5 ± 9.19 cm to 78 ± 9.89 cm (p < 0.05) was observed 1 month after the last treatment. All subjects reported that their buttocks and abdomens felt more lift and toned. The average abdomen and buttocks satisfaction scores improve significantly at 1-month FU. Conclusions: Our data show that FMS treatment could be used as an effective mechanism for muscle toning.
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Affiliation(s)
| | - Giovanni Cannarozzo
- Lasers in Dermatology Unit, Department of Dermatology, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (T.Z.)
| | - Tiziano Zingoni
- Lasers in Dermatology Unit, Department of Dermatology, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (T.Z.)
| | | | - Irene Fusco
- Department of Biology, University of Florence, 50121 Florence, Italy
- Correspondence: ; Tel.: +39-32-86-853-105
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16
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Effects of Peripheral Electromagnetic Fields on Spasticity: A Systematic Review. J Clin Med 2022; 11:jcm11133739. [PMID: 35807019 PMCID: PMC9267146 DOI: 10.3390/jcm11133739] [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: 05/12/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 02/05/2023] Open
Abstract
Electromagnetic fields are emerging as a therapeutic option for patients with spasticity. They have been applied at brain or peripheral level. The effects of electromagnetic fields applied to the brain have been extensively studied for years in spasticity, but not so at the peripheral level. Therefore, the purpose of our work is to analyze the effects of electromagnetic fields, applied peripherally to spasticity. A systematic review was conducted resulting in 10 clinical trials. The frequency ranged from 1 Hz to 150 Hz, with 25 Hz being the most commonly used and the intensity it was gradually increased but there was low homogeneity in how it was increased. Positive results on spasticity were found in 80% of the studies: improvements in stretch reflex threshold, self questionnaire about difficulties related to spasticity, clinical spasticity score, performance scale, Ashworth scale, spastic tone, Hmax/Mmax Ratio and active and passive dorsal flexion. However, results must be taken with caution due to the large heterogeneity and the small number of articles. In future studies, it would be interesting to agree on the parameters to be used, as well as the way of assessing spasticity, to be more objective in the study of their effectiveness.
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17
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Implicit Body Representation of the Hand Enlarged by Repetitive Peripheral Magnetic Stimulation within the Boundary of a Real Hand. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12105250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Deafferentation induced by local anesthesia causes a larger perceived area than the real area of the mouth, which, in the perspective of body representation, belongs to implicit body representation. In this study, we applied repetitive peripheral magnetic stimulation (rPMS) on the motor branch of the radial nerve of participants’ non-dominant-side forearm to induce extension movements of wrist and fingers. This intervention was supposed to increase proprioception to the brain and had an enlargement effect on implicit body representation of the hand in our hypothesis. A total of 39 participants were randomly allocated to the real rPMS group (n = 19) or the sham rPMS group (n = 20). Implicit representation of the hand was measured by a simplified paradigm based on the proposal of Longo and Haggard that depicted perceived locations of fingertips and metacarpophalangeal joints of participants’ occluded hand, in which they showed that implicit body representation of the hand was smaller than the real hand. We compare the main effect of real rPMS vs. sham rPMS and its interaction effect with time by setting four timepoints—before stimulation, right after stimulation, 10 min after stimulation and 20 min after stimulation—to demonstrate the possible short-lasting effect. Results showed that real rPMS had a short-lasting enlargement effect on implicit representation of the hand in general, which was significant especially on the ulnar side of fingers. What is more, the enlarged implicit body representation of the hand was still within the boundary of a real hand, which might indicate the identification role of a real body part.
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18
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Leone A, Piccolo D, Conforti C, Pieri L, Fusco I. Evaluation of safety and efficacy of a new device for muscle toning and body shaping. J Cosmet Dermatol 2021; 20:3863-3870. [PMID: 34716647 DOI: 10.1111/jocd.14579] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/31/2021] [Accepted: 10/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The spread of non-invasive procedures for fat deposits removal has increased rapidly in recent years. In the field of esthetic medicine, high-intensity focused electromagnetic field (HIFEM) technology has recently been introduced, as a tool for toning and strengthening muscles, which goes far beyond normal physical exercise. OBJECTIVE The purpose of this study is to evaluate the efficacy and safety of a new device for body remodeling. METHODS A set of 15 patients (7 males and 8 females, BMI 24.05 ± 2.01 kg m-2 , age 32-57) participated in this study. Patients were enrolled at Dermatos center, Montesilvano, Abruzzo, Italy. The technology used is FMS (Flat Magnetic Stimulation): 6-8 treatment sessions were performed. The sessions must be repeated twice a week, with a minimum of 2 days between each session. Treatment duration varies from 20 to 45 min, depending on patients. RESULTS During 1-month follow-up after the last treatment evaluations, the results showed tonification, the strengthening of muscles, and the reduction of localized adiposity. There is a significant reduction in waist circumference (80.7 ± 4.3 cm vs 77.3 ± 5.6 cm, p < 0.001). All patients showed relatively high satisfaction immediately after the last treatment. CONCLUSIONS Our data show that intense muscle activity is generated by FMS treatments, suggesting that this technology could be used as a convenient and effective muscle toning tool.
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19
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Peña-Toledo MA, Luque E, Ruz-Caracuel I, Agüera E, Jimena I, Peña-Amaro J, Tunez I. Transcranial Magnetic Stimulation Improves Muscle Involvement in Experimental Autoimmune Encephalomyelitis. Int J Mol Sci 2021; 22:ijms22168589. [PMID: 34445295 PMCID: PMC8395284 DOI: 10.3390/ijms22168589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/19/2021] [Accepted: 08/04/2021] [Indexed: 12/15/2022] Open
Abstract
Skeletal muscle is affected in experimental autoimmune encephalomyelitis (EAE), which is a model of multiple sclerosis that produces changes including muscle atrophy; histological features of neurogenic involvement, and increased oxidative stress. In this study, we aimed to evaluate the therapeutic effects of transcranial magnetic stimulation (TMS) on the involvement of rat skeletal muscle and to compare them with those produced by natalizumab (NTZ). EAE was induced by injecting myelin oligodendrocyte glycoprotein (MOG) into Dark Agouti rats. Both treatments, NTZ and TMS, were implemented from day 15 to day 35. Clinical severity was studied, and after sacrifice, the soleus and extensor digitorum longus muscles were extracted for subsequent histological and biochemical analysis. The treatment with TMS and NTZ had a beneficial effect on muscle involvement in the EAE model. There was a clinical improvement in functional motor deficits, atrophy was attenuated, neurogenic muscle lesions were reduced, and the level of oxidative stress biomarkers was lower in both treatment groups. Compared to NTZ, the best response was obtained with TMS for all the parameters analyzed. The myoprotective effect of TMS was higher than that of NTZ. Thus, the use of TMS may be an effective strategy to reduce muscle involvement in multiple sclerosis.
