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Sudo M, Kitajima D, Takagi Y, Mochizuki K, Fujibayashi M, Costello JT, Ando S. Effects of voluntary exercise and electrical muscle stimulation on reaction time in the Go/No-Go task. Eur J Appl Physiol 2024:10.1007/s00421-024-05562-8. [PMID: 39044028 DOI: 10.1007/s00421-024-05562-8] [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: 03/28/2024] [Accepted: 07/10/2024] [Indexed: 07/25/2024]
Abstract
INTRODUCTION Acute exercise improves cognitive performance. However, it remains unclear what triggers cognitive improvement. Electrical muscle stimulation (EMS) facilitates the examination of physiological changes derived from peripheral muscle contraction during exercise. Thus, we compared the effects of EMS and voluntary exercise at low- or moderate-intensity on reaction time (RT) in a cognitive task to understand the contribution of central and peripheral physiological factors to RT improvement. METHODS Twenty-four young, healthy male participants performed a Go/No-Go task before and after EMS/exercise. In the EMS condition, EMS was applied to the lower limb muscles. In the low-intensity exercise condition, the participants cycled an ergometer while maintaining their heart rate (HR) at the similar level during EMS. In the moderate-intensity exercise condition, exercise intensity corresponded to ratings of perceived exertion of 13/20. The natural log-transformed root mean square of successive differences between adjacent inter-beat (R-R) intervals (LnRMSSD), which predominantly reflects parasympathetic HR modulation, was calculated before and during EMS/exercise. RESULTS RT improved following moderate-intensity exercise (p = 0.002, Cohen' d = 0.694), but not following EMS (p = 0.107, Cohen' d = 0.342) and low-intensity exercise (p = 0.076, Cohen' d = 0.380). Repeated measures correlation analysis revealed that RT was correlated with LnRMSSD (Rrm(23) = 0.599, p = 0.002) in the moderate-intensity exercise condition. CONCLUSION These findings suggest that the amount of central neural activity and exercise pressor reflex may be crucial for RT improvement. RT improvement following moderate-intensity exercise may, at least partly, be associated with enhanced sympathetic nervous system activity.
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Affiliation(s)
- Mizuki Sudo
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, 150 Tobuki, Hachioji, Tokyo, 192-0001, Japan
| | - Daisuke Kitajima
- Faculty of Informatics and Engineering, The University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo, 182-8585, Japan
| | - Yoko Takagi
- Graduate School of Informatics and Engineering, The University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo, 182-8585, Japan
| | - Kodai Mochizuki
- Graduate School of Informatics and Engineering, The University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo, 182-8585, Japan
| | - Mami Fujibayashi
- Faculty of Agriculture, Setsunan University, 45-1 Nagaotoge-Cho, Hirakata, Osaka, 573-0101, Japan
| | - Joseph T Costello
- School of Psychology, Sport and Health Sciences, University of Portsmouth, Portsmouth, UK
| | - Soichi Ando
- Graduate School of Informatics and Engineering, The University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo, 182-8585, Japan.
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Tamiya H, Kawashiri H, Miyamoto T, Tsubaki A. Acute Effects of Skeletal Muscle Electrical Stimulation on Central and Lower Extremity Hemodynamics. Cureus 2024; 16:e62988. [PMID: 38915840 PMCID: PMC11194163 DOI: 10.7759/cureus.62988] [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] [Accepted: 06/21/2024] [Indexed: 06/26/2024] Open
Abstract
INTRODUCTION Belt electrode-skeletal muscle electrical stimulation (B-SES) is a treatment prescribed for individuals with difficulty performing exercise therapy that improves muscle strength, exercise tolerance, and glucose metabolism. However, the effects of B-SES on the hemodynamics of the central and lower extremity conduit arteries have not been studied. Therefore, this study compared the acute effects of B-SES on the central and lower extremity conduit arteries in healthy young males. METHODS This randomized crossover study included nine healthy young males (mean age: 21.0±1.1 years). Participants were assigned to the following experimental conditions, with a washout period of one week: condition 1 included 20 min of electrical stimulation of the lower extremity at the participant's sensation threshold intensity (Sham, n=9) and condition 2 included 20 min of electrical stimulation of the lower extremity at the maximum intensity the participant can tolerate (B-SES, n=9). The heart rate (HR), stroke volume (SV), cardiac output (CO), mean arterial pressure (MAP), and total peripheral vascular resistance (TPR) were measured as central hemodynamics. The hemodynamics of the lower extremity conduit arteries were measured and calculated for the shallow femoral artery (SFA), including vessel diameter, mean blood flow velocity (MBFV), shear rate (SR), and mean blood flow (MBF) rate. These indices were measured before stimulation (Pre), 10 min after the start of stimulation (Stimulating), and immediately after the end of stimulation (Post). These indices were compared using a repeated two-way analysis of variance. RESULTS In B-SES, HR (Pre: 63.2±8.6; Stimulating: 73.7±6.9; Post: 70.0±4.2 bpm, p<0.01), CO (Pre: 5.1±1.0; Stimulating: 6.5±1.5, p<0.01; Post: 6.3±1.2 L/min, p=0.02), and MAP (Pre: 104.0±11.5; Stimulating: 116.4±10.8, p<0.01; Post: 109.6±9.7 mmHg, p=0.02) increased significantly. In addition, B-SES significantly increased MBFV (Pre: 19.2±4.0; Stimulating: 50.5±14.9; Post: 30.1±4.0 cm/s, p<0.01), SR (Pre: 118.9±28.8; Stimulating: 302.7±91. 2, p<0.01; Post: 182.1±70.1/s, p=0.02), and MBF (Pre: 382.0±61.5; Stimulating: 1009.6±321.4; Post: 626.8±176.6 mL/min, p<0.01). However, there were no significant changes in SV and TPR. CONCLUSIONS The findings of this study indicate that B-SES in healthy young males increases CO without increasing SV or TPR and improves the MBFV and SR in the SFA.