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MESH Headings
- Animals
- Cell Count
- Encephalomyelitis, Autoimmune, Experimental/chemically induced
- Encephalomyelitis, Autoimmune, Experimental/pathology
- Encephalomyelitis, Autoimmune, Experimental/physiopathology
- Encephalomyelitis, Autoimmune, Experimental/therapy
- Male
- Muscle Fibers, Skeletal/drug effects
- Muscle Fibers, Skeletal/pathology
- Muscle Fibers, Skeletal/physiology
- Muscle, Skeletal/drug effects
- Muscle, Skeletal/pathology
- Muscle, Skeletal/physiopathology
- Muscular Atrophy/physiopathology
- Muscular Atrophy/prevention & control
- Myelin-Oligodendrocyte Glycoprotein
- Natalizumab/pharmacology
- Rats
- Transcranial Magnetic Stimulation
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Affiliation(s)
- Maria Angeles Peña-Toledo
- Dementia and Multiple Sclerosis Unit, Neurology Service, Reina Sofia University Hospital, 14004 Cordoba, Spain
- Maimonides Institute for Biomedical Research IMIBIC, Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain
| | - Evelio Luque
- Maimonides Institute for Biomedical Research IMIBIC, Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain
- Department of Morphological Sciences, Section of Histology, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain
| | - Ignacio Ruz-Caracuel
- Department of Morphological Sciences, Section of Histology, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain
| | - Eduardo Agüera
- Dementia and Multiple Sclerosis Unit, Neurology Service, Reina Sofia University Hospital, 14004 Cordoba, Spain
- Maimonides Institute for Biomedical Research IMIBIC, Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain
| | - Ignacio Jimena
- Maimonides Institute for Biomedical Research IMIBIC, Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain
- Department of Morphological Sciences, Section of Histology, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain
| | - Jose Peña-Amaro
- Maimonides Institute for Biomedical Research IMIBIC, Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain
- Department of Morphological Sciences, Section of Histology, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain
| | - Isaac Tunez
- Maimonides Institute for Biomedical Research IMIBIC, Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain
- Cooperative Research Thematic Excellent Network on Brain Stimulation (REDESTIM), Ministery for Economy, Industry and Competitiveness, 28046 Madrid, Spain
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20
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Mezzana P, Pieri L, Leone A, Fusco I. Schwarzy: The new system for muscle toning and body shaping. J Cosmet Dermatol 2021; 20:2678-2680. [PMID: 34092013 DOI: 10.1111/jocd.14275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/18/2021] [Accepted: 06/01/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Paolo Mezzana
- Plastic Surgery Department, Delle Medical Center, Rome, Italy
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21
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Trost JP, Chen M, Stark MM, Hodges JS, Richter S, Lindsay A, Warren GL, Lowe DA, Kimberley TJ. Voluntary and magnetically evoked muscle contraction protocol in males with Duchenne muscular dystrophy: Safety, feasibility, reliability, and validity. Muscle Nerve 2021; 64:190-198. [PMID: 33974714 DOI: 10.1002/mus.27323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 05/04/2021] [Accepted: 05/08/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION/AIMS Clinical trials addressing treatments for Duchenne muscular dystrophy (DMD) require reliable and valid measurement of muscle contractile function across all disease severity levels. In this work we aimed to evaluate a protocol combining voluntary and evoked contractions to measure strength and excitability of wrist extensor muscles for safety, feasibility, reliability, and discriminant validity between males with DMD and controls. METHODS Wrist extensor muscle strength and excitability were assessed in males with DMD (N = 10; mean ± standard deviation: 15.4 ± 5.9 years of age), using the Brooke Upper Extremity Rating Scale (scored 1-6), and age-matched healthy male controls (N = 15; 15.5 ± 5.0 years of age). Torque and electromyographic (EMG) measurements were analyzed under maximum voluntary and stimulated conditions at two visits. RESULTS A protocol of multiple maximal voluntary contractions (MVCs) and evoked twitch contractions was feasible and safe, with 96% of the participants completing the protocol and having a less than 7% strength decrement on either measure for both DMD patients and controls (P ≥ .074). Reliability was excellent for voluntary and evoked measurements of torque and EMG (intraclass correlation coefficient [ICC] over 0.90 and over 0.85 within and between visits, respectively). Torque, EMG, and timing of twitch-onset measurements discriminated between DMD and controls (P < .001). Twitch contraction time did not differ significantly between groups (P = .10). DISCUSSION Findings from this study show that the protocol is a safe, feasible, reliable, and a valid method to measure strength and excitability of wrist extensors in males with DMD.
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Affiliation(s)
- Joyceann P Trost
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Mo Chen
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Molly M Stark
- Department of Neurology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - James S Hodges
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sara Richter
- Professional Data Analysts, Minneapolis, Minnesota, USA
| | - Angus Lindsay
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Gordon L Warren
- Department of Physical Therapy, Georgia State University, Atlanta, Georgia, USA
| | - Dawn A Lowe
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Teresa J Kimberley
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA.,School of Health and Rehabilitation Sciences, Department of Physical Therapy, MGH Institute of Health Professions, Boston, Massachusetts, USA
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22
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Kream E, Boen M, Fabi SG, Goldman MP. Nonsurgical Postpartum Abdominal Rejuvenation: A Review and Our Experience. Dermatol Surg 2021; 47:768-774. [PMID: 33867470 DOI: 10.1097/dss.0000000000003003] [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: 11/26/2022]
Abstract
BACKGROUND A significant population of aesthetic patients are postpartum women motivated to achieve a more youthful abdomen. Although traditionally, abdominoplasty was the treatment of choice, minimally invasive procedures have grown in popularity because of minimal downtime and the favorable side effect profile. so many women share concerns regarding their postpartum abdominal appearance, a limited number of studies focus specifically on postpartum abdominal rejuvenation. OBJECTIVE To review pertinent aspects of abdominal anatomy, associated changes with pregnancy, available nonsurgical cosmetic procedures, and to provide our experience to help guide treatment combinations which comprehensively address the concerns of the postpartum patient. MATERIALS AND METHODS A review of the literature surrounding nonsurgical treatment options for postpartum abdominal lipohypertrophy, muscle changes, tissue laxity, and striae gravidarum, along with the authors' experience in this area are provided. CONCLUSION This review summarizes available nonsurgical modalities to address postpartum abdominal defects, including procedures that tone muscles, reduce fat, tighten skin, and improve the appearance of striae. Both the published literature and the authors' experience favor a combination of treatments to address the various lamellae affected by pregnancy. Further clinical trials focusing on the postpartum patient would further help create a standardized approach for postpartum abdominal rejuvenation.
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Affiliation(s)
- Elizabeth Kream
- Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, Illinois
| | - Monica Boen
- Cosmetic Laser Dermatology, A West Dermatology Company, San Diego, California
| | - Sabrina G Fabi
- Cosmetic Laser Dermatology, A West Dermatology Company, San Diego, California
| | - Mitchel P Goldman
- Cosmetic Laser Dermatology, A West Dermatology Company, San Diego, California
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23
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Fernandez-Lobera M, Morales M, Valls-Solé J. Repetitive peripheral magnetic stimulation for the assessment of wrist spasticity: reliability, validation and correlation with clinical measures. Disabil Rehabil 2021; 44:5257-5267. [PMID: 34027756 DOI: 10.1080/09638288.2021.1925979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To determine feasibility and reliability of using repetitive peripheral magnetic stimulation (rPMS) to induce wrist extension movement for the assessment of spasticity in wrist flexors, instead of the passive stretch used in the modified Tardieu scale. METHODS Spasticity was assessed with the index of movement restriction (iMR), calculated as the difference between the range of maximum wrist passive movement and the rPMS-induced movement, in 12 healthy subjects (HS), 12 acute stroke patients without spasticity (AS) and 12 chronic stroke patients with spasticity (CS). Test-retest reliability and clinical correlation were assessed in CS patients before Botulinum neurotoxin type A (BoNT-A) treatment. RESULTS In comparison to HS and AS patients, CS patients showed statistically significant reduction of rPMS-induced movement amplitude, velocity, and acceleration. The mean iMR was 2.8 (SD = 2.6) in HS, 13.0 (SD = 11.2) in AS and 59.2 (SD = 23.4) in CS. This score significantly reduced to 41.1 (SD = 19.7) in CS after BoNT-A (p < 0.01). Test-retest reliability was very good, with an intraclass correlation coefficient ranging between 0.85 and 0.99 for the variables analysed. CONCLUSIONS We have shown good reliability and feasibility of a new method providing quantifiable data for the assessment of spasticity and its response to BoNT-A treatment.IMPLICATIONS FOR REHABILITATIONThe muscle contraction induced by repetitive peripheral magnetic stimulation (rPMS) in paretic muscles of post-stroke patients was used to assess spasticity.The index of movement restriction (iMR), calculated as the difference between the maximum passive range of movement and the rPMS induced movement, improved after botulinum toxin treatment.Measuring spastic reactions to rPMS provides quantifiable and reliable data for follow-up and assessment of therapeutic benefits.
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Affiliation(s)
- Marta Fernandez-Lobera
- Escoles Universitaries de Fisioterapia i infermeria Gimbernat, Universitat Autònoma de Barcelona, Sant Cugat del Vallès, Spain
| | | | - Josep Valls-Solé
- IDIBAPS (Institut d, Investigació August Pi i Sunyer), Barcelona, Spain
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Abstract
Neuromuscular fatigue (NMF) is usually assessed non-invasively in healthy, athletic or clinical populations with the combination of voluntary and evoked contractions. Although it might appear relatively straightforward to magnetically or electrically stimulate at different levels (cortical/spinal/muscle) and to measure mechanical and electromyographic responses to quantify neuromuscular adjustments due to sustained/repeated muscle contractions, there are drawbacks that researchers and clinicians need to bear in mind. The aim of this opinion paper is to highlight the pitfalls inevitably faced when NMF is quantified. The first problem might arise from the definition of fatigue itself and the parameter(s) used to measure it; for instance, measuring power vs. isometric torque may lead to different conclusions. Another potential limitation is the delay between exercise termination and the evaluation of neuromuscular function; the possible underestimation of exercise-induced neural and contractile impairment and misinterpretation of fatigue etiology will be discussed, as well as solutions recently proposed to overcome this problem. Quantification of NMF can also be biased (or not feasible) because of the techniques themselves (e.g. results may depend on stimulation intensity for transcranial magnetic stimulation) or the way data are analyzed (e.g. M wave peak-to-peak vs first phase amplitude). When available, alternatives recently suggested in the literature to overcome these pitfalls are considered and recommendations about the best practices to assess NMF (e.g. paying attention to the delay between exercise and testing, adapting the method to the characteristics of the population to be tested and considering the limitations associated with the techniques) are proposed.
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Affiliation(s)
- Nicolas Place
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Guillaume Y Millet
- Univ Lyon, UJM-Saint-Etienne, Inter-University Laboratory of Human Movement Biology, EA 7424, 42023, Saint-Étienne, France. .,Faculty of Kinesiology, University of Calgary, Calgary, Canada.
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Hirono T, Ikezoe T, Taniguchi M, Nojiri S, Tanaka H, Ichihashi N. Acute effects of repetitive peripheral magnetic stimulation following low-intensity isometric exercise on muscle swelling for selective muscle in healthy young men. Electromagn Biol Med 2021; 40:420-427. [PMID: 33764250 DOI: 10.1080/15368378.2021.1907402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Repetitive peripheral magnetic stimulation (rPMS) is a non-invasive stimulator that can induce strong muscle contraction in selective regions. This study aimed to measure acute changes in skeletal muscle thickness induced by rPMS following a low-intensity exercise. Fifteen healthy young men performed an isometric knee extensor exercise at 30% of maximum strength consisting of three sets of 10 contractions on their dominant leg. rPMS was then applied on the vastus lateralis (VL) at the maximum intensity of the rPMS device. Muscle thicknesses of the rectus femoris (RF) and VL were measured using an ultrasound device and were compared among baseline, post-exercise, and post-rPMS. There were significant increases in muscle thickness of both the RF and VL post-exercise compared with baseline values (RF: baseline; 24.7 ± 2.4, post-exercise; 25.3 ± 2.4 mm, p = .034, VL: baseline; 27.0 ± 2.8, post-exercise; 27.4 ± 2.8 mm, p = .006). Compared with post-exercise, there was a significant increase post-rPMS in only the VL (VL: post-rPMS; 28.3 ± 2.9 mm, p = .002). These findings suggest that low-intensity isometric exercise can induce acute increases in muscle thickness (muscle swelling) in synergist muscles, and rPMS following exercise can induce further acute muscle swelling via repetitive muscle contraction.
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Affiliation(s)
- Tetsuya Hirono
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Tome Ikezoe
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masashi Taniguchi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shusuke Nojiri
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroki Tanaka
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Nakanishi R, Takeuchi K, Akizuki K, Nakagoshi R, Kakihana H. The effect of neuromuscular electrical stimulation on muscle EMG activity and the initial phase rate of force development during tetanic contractions in the knee extensor muscles of healthy adult males. Phys Ther Res 2021; 23:195-201. [PMID: 33489659 DOI: 10.1298/ptr.e10030] [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: 01/30/2020] [Accepted: 06/02/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Neuromuscular electrical stimulation (NMES) has been noted as an effective pre- contraction for an increase of neural and muscle factors during twitch contractions. However, it is unknown if this intervention is effective for the rate of force development (RFD), which is the ability to increase joint torque strength as quickly as possible, during tetanic contractions. NMES can be safely used by anyone, but, the strength setting of NMES requires attention so as not to cause pain. Therefore, the purpose of this study investigated whether NMES at less painful levels was effective for RFD during tetanic contractions. We also investigated effect activation by analyzing electromyogram (EMG) and RFD for each phase. METHODS Eighteen healthy males were studied. Before and after NMES intervention at 10% or 20% maximal voluntary isometric contraction (MVIC) level (10%NMES, 20%NMES respectively), EMG activity and the initial phase (30-, 50-, 100-, and 200-msec) RFD were measured. Visual analog scale (VAS) was also measured as an indicator of pain during each NMES. RESULTS 20%NMES increased EMG activity and 30-, 50-, and 100-msec of RFD during MVIC, but could not improve 200 msec of RFD. However, 10%NMES could be failed to increase all phases RFD, but VAS was lower than that of 20% NMES. CONCLUSION These results suggest that muscle pre-contraction using 20%NMES could induce moderate pain, but could be an effective intervention to improve RFD via neural factor activity.
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Abe G, Oyama H, Liao Z, Honda K, Yashima K, Asao A, Izumi SI. Difference in Pain and Discomfort of Comparable Wrist Movements Induced by Magnetic or Electrical Stimulation for Peripheral Nerves in the Dorsal Forearm. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2020; 13:439-447. [PMID: 33376417 PMCID: PMC7755354 DOI: 10.2147/mder.s271258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/29/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Both repetitive peripheral magnetic stimulation (rPMS) and transcutaneous electrical current stimulation (TES) could elicit the limb movements; it is still unclear how subjective sensation is changed according to the amount of limb movements. We investigated the pain and discomfort induced by newly developed rPMS and TES of peripheral nerves in the dorsal forearm. Methods The subjects were 12 healthy adults. The stimulus site was the right dorsal forearm; thus, when stimulated, wrist dorsiflexion was induced. The rPMS was delivered by the new stimulator, Pathleader at 10 stimulus intensity levels, and TES intensity was in 1-mA increments. The duration of each stimulation was 2 s. The analysis parameters were subjective pain and discomfort, measured by a numerical rating scale. The rating scale at corresponding levels of integrated range of movement (iROM) induced by rPMS or TES was compared. The subjective values were analyzed by two-way repeated measures ANOVA with the stimulus conditions (rPMS, TES) and the seven levels of iROM (20-140 ºs). Results In the rPMS experiments, stimuli were administered to all subjects at all stimulus intensities. In the TES experiments, none of the subjects dropped out between 1 and 16 mA, but there were dropouts at each of the intensities as follows: 1 subject at 17 mA, 20 mA, 22 mA, 23 mA, 27 mA, 29 mA and 2 subjects at 21 mA, 24 mA, 26 mA. The main effects of the stimulus conditions and iROM were significant for pain and discomfort. Post hoc analysis demonstrated that pain and discomfort in rPMS were significantly lower compared to TES when the iROM was above 60 ºs and 80 ºs, respectively. Conclusion New rPMS stimulator, Pathleader, caused less pain and discomfort than TES, but this was only evident when comparatively large joint movements occurred.
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Affiliation(s)
- Genji Abe
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.,Department of Rehabilitation, Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University, Sendai, Miyagi, Japan
| | - Hideki Oyama
- Department of Physical Medicine and Rehabilitation, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Miyagi, Japan
| | - Zhenyi Liao
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Keita Honda
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | | | - Akihiko Asao
- Department of Occupational Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Shin-Ichi Izumi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.,Department of Physical Medicine and Rehabilitation, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Miyagi, Japan
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Suzuki K, Ito T, Okada Y, Hiraoka T, Hanayama K, Tsubahara A. Preventive Effects of Repetitive Peripheral Magnetic Stimulation on Muscle Atrophy in the Paretic Lower Limb of Acute Stroke Patients: A Pilot Study. Prog Rehabil Med 2020; 5:20200008. [PMID: 32789276 PMCID: PMC7365239 DOI: 10.2490/prm.20200008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/06/2020] [Indexed: 01/31/2023] Open
Abstract
Objective: The aim of this study was to investigate the effect of repetitive peripheral magnetic
stimulation (rPMS) on muscle atrophy prevention in the rectus femoris muscle (RF) of the
paretic limb in acute stroke patients. Methods: Twelve acute stroke patients with a National Institute of Health Stroke Scale score
>5 and a motor score of the paretic lower limb >2 at admission were divided into
an intervention group (rPMS: mean age, 75±6.4 years) and a conventional care group
(non-rPMS: mean age, 62±11.8 years). Baseline measurements were performed within 4 days
of stroke onset. In the rPMS group, treatment was applied to the paretic thigh only for
2 weeks, 5 days a week, in addition to conventional care. The cross-sectional area (CSA)
of the RF was assessed in both limbs using ultrasound at baseline and 2 weeks later.