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Affiliation(s)
- Hajime Tamiya
- Department of Exercise Physiology, Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, JPN
| | - Hina Kawashiri
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, JPN
| | - Toshiaki Miyamoto
- Department of Physical Therapy, Faculty of Rehabilitation, Kansai Medical University, Osaka, JPN
| | - Atsuhiro Tsubaki
- Department of Exercise Physiology, Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, JPN
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Ra SG, Miura H, Iwata T. Effects of electrical stimulation of the lower extremities on postprandial hyperglycemia and arterial stiffness. Phys Act Nutr 2024; 28:7-13. [PMID: 39097992 PMCID: PMC11298285 DOI: 10.20463/pan.2024.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/09/2024] [Accepted: 04/17/2024] [Indexed: 08/06/2024] Open
Abstract
PURPOSE To compare the acute effects of electrical stimulation (ES) of the lower extremities on postprandial hyperglycemia and arterial stiffness during oral glucose tolerance testing (OGTT). METHODS In a randomized crossover study, eight healthy young men completed three experimental trials in which they underwent ES for 30 min, starting 60 min before (Before) or 30 min after (After) ingesting 75 g of glucose; ES was not performed in the control trial (Control). The subjects' blood glucose levels and brachial-ankle pulse wave velocity (baPWV) were measured as an index of arterial stiffness at baseline and 30, 60, and 120 min after glucose ingestion. Serum insulin levels were measured at baseline and 60 min after glucose ingestion. RESULTS The subjects' glucose intake led to an increase in their blood glucose concentration in all trials, however, in the After trial, ES resulted in significantly lower blood glucose concentrations at 60 min post glucose ingestion compared to the Control and Before trials. The area under the curve (AUC) of serum insulin concentrations during the OGTT in the After trial was significantly lower than that in the other two trials. Moreover, glucose ingestion did not increase the baPWV, however, 30 min of ES during the postprandial state acutely reduced the baPWV. CONCLUSION These results suggest that ES is most effective in reducing postprandial hyperglycemia when administered after a meal. Thus, lower extremity ES may be an alternative exercise method to activate postprandial glucose metabolism in healthy individuals.
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Affiliation(s)
- Song-Gyu Ra
- Laboratory of Exercise Nutrition, Institute of Liberal Arts and Sciences, Tokushima University, Tokushima, Japan
| | - Hajime Miura
- Laboratory for Applied Physiology, Institutes of Socio-Arts and Sciences, Tokushima University, Tokushima, Japan
| | - Takashi Iwata
- Laboratory of Exercise Nutrition, Institute of Liberal Arts and Sciences, Tokushima University, Tokushima, Japan
- Department of Surgery, Tokushima University, Tokushima, Japan
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Ando S, Ishioka Y, Kambayashi S, Kano K, Fujibayashi M, Costello JT, Sudo M. Combined effects of electrical muscle stimulation and cycling exercise on cognitive performance. Front Physiol 2024; 15:1408963. [PMID: 38827991 PMCID: PMC11140777 DOI: 10.3389/fphys.2024.1408963] [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: 03/29/2024] [Accepted: 05/08/2024] [Indexed: 06/05/2024] Open
Abstract
The purpose of this study was to investigate whether a combination of electrical muscle stimulation (EMS) and cycling exercise is beneficial for improving cognitive performance. Eighteen participants (7 females and 11 males) performed a Go/No-Go task before and 2 min after i) cycling exercise (EX), ii) a combination of EMS and cycling (EMS + EX) and iii) a control (rest) intervention in a randomized controlled crossover design. In the EX intervention, the participants cycled an ergometer for 20 min with their heart rate maintained at ∼120 beats·min-1. In the EMS + EX intervention, the participants cycled an ergometer simultaneously with EMS for 20 min, with heart rate maintained at ∼120 beats·min-1. In the Control intervention, the participants remained at rest while seated on the ergometer. Cognitive performance was assessed by reaction time (RT) and accuracy. There was a significant interaction between intervention and time (p = 0.007). RT was reduced in the EX intervention (p = 0.054, matched rank biserial correlation coefficient = 0.520). In the EMS + EX intervention, RT was not altered (p = 0.243, Cohen's d = 0.285) despite no differences in heart rate between the EX and EMS + EX interventions (p = 0.551). RT was increased in the Control intervention (p = 0.038, Cohen's d = -0.529). These results indicate that combining EMS and cycling does not alter cognitive performance despite elevated heart rate, equivalent to a moderate intensity. The present findings suggest that brain activity during EMS with cycling exercise may be insufficient to improve cognitive performance when compared to exercise alone.