Data on patient characteristics were collected from the clinical records to assess
correlations with the CSA rate of change. Results: Patients in the rPMS group were significantly older. Although the CSA of the RF did
not change significantly on either side in the rPMS group, there was a significant
decrease in the CSA on the paretic side in the non-rPMS group. However, no significant
difference was observed in the CSA rate of change in the rPMS and non-rPMS groups. The
CSA rate of change on the paretic side correlated negatively with age in the rPMS group.
Conclusions: Our results suggest that rPMS prevents muscle atrophy more effectively in patients in
their 60s than in patients more than 70 years old.
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Affiliation(s)
- Keita Suzuki
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.,Department of Rehabilitation, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan
| | - Tomotaka Ito
- Department of Rehabilitation, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan.,Rehabilitation Center, Kawasaki Medical School Hospital, Kurashiki, Okayama, Japan
| | - Yuji Okada
- Rehabilitation Center, Kawasaki Medical School Hospital, Kurashiki, Okayama, Japan
| | - Takashi Hiraoka
- Department of Rehabilitation, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan.,Department of Rehabilitation Medicine, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Kozo Hanayama
- Department of Rehabilitation Medicine, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Akio Tsubahara
- Department of Rehabilitation, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan
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Tani K, Hirata A, Tanaka S. Quantitative Assessment of Pain Threshold Induced by a Single-Pulse Transcranial Magnetic Stimulation. Front Neurosci 2020; 14:559. [PMID: 32581694 PMCID: PMC7287165 DOI: 10.3389/fnins.2020.00559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/06/2020] [Indexed: 11/16/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) is commonly used in basic research to evaluate human brain function. Although scalp pain is a side effect, no studies have quantitatively assessed the TMS intensity threshold for inducing pain and whether sensitivity to TMS-induced pain differs between sexes. In the present study, we measured pain thresholds when single-pulse TMS was applied over either Broca’s area (BA) or left primary motor cortex (M1), and compared these thresholds with the motor threshold (MT) for inducing motor evoked potentials (MEPs) through M1 stimulation. Additionally, we compared the pain thresholds for BA and M1 between males and females. We found that pain thresholds for both sites were significantly lower than the MT. Furthermore, the pain threshold for BA was much lower than that for M1. No significant difference was observed between sexes. The results suggest that TMS at an intensity equivalent to MTs, which is often used in experimental or clinical studies, causes slight scalp pain. Experimental designs using TMS to evaluate functional relationships between brain and behavior should consider scalp pain and reduce its likelihood as much as possible.
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Affiliation(s)
- Keisuke Tani
- Laboratory of Psychology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Akimasa Hirata
- Department of Electrical and Electronic Engineering, Nagoya Institute of Technology, Aichi, Japan
| | - Satoshi Tanaka
- Laboratory of Psychology, Hamamatsu University School of Medicine, Shizuoka, Japan
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Duncan D, Dinev I. Noninvasive Induction of Muscle Fiber Hypertrophy and Hyperplasia: Effects of High-Intensity Focused Electromagnetic Field Evaluated in an In-Vivo Porcine Model: A Pilot Study. Aesthet Surg J 2020; 40:568-574. [PMID: 31665217 PMCID: PMC7154795 DOI: 10.1093/asj/sjz244] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND High-intensity focused electromagnetic (HIFEM) field technology has been reported to increase muscle thickness and hypertrophy. However, this process has not yet been confirmed on a histologic level. OBJECTIVES The aim of this study was to evaluate in-vivo structural changes in striated porcine muscle tissue following HIFEM treatment. METHODS Three Yorkshire pigs received four 30-minute HIFEM treatments applied to the biceps femoris muscle on 1 side only. The fourth pig served as a control subject. At baseline and 2 weeks after the last treatment, biopsy specimens of the muscle tissue were collected from the treatment site. The control pig underwent muscle biopsy from a similar but untreated site. Twenty-five histology slides were evaluated from each pig. A certified histopathologist analyzed sliced biopsy samples for structural changes in the tissue. RESULTS Histologic analysis showed hypertrophic changes 2 weeks posttreatment. The muscle mass density increased by 20.56% (to a mean of 17,053.4 [5617.9] µm2) compared with baseline. Similarly, muscle fiber density (hyperplasia) increased: the average change in the number of fibers in a slice area of 136,533.3 µm2 was +8.0%. The mean size of an individual muscle fiber increased by 12.15% (to 332.23 [280.2] µm2) 2 weeks posttreatment. Control samples did not show any significant change in fiber density or hyperplasia. CONCLUSIONS Histopathologic quantification showed significant structural muscle changes through a combination of fiber hypertrophy and hyperplasia. Control biopsies showed a lack of similar changes. The data correlate with findings of other HIFEM research and suggest that HIFEM could be used for noninvasive induction of muscle growth.
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Affiliation(s)
| | - Ivan Dinev
- General and Clinical Pathology, Faculty of Veterinary Medicine, Trakia University, Stara Zagora, Bulgaria
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Ultrasound Assessment of Subcutaneous Abdominal Fat Thickness After Treatments With a High-Intensity Focused Electromagnetic Field Device: A Multicenter Study. Dermatol Surg 2020; 45:1542-1548. [PMID: 30882507 DOI: 10.1097/dss.0000000000001902] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND High-intensity focused electromagnetic (HIFEM) technology is intended for muscle toning, firming, and strengthening. OBJECTIVE The goal of this study is to quantify the effect of HIFEM treatments on subcutaneous fat. MATERIALS AND METHODS A total of 33 patients participated in the study. Each subject underwent 4 treatments on the abdomen with the HIFEM device. Ultrasound images were obtained measuring the thickness of the subcutaneous fat from 4 standardized measurement points. Ultrasound images were taken before treatment and at 1-month and 3-month follow-up visits. Photographs were captured using both 2D and 3D cameras. Weight measurements were taken, as well as surveys assessing both patient comfort, satisfaction, and adverse events. RESULTS A significant reduction in the subcutaneous fat thickness across the abdomen was observed, averaging 19.0%/4.47 ± 3.23 mm (p < .01) at 1 month after treatment and 23.3%/5.78 ± 4.07 mm 3 months after treatment. At 1 month, the most significant reduction in subcutaneous fat was measured subumbilically (26.6%/6.25 ± 4.70 mm; p < .01) and epiumbilically (21.6%/5.08 ± 3.69 mm; p < .01). No discomfort was reported, and 91% of study participants were satisfied with their result. CONCLUSION Based on the ultrasonographic and photographic observations, the authors conclude that the application of an HIFEM field is an effective option for the noninvasive treatment of subcutaneous fat.
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Sakai K, Yasufuku Y, Kamo T, Ota E, Momosaki R. Repetitive peripheral magnetic stimulation for impairment and disability in people after stroke. Cochrane Database Syst Rev 2019; 11:CD011968. [PMID: 31784991 PMCID: PMC6884423 DOI: 10.1002/14651858.cd011968.pub3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Repetitive peripheral magnetic stimulation (rPMS) is a non-invasive treatment method that can penetrate to deeper structures with painless stimulation to improve motor function in people with physical impairment due to brain or nerve disorders. rPMS for people after stroke has proved to be a feasible approach to improving activities of daily living and functional ability. However, the effectiveness and safety of this intervention for people after stroke currently remain uncertain. This is an update of the review published in 2017. OBJECTIVES To assess the effects of rPMS in improving activities of daily living and functional ability in people after stroke. SEARCH METHODS On 7 January 2019, we searched the Cochrane Stroke Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library; MEDLINE; Embase; the Cumulative Index to Nursing and Allied Health Literature (CINAHL); PsycINFO; the Allied and Complementary Medicine Database (AMED); Occupational Therapy Systematic Evaluation of Evidence (OTseeker); the Physiotherapy Evidence Database (PEDro); ICHUSHI Web; and six ongoing trial registries. We screened reference lists, and we contacted experts in the field. We placed no restrictions on the language or date of publication when searching electronic databases. SELECTION CRITERIA We included randomised controlled trials (RCTs) conducted to assess the therapeutic effect of rPMS for people after stroke. Comparisons eligible for inclusion were (1) active rPMS only compared with 'sham' rPMS (a very weak form of stimulation or a sound only); (2) active rPMS only compared with no intervention; (3) active rPMS plus rehabilitation compared with sham rPMS plus rehabilitation; and (4) active rPMS plus rehabilitation compared with rehabilitation only. DATA COLLECTION AND ANALYSIS Two review authors independently assessed studies for inclusion. The same review authors assessed methods and risk of bias, undertook data extraction, and used the GRADE approach to assess the quality of evidence. We contacted trial authors to request unpublished information if necessary. We resolved all disagreements through discussion. MAIN RESULTS We included four trials (three RCTs and one cross-over trial) involving 139 participants. Blinding of participants and physicians was well reported within all trials. We judged the overall risk of bias across trials as low. Only two trials (with 63 and 18 participants, respectively) provided sufficient information to be included in the meta-analysis. We found no clear effect of rPMS on activities of daily living at the end of treatment (mean difference (MD) -3.00, 95% confidence interval (CI) -16.35 to 10.35; P = 0.66; 1 trial; 63 participants; low-quality evidence) and at the end of follow-up (MD -2.00, 95% CI -14.86 to 10.86; P = 0.76; 1 trial; 63 participants; low-quality evidence) when comparing rPMS plus rehabilitation versus sham plus rehabilitation. We found no statistical difference in improvement of upper limb function at the end of treatment (MD 2.00, 95% CI -4.91 to 8.91; P = 0.57; 1 trial; 63 participants; low-quality evidence) and at the end of follow-up (MD 4.00, 95% CI -2.92 to 10.92; P = 0.26; 1 trial; 63 participants; low-quality evidence) when comparing rPMS plus rehabilitation versus sham plus rehabilitation. We observed a significant decrease in spasticity of the elbow at the end of follow-up (MD -0.48, 95% CI -0.93 to -0.03; P = 0.03; 1 trial; 63 participants; low-quality evidence) when comparing rPMS plus rehabilitation versus sham plus rehabilitation. In terms of muscle strength, rPMS treatment was not associated with improved muscle strength of the ankle dorsiflexors at the end of treatment (MD 3.00, 95% CI -2.44 to 8.44; P = 0.28; 1 trial; 18 participants; low-quality evidence) when compared with sham rPMS. No studies provided information on lower limb function or adverse events, including death. Based on the GRADE approach, we judged the quality of evidence related to the primary outcome as low, owing to the small sample size of the studies. AUTHORS' CONCLUSIONS Available trials provided insufficient evidence to permit any conclusions about routine use of rPMS for people after stroke. Additional trials with large sample sizes are needed to provide robust evidence for rPMS after stroke.
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Affiliation(s)
- Kotomi Sakai
- Setagaya Memorial HospitalDepartment of Rehabilitation MedicineTokyoJapan
- St. Luke's International UniversityGraduate School of Public HealthTokyoJapan
| | - Yuichi Yasufuku
- Kyoto Tachibana UniversityDepartment of Physical Therapy34 Yamada‐cho, Oyake, Yamashina‐kuKyotoJapan607‐8175
| | - Tomohiko Kamo
- Japan University of Health SciencesSchool of Health Sciences2‐555, Hirasuka, Satte‐CitySaitamaJapan340‐0145
| | - Erika Ota
- St. Luke's International UniversityGlobal Health Nursing, Graduate School of Nursing Science10‐1 Akashi‐choChuo‐KuTokyoMSJapan104‐0044
| | - Ryo Momosaki
- Teikyo University School of Medicine University Hospital, MizonokuchiDepartment of Rehabilitation Medicine5‐1‐1 Futako, Takatsu‐ku, KawasakiKanagawaJapan213‐8507
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Fujimura K, Kagaya H, Endou C, Ishihara A, Nishigaya K, Muroguchi K, Tanikawa H, Yamada M, Kanada Y, Saitoh E. Effects of Repetitive Peripheral Magnetic Stimulation on Shoulder Subluxations Caused by Stroke: A Preliminary Study. Neuromodulation 2019; 23:847-851. [PMID: 32840021 DOI: 10.1111/ner.13064] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 08/28/2019] [Accepted: 09/17/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Shoulder subluxation is a common problem after stroke. It causes shoulder pain that affects activities of daily living. This study aimed to investigate the effect of repetitive peripheral magnetic stimulation on shoulder subluxation after stroke. METHODS We enrolled 12 consecutive patients who, as a result of stroke, suffered shoulder subluxations, measuring at half of a fingerbreadth or more. All subjects underwent conventional rehabilitation, as well as repetitive peripheral magnetic stimulation of their supraspinatus, posterior deltoid, and infraspinatus muscles. We assessed the following parameters: shoulder subluxation, evaluated as the acromio-humeral interval using measurements taken from X-rays; shoulder pain, evaluated using the Numerical Rating Scale; the active range of motion of shoulder abduction; and the motor impairment of the upper extremities, evaluated using the upper extremity of the Fugl-Meyer Assessment scale. RESULTS The acromio-humeral interval before treatment was 22.8 ± 5.7 mm (mean ± SD). It significantly decreased to 19.6 ± 7.0 mm (p = 0.004) after treatment. Shoulder pain (p = 0.039), active range of motion of shoulder abduction (p = 0.016), and total (p = 0.005), subscale A (p = 0.005), and subscale C (p = 0.008) Fugl-Meyer Assessment scores also improved significantly after treatment. CONCLUSIONS Repetitive peripheral magnetic stimulation effectively reduced shoulder subluxations and shoulder pain caused by stroke and improved voluntary upper-limb movements in stroke patients.
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Affiliation(s)
- Kenta Fujimura
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Chiharu Endou
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Akihito Ishihara
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Kozue Nishigaya
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Kana Muroguchi
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Hiroki Tanikawa
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Masayuki Yamada
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Yoshikiyo Kanada
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
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Zschorlich VR, Hillebrecht M, Tanjour T, Qi F, Behrendt F, Kirschstein T, Köhling R. Repetitive Peripheral Magnetic Nerve Stimulation (rPMS) as Adjuvant Therapy Reduces Skeletal Muscle Reflex Activity. Front Neurol 2019; 10:930. [PMID: 31507528 PMCID: PMC6718706 DOI: 10.3389/fneur.2019.00930] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 08/09/2019] [Indexed: 12/02/2022] Open
Abstract
Background: The reduction of muscle hypertonia and spasticity, as well as an increase in mobility, is an essential prerequisite for the amelioration of physiotherapeutical treatments. Repetitive peripheral magnetic nerve stimulation (rPMS) is a putative adjuvant therapy that improves the mobility of patients, but the underlying mechanism is not entirely clear. Methods: Thirty-eight participants underwent either an rPMS treatment (N = 19) with a 5 Hz stimulation protocol in the posterior tibial nerve or sham stimulation (N = 19). The stimulation took place over 5 min. The study was conducted in a pre-test post-test design with matched groups. Outcome measures were taken at the baseline and after following intervention. Results: The primary outcome was a significant reduction of the reflex activity of the soleus muscle, triggered by a computer-aided tendon-reflex impact. The pre-post differences of the tendon reflex response activity were −23.7% (P < 0.001) for the treatment group. No significant effects showed in the sham stimulation group. Conclusion: Low-frequency magnetic stimulation (5 Hz rPMS) shows a substantial reduction of the tendon reflex amplitude. It seems to be an effective procedure to reduce muscular stiffness, increase mobility, and thus, makes the therapeutic effect of neuro-rehabilitation more effective. For this reason, the 5 Hz rPMS treatment might have the potential to be used as an adjuvant therapy in the rehabilitation of gait and posture control in patients suffering from limited mobility due to spasticity. The effect observed in this study should be investigated conjoined with the presented method in patients with impaired mobility due to spasticity.