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Affiliation(s)
- Soichi Ando
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Chofu, Tokyo, Japan
| | - Yuka Ishioka
- Faculty of Informatics and Engineering, The University of Electro-Communications, Chofu, Tokyo, Japan
| | - Sari Kambayashi
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Chofu, Tokyo, Japan
| | - Kosuke Kano
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Chofu, Tokyo, Japan
| | | | - Joseph T. Costello
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Mizuki Sudo
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Shinjuku, Tokyo, Japan
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Ando S, Fujimoto T, Sudo M, Watanuki S, Hiraoka K, Takeda K, Takagi Y, Kitajima D, Mochizuki K, Matsuura K, Katagiri Y, Nasir FM, Lin Y, Fujibayashi M, Costello JT, McMorris T, Ishikawa Y, Funaki Y, Furumoto S, Watabe H, Tashiro M. The neuromodulatory role of dopamine in improved reaction time by acute cardiovascular exercise. J Physiol 2024; 602:461-484. [PMID: 38165254 DOI: 10.1113/jp285173] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/06/2023] [Indexed: 01/03/2024] Open
Abstract
Acute cardiovascular physical exercise improves cognitive performance, as evidenced by a reduction in reaction time (RT). However, the mechanistic understanding of how this occurs is elusive and has not been rigorously investigated in humans. Here, using positron emission tomography (PET) with [11 C]raclopride, in a multi-experiment study we investigated whether acute exercise releases endogenous dopamine (DA) in the brain. We hypothesized that acute exercise augments the brain DA system, and that RT improvement is correlated with this endogenous DA release. The PET study (Experiment 1: n = 16) demonstrated that acute physical exercise released endogenous DA, and that endogenous DA release was correlated with improvements in RT of the Go/No-Go task. Thereafter, using two electrical muscle stimulation (EMS) studies (Experiments 2 and 3: n = 18 and 22 respectively), we investigated what triggers RT improvement. The EMS studies indicated that EMS with moderate arm cranking improved RT, but RT was not improved following EMS alone or EMS combined with no load arm cranking. The novel mechanistic findings from these experiments are: (1) endogenous DA appears to be an important neuromodulator for RT improvement and (2) RT is only altered when exercise is associated with central signals from higher brain centres. Our findings explain how humans rapidly alter their behaviour using neuromodulatory systems and have significant implications for promotion of cognitive health. KEY POINTS: Acute cardiovascular exercise improves cognitive performance, as evidenced by a reduction in reaction time (RT). However, the mechanistic understanding of how this occurs is elusive and has not been rigorously investigated in humans. Using the neurochemical specificity of [11 C]raclopride positron emission tomography, we demonstrated that acute supine cycling released endogenous dopamine (DA), and that this release was correlated with improved RT. Additional electrical muscle stimulation studies demonstrated that peripherally driven muscle contractions (i.e. exercise) were insufficient to improve RT. The current study suggests that endogenous DA is an important neuromodulator for RT improvement, and that RT is only altered when exercise is associated with central signals from higher brain centres.
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Affiliation(s)
- Soichi Ando
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Toshihiko Fujimoto
- Institute of Excellence in Higher Education, Tohoku University, Miyagi, Japan
| | - Mizuki Sudo
- Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
| | - Shoichi Watanuki
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Kotaro Hiraoka
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Kazuko Takeda
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Yoko Takagi
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
| | - Daisuke Kitajima
- Faculty of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
| | - Kodai Mochizuki
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
| | - Koki Matsuura
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
| | - Yuki Katagiri
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
| | - Fairuz Mohd Nasir
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
- Faculty of Health Sciences, University Sultan Zainal Abidin, Malaysia
| | - Yuchen Lin
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
- Department of Occupational Therapy, Da-Yeh University, Changhua, Taiwan
| | | | - Joseph T Costello
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Terry McMorris
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
- Institue of Sport, Nursing and Allied Health, University of Chichester, Chichester, UK
| | - Yoichi