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Affiliation(s)
- Volker R Zschorlich
- Faculty of Philosophy, Institute of Sports Science, University of Rostock, Rostock, Germany.,Department of Ageing of Individuals and Society, Faculty of Interdisciplinary Research, University of Rostock, Rostock, Germany
| | - Martin Hillebrecht
- Department of Sport Science, University of Oldenburg, Oldenburg, Germany
| | - Tammam Tanjour
- Faculty of Philosophy, Institute of Sports Science, University of Rostock, Rostock, Germany
| | - Fengxue Qi
- Faculty of Philosophy, Institute of Sports Science, University of Rostock, Rostock, Germany.,Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Dortmund, Germany.,Department of Sport Training, Sport Coaching College, Beijing Sport University, Bejing, China
| | - Frank Behrendt
- Reha Rheinfelden, Research Department, Rheinfelden, Switzerland
| | - Timo Kirschstein
- Oscar-Langendorff-Institute of Physiology, University Medicine Rostock, Rostock, Germany
| | - Rüdiger Köhling
- Department of Ageing of Individuals and Society, Faculty of Interdisciplinary Research, University of Rostock, Rostock, Germany.,Oscar-Langendorff-Institute of Physiology, University Medicine Rostock, Rostock, Germany
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Marklund S, Bui KL, Nyberg A. Measuring and monitoring skeletal muscle function in COPD: current perspectives. Int J Chron Obstruct Pulmon Dis 2019; 14:1825-1838. [PMID: 31695351 PMCID: PMC6707440 DOI: 10.2147/copd.s178948] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 06/25/2019] [Indexed: 11/23/2022] Open
Abstract
Skeletal muscle dysfunction is an important systemic consequence of chronic obstructive pulmonary disease (COPD) that worsens the natural cause of the disease. Up to a third of all people with COPD express some form of impairment which encompasses reductions in strength and endurance, as well as an increased fatigability. Considering this complexity, no single test could be used to measure and monitor all aspects of the impaired skeletal muscle function within the COPD population, resulting in a wide range of available tests and measurement techniques. The aim of the current review is to highlight current and new perspectives relevant to skeletal muscle function measurements within the COPD population in order to provide guidance for researchers as well as for clinicians. First of all, standardized and clinically feasible measurement protocols, as well as normative values and predictive equations across the spectrum of impaired function in COPD, are needed before assessment of skeletal muscle function can become a reality in clinical praxis. This should minimally target the quadriceps muscle; however, depending on the objective of measurements, eg, to determine upper limb muscle function or walking capacity, other muscles could also be tested. Furthermore, even though muscle strength measurements are important, current evidence suggests that other aspects, such as the endurance and power capacity of the muscle, should also be considered. Moreover, although static (isometric) measurements have been favored, dynamic measurements of skeletal muscle function should not be neglected as they, in a larger extent than static measurements, are related to tasks of daily living. Lastly, the often modest relationships between functional tests and skeletal muscle function measurements indicate that they evaluate different constructs and thus cannot replace one another. Therefore, for accurate measurements of skeletal muscle function in people with COPD, specific and formal measurements should still be prioritized.
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Affiliation(s)
- Sarah Marklund
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Kim-Ly Bui
- Rehabilitation Department, Faculty of Medicine Laval University and Centre de recherche, Laval University Quebec Heart and Lung Institute (CRIUCPQ), Québec, QC, Canada
| | - Andre Nyberg
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
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Short-term session of repetitive peripheral magnetic stimulation combined with motor imagery facilitates corticospinal excitability in healthy human participants. Neuroreport 2019; 30:562-566. [DOI: 10.1097/wnr.0000000000001245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Neuromuscular magnetic stimulation counteracts muscle decline in ALS patients: results of a randomized, double-blind, controlled study. Sci Rep 2019; 9:2837. [PMID: 30808899 PMCID: PMC6391419 DOI: 10.1038/s41598-019-39313-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/21/2019] [Indexed: 12/14/2022] Open
Abstract
The aim of the study was to verify whether neuromuscular magnetic stimulation (NMMS) improves muscle function in spinal-onset amyotrophic lateral sclerosis (ALS) patients. Twenty-two ALS patients were randomized in two groups to receive, daily for two weeks, NMMS in right or left arm (referred to as real-NMMS, rNMMS), and sham NMMS (sNMMS) in the opposite arm. All the patients underwent a median nerve conduction (compound muscle action potential, CMAP) study and a clinical examination that included a handgrip strength test and an evaluation of upper limb muscle strength by means of the Medical Research Council Muscle Scale (MRC). Muscle biopsy was then performed bilaterally on the flexor carpi radialis muscle to monitor morpho-functional parameters and molecular changes. Patients and physicians who performed examinations were blinded to the side of real intervention. The primary outcome was the change in the muscle strength in upper arms. The secondary outcomes were the change from baseline in the CMAP amplitudes, in the nicotinic ACh currents, in the expression levels of a selected panel of genes involved in muscle growth and atrophy, and in histomorphometric parameters of ALS muscle fibers. The Repeated Measures (RM) ANOVA with a Greenhouse-Geisser correction (sphericity not assumed) showed a significant effect [F(3, 63) = 5.907, p < 0.01] of rNMMS on MRC scale at the flexor carpi radialis muscle, thus demonstrating that the rNMMS significantly improves muscle strength in flexor muscles in the forearm. Secondary outcomes showed that the improvement observed in rNMMS-treated muscles was associated to counteracting muscle atrophy, down-modulating the proteolysis, and increasing the efficacy of nicotinic ACh receptors (AChRs). We did not observe any significant difference in pre- and post-stimulation CMAP amplitudes, evoked by median nerve stimulation. This suggests that the improvement in muscle strength observed in the stimulated arm is unlikely related to reinnervation. The real and sham treatments were well tolerated without evident side effects. Although promising, this is a proof of concept study, without an immediate clinical translation, that requires further clinical validation.
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Kinney BM, Lozanova P. High intensity focused electromagnetic therapy evaluated by magnetic resonance imaging: Safety and efficacy study of a dual tissue effect based non-invasive abdominal body shaping. Lasers Surg Med 2019; 51:40-46. [PMID: 30302767 PMCID: PMC6585690 DOI: 10.1002/lsm.23024] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVES This study introduces an initial evaluation of a novel High-Intensity Focused Electromagnetic (HIFEM) technology. The primary goal is to quantify any effects the treatments may have on abdominal tissues, as well as to establish hypotheses for future research of this technology. METHODS Twenty-two patients received four abdominal treatments using the EMSCULPT device (BTL Industries Inc., Boston, MA). Anthropometric evaluations were recorded and digital photographs were taken at baseline, at 2 months, and at 6 months post-treatments. The MRI without contrast determined by vertertebras T12 and S1 (FIESTA and FSPRG sequences) was used to measure dimensions in coronal cross-sectional images of abdominal muscle and fatty tissues, in order to assess any anatomical changes induced by the application. RESULTS Analysis of the same MRI slices verified by tissue artefacts showed a statistically significant (all P < 0.0001) average 18.6% reduction of adipose tissue thickness, 15.4% increase in rectus abdominis muscle thickness, and 10.4% reduction in rectus abdominus separation (diastasis recti) as measured from the medial border of the muscle 2 months post-treatment. More significant improvements were observed in patients with BMI 18.5-24.9 (classified as "normal"). MRI data from 6-month follow-up suggest the changes can be preserved in longer term. Tape measurements showed on average 3.8 cm subumbilical circumference reduction. The weight of the subjects did not change significantly (average -0.5 lb; P > 0.05). No adverse events were reported. CONCLUSIONS MRI, considered as a highly precise diagnostic method, revealed simultaneous muscle growth, fat reduction and reduced abdominal separation at 2 months and at 6 months post treatments, unrelated with dieting. Further research should investigate the exact physiological processes which stand behind the tissue changes observed in this study. Lasers Surg. Med. 51:40-46, 2019. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Brian M. Kinney
- University of Southern California Division of Plastic SurgeryBeverly HillsCalifornia
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Weiss RA, Bernardy J. Induction of fat apoptosis by a non-thermal device: Mechanism of action of non-invasive high-intensity electromagnetic technology in a porcine model. Lasers Surg Med 2018; 51:47-53. [PMID: 30549290 PMCID: PMC6590311 DOI: 10.1002/lsm.23039] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2018] [Indexed: 12/30/2022]
Abstract
Objectives While controlled thermal changes in subcutaneous tissue have been used to trigger apoptosis of fat cells and have been proven clinically efficacious, another mechanism of electromagnetic stress suggests that fat apoptosis could be achieved by a non‐thermal manner as well. This animal model study investigates the use of a non‐invasive high‐intensity magnetic field device to induce apoptosis in fat cells. Methods Yorkshire pigs (N = 2) received one treatment (30 minutes) in the abdominal area using a High‐Intensity Focused Electromagnetic (HIFEM) device. Punch biopsy samples of fat tissue and blood samples were collected at the baseline, 1 and 8 hours after the treatment. Biopsy samples were sectioned and evaluated for the levels of an apoptotic index (AI) by the TUNEL method. Statistical significance was examined using the rANOVA and Tukey's test (α 5%). Biopsy samples were also assessed for molecular biomarkers. Blood samples were evaluated to determine changes related to fat and muscle metabolism. Free fatty acids (FFA), triacylglycerol (TG), glycerol and glucose (Glu) were used as the main biomarkers of fat metabolism. Creatinine, creatinine kinase (CK), lactate dehydrogenase (LDH) and interleukin 6 (IL6) served as the main biomarkers to evaluate muscle metabolism. Results In treated pigs, a statistically significant increase in the apoptotic index (AI) (P = 1.17E‐4) was observed. A significant difference was found between AI at baseline (AI = 18.75%) and 8‐hours post‐treatment (AI = 35.95%). Serum levels of fat and muscle metabolism indicated trends (FFA −0.32 mmol · l−1, −28.1%; TG −0.24 mmol · l−1, −51.8%; Glycerol −5.68 mg · l−1, −54.8%; CK +67.58 μkat · l−1, +227.8%; LDH +4.9 μkat · l−1,+35.4%) suggesting that both adipose and muscle tissue were affected by HIFEM treatment. No adverse events were noted to skin and surrounding tissue. Conclusions Application of a high‐intensity electromagnetic field in a porcine model results in adipocyte apoptosis. The analysis of serum levels suggests that HIFEM treatment influences fat and muscle metabolism. Lasers Surg. Med. 51:47–53, 2019. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Robert A Weiss
- Maryland Laser Skin, & Vein Institute, Hunt Valley, Maryland
| | - Jan Bernardy
- Veterinary Research Institute, Brno, Czech Republic
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Jacob CI, Paskova K. Safety and efficacy of a novel high-intensity focused electromagnetic technology device for noninvasive abdominal body shaping. J Cosmet Dermatol 2018; 17:783-787. [PMID: 30225976 DOI: 10.1111/jocd.12779] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 07/27/2018] [Accepted: 08/06/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Thermal fat reduction technologies are leading the market for nonsurgical abdominal contouring. However, they are ideal principally for patients with fat bulges. OBJECTIVES Our study investigates the effects of a novel nonthermal technology affecting the abdominal musculature and subcutaneous adipose tissue. MATERIALS AND METHODS A total of 22 patients (avg. BMI 23.8 kg m-2 ) underwent 4 treatments on abdomen with high-intensity focused electromagnetic (HIFEM) field device. Treatments took 30 minutes and were spaced apart by 2-3 days. Photographs, weight, and waist measurements were taken at the baseline, after the last treatment, and at month 3 follow-up. Patient satisfaction was noted. Photographs were evaluated by blinded evaluators. RESULTS The study protocol was completed by 19 patients. At month 3, the average waist size reduction was 4.37 ± 2.63 cm (P < 0.01). The evaluators identified the before image from the 3-month image 89.47% of the time. About 91% of patients reported their abdominal appearance improved, and 92% stated they are satisfied with treatment results at month 3. No adverse events occurred. CONCLUSION Observed waist size reduction and aesthetic improvement appear to be a combination of fat reduction and increased muscle definition of abdominal wall. In lower BMI patients, the increased abdominal muscle definition was largely responsible for the improvement. This novel energy device provides an additional tool for body contouring with primary application for lower and medium BMI patients.
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Kagaya H, Ogawa M, Mori S, Aoyagi Y, Shibata S, Inamoto Y, Mori H, Saitoh E. Hyoid Bone Movement at Rest by Peripheral Magnetic Stimulation of Suprahyoid Muscles in Normal Individuals. Neuromodulation 2018; 22:593-596. [DOI: 10.1111/ner.12777] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 02/03/2018] [Accepted: 02/13/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of MedicineFujita Health UniversityToyoake Aichi Japan
| | - Mao Ogawa
- Department of Rehabilitation Medicine I, School of MedicineFujita Health UniversityToyoake Aichi Japan
| | - Shino Mori
- Department of Rehabilitation Medicine I, School of MedicineFujita Health UniversityToyoake Aichi Japan
| | - Yoichiro Aoyagi
- Department of Rehabilitation Medicine I, School of MedicineFujita Health UniversityToyoake Aichi Japan
| | - Seiko Shibata
- Department of Rehabilitation Medicine I, School of MedicineFujita Health UniversityToyoake Aichi Japan
| | - Yoko Inamoto
- Faculty of Rehabilitation, School of Health SciencesFujita Health UniversityToyoake Aichi Japan
| | | | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of MedicineFujita Health UniversityToyoake Aichi Japan
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Baek J, Park N, Lee B, Jee S, Yang S, Kang S. Effects of Repetitive Peripheral Magnetic Stimulation Over Vastus Lateralis in Patients After Hip Replacement Surgery. Ann Rehabil Med 2018; 42:67-75. [PMID: 29560326 PMCID: PMC5852231 DOI: 10.5535/arm.2018.42.1.67] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 07/03/2017] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate the effects of repetitive peripheral magnetic stimulation (rPMS) on the vastus lateralis (VL) in the early stage after hip replacement surgery. Methods Twenty-two patients who underwent hip replacement after proximal femur fracture were included in this study. After hip surgery, the experimental group was applied with 15 sessions of 10 Hz rPMS over the VL 5 times per week for 3 weeks, while the control group took sham stimulation. All patients were also given conventional physical therapy. The VL strength was measured with the root mean square (RMS) value of the VL with surface electromyography technique. The ratio of RMS values between fractured and unfractured legs and tandem stand test were used to assess standing balance. Usual gait speed was measured to evaluate gait function. Pain in two groups was assessed with visual analog scale (VAS). Results Both RMS value of the VL and the ratio of RMS values after rPMS were significantly improved (p<0.05). Also, tandem standing time and usual gait speed in rPMS group were dramatically increased (p<0.05). However, no significant difference in VAS was found between the two groups after 3 weeks. Conclusion rPMS on the VL improved muscle strength, standing balance and gait function in the early stage after hip surgery. Therefore, rPMS could be applied to patients who cannot take electrical stimulation due to pain and an unhealed wound.
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Affiliation(s)
- Junghyun Baek
- Department of Physical Medicine and Rehabilitation, Sun General Hospital, Daejeon, Korea
| | - Nohkyoung Park
- Department of Physical Medicine and Rehabilitation, Sun General Hospital, Daejeon, Korea
| | - Bongju Lee
- Department of Orthopedic Surgery, Sun General Hospital, Daejeon, Korea
| | - Sungju Jee
- Department of Physical Medicine and Rehabilitation, Chungnam National University Hospital, Daejeon, Korea
| | - Shinseung Yang
- Department of Physical Medicine and Rehabilitation, Chungnam National University Hospital, Daejeon, Korea
| | - Sangkuk Kang
- Department of Physical Medicine and Rehabilitation, Sun General Hospital, Daejeon, Korea
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Momosaki R, Yamada N, Ota E, Abo M. Repetitive peripheral magnetic stimulation for activities of daily living and functional ability in people after stroke. Cochrane Database Syst Rev 2017; 2017:CD011968. [PMID: 28644548 PMCID: PMC6481821 DOI: 10.1002/14651858.cd011968.pub2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Repetitive peripheral magnetic stimulation (rPMS) is a form of therapy that creates painless stimulation of deep muscle structures to improve motor function in people with physical impairment from brain or nerve disorders. Use of rPMS for people after stroke has been identified as a feasible approach to improve activities of daily living and functional ability. However, no systematic reviews have assessed the findings of available trials. The effect and safety of this intervention for people after stroke currently remain uncertain. OBJECTIVES To assess the effect of rPMS for improving activities of daily living and functional ability in people after stroke. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register (August 2016), the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 8) in the Cochrane Library (August 2016), MEDLINE Ovid (November 2016), Embase Ovid (August 2016), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) in Ebsco (August 2016), PsycINFO Ovid (August 2016), the Allied and Complementary Medicine Database (AMED) Ovid (August 2016), Occupational Therapy Systematic Evaluation of Evidence (OTseeker) (August 2016), the Physiotherapy Evidence Database (PEDro) (October 2016), and ICHUSHI Web (October 2016). We also searched five ongoing trial registries, screened reference lists, and contacted experts in the field. We placed no restrictions on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomised controlled trials (RCTs) conducted to assess the therapeutic effect of rPMS for people after stroke. Comparisons eligible for inclusion were (1) active rPMS only compared with 'sham' rPMS (a very weak form of stimulation or a sound only); (2) active rPMS only compared with no intervention; (3) active rPMS plus rehabilitation compared with sham rPMS plus rehabilitation; and (4) active rPMS plus rehabilitation compared with rehabilitation only. DATA COLLECTION AND ANALYSIS Two review authors independently assessed studies for inclusion. The same review authors assessed methods and risk of bias and extracted data. We contacted trial authors to ask for unpublished information if necessary. We resolved all disagreements through discussion. MAIN RESULTS We included three trials (two RCTs and one cross-over trial) involving 121 participants. Blinding of participants and physicians was well reported in all trials, and overall risk of bias was low. We found no clear effect of rPMS on activities of daily living at the end of treatment (mean difference (MD) -3.00, 95% confidence interval (CI) -16.35 to 10.35; low-quality evidence) and at the end of follow-up (MD -2.00, 95% CI -14.86 to 10.86; low-quality evidence). Investigators in one study with 63 participants observed no statistical difference in improvement of upper limb function at the end of treatment (MD 2.00, 95% CI -4.91 to 8.91) and at the end of follow-up (MD 4.00, 95% CI -2.92 to 10.92). One trial with 18 participants showed that rPMS treatment was not associated with improved muscle strength at the end of treatment (MD 3.00, 95% CI -2.44 to 8.44). Another study reported a significant decrease in spasticity of the elbow at the end of follow-up (MD -0.48, 95% CI -0.93 to -0.03). No studies provided information on lower limb function and death. Based on the GRADE approach, we judged the certainty of evidence related to the primary outcome as low owing to the small sample size of one study. AUTHORS' CONCLUSIONS Available trials provided inadequate evidence to permit any conclusions about routine use of rPMS for people after stroke. Additional trials with large sample sizes are needed to determine an appropriate rPMS protocol as well as long-term effects. We identified three ongoing trials and will include these trials in the next review update.
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Affiliation(s)
- Ryo Momosaki
- Teikyo University School of Medicine University Hospital, MizonokuchiDepartment of Rehabilitation Medicine5‐1‐1 Futako, Takatsu‐ku, KawasakiKanagawaJapan213‐8507
| | - Naoki Yamada
- The Jikei University School of MedicineDepartment of Rehabilitation MedicineTokyoJapan
| | - Erika Ota
- St. Luke's International University, Graduate School of Nursing SciencesGlobal Health Nursing10‐1 Akashi‐choChuo‐KuTokyoJapan104‐0044
| | - Masahiro Abo
- The Jikei University School of MedicineDepartment of Rehabilitation MedicineTokyoJapan
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Strengthening of Quadriceps by Neuromuscular Magnetic Stimulation in Healthy Subjects. PM R 2017; 9:767-773. [DOI: 10.1016/j.pmrj.2016.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 12/13/2016] [Accepted: 12/23/2016] [Indexed: 11/16/2022]
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Why and How Limb Muscle Mass and Function Should Be Measured in Patients with Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc 2016. [PMID: 26208090 DOI: 10.1513/annalsats.201505-278ps] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Impaired limb muscle function is a common occurrence in patients with chronic obstructive pulmonary disease (COPD), and it negatively influences exercise tolerance, quality of life, and even survival. Assessment of limb muscle mass and function in COPD is highly encouraged; it should include the quadriceps muscle, but other lower and upper limb muscles may also be evaluated to provide valuable information. Quantification of muscle mass as well as assessment of muscle strength and endurance are suggested. Bioelectrical impedance and dual-energy X-ray absorption can be realistically used in the clinical environment to monitor body composition. Although sophisticated computerized dynamometers provide the most accurate assessment, simple exercise and testing equipment are valid alternatives and they should help in implementing limb muscle function assessment in clinical settings. Isometric measurements, using strain-gauges or hand-held dynamometers, should be favored for their simplicity, availability, and quality of information provided. This perspective provides a rationale for the evaluation of limb muscle mass and function in COPD in routine clinical practice. In addition, measurement techniques used to assess limb muscle mass, strength, endurance, and fatigue in various clinical settings are discussed.
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Tofari PJ, Opar DA, Kemp JG, Billaut F, Cormack S. Reliability of measures of quadriceps muscle function using magnetic stimulation. Muscle Nerve 2016; 53:770-8. [PMID: 26427047 DOI: 10.1002/mus.24926] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 09/23/2015] [Accepted: 09/29/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Paul J Tofari
- School of Exercise Science, Australian Catholic University, 115 Victoria Parade, Fitzroy, 3065, Melbourne, Victoria, Australia
| | - David A Opar
- School of Exercise Science, Australian Catholic University, 115 Victoria Parade, Fitzroy, 3065, Melbourne, Victoria, Australia
| | - Justin G Kemp
- School of Exercise Science, Australian Catholic University, 115 Victoria Parade, Fitzroy, 3065, Melbourne, Victoria, Australia
| | - Francois Billaut
- Département de Kinésiologie, Université Laval, Quebec City, Quebec, Canada
| | - Stuart Cormack
- School of Exercise Science, Australian Catholic University, 115 Victoria Parade, Fitzroy, 3065, Melbourne, Victoria, Australia
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Repetitive peripheral magnetic stimulation to reduce pain or improve sensorimotor impairments: A literature review on parameters of application and afferents recruitment. Neurophysiol Clin 2015; 45:223-37. [DOI: 10.1016/j.neucli.2015.08.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 08/06/2015] [Accepted: 08/06/2015] [Indexed: 11/22/2022] Open
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Leung A, Shukla S, Lee J, Metzger-Smith V, He Y, Chen J, Golshan S. Effect of low frequency transcutaneous magnetic stimulation on sensory and motor transmission. Bioelectromagnetics 2015; 36:410-9. [PMID: 25989482 DOI: 10.1002/bem.21921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 04/05/2015] [Indexed: 11/06/2022]
Abstract
Peripheral nerve injury diminishes fast conducting large myelinated afferent fibers transmission but enhances smaller pain transmitting fibers firing. This aberrant afferent neuronal behavior contributes to development of chronic post-traumatic peripheral neuropathic pain (PTP-NP). Non-invasive dynamic magnetic flux stimulation has been implicated in treating PTP-NP, a condition currently not adequately addressed by other therapies including transcutaneous electrical nerve stimulation (TENS). The current study assessed the effect of low frequency transcutaneous magnetic stimulation (LFTMS) on peripheral sensory thresholds, nerve conduction properties, and TENS induced fast afferent slowing effect as measured by motor and sensory conduction studies in the ulnar nerve. Results indicated sham LFTMS with TENS (Sham + TENS) significantly (P = 0.02 and 0.007, respectively) reduces sensory conduction velocity (CV) and increases sensory onset latency (OL), and motor peak latency (PL) whereas, real LFTMS with TENS (Real + TENS) reverses effects of TENS on sensory CV and OL, and significantly (P = 0.036) increases the sensory PL. LFTMS alone significantly (P < 0.05) elevates sensory PL and onset-to-peak latency. LFTMS appears to reverse TENS slowing effect on fast conducting fibers and casts a selective peripheral modulatory effect on slow conducting pain afferent fibers.
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Affiliation(s)
- Albert Leung
- Department of Anesthesiology, University of California, School of Medicine, San Diego, California.,Veterans Administration San Diego Healthcare System (California), San Diego, California
| | - Shivshil Shukla
- Department of Anesthesiology, University of California, School of Medicine, San Diego, California.,Veterans Administration San Diego Healthcare System (California), San Diego, California
| | | | | | - Yifan He
- University of California, San Diego, California
| | - Jeffrey Chen
- Department of Anesthesiology, University of California, School of Medicine, San Diego, California.,Veterans Administration San Diego Healthcare System (California), San Diego, California
| | - Shahrokh Golshan
- Department of Psychiatry, University of California, School of Medicine, San Diego, California
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Neyroud D, Temesi J, Millet GY, Verges S, Maffiuletti NA, Kayser B, Place N. Comparison of electrical nerve stimulation, electrical muscle stimulation and magnetic nerve stimulation to assess the neuromuscular function of the plantar flexor muscles. Eur J Appl Physiol 2015; 115:1429-39. [DOI: 10.1007/s00421-015-3124-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 02/03/2015] [Indexed: 01/15/2023]
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Comparison of Torque and Discomfort Produced by Sinusoidal and Rectangular Alternating Current Electrical Stimulation in the Quadriceps Muscle at Variable Burst Duty Cycles. Am J Phys Med Rehabil 2014; 93:146-59. [DOI: 10.1097/phm.0000000000000008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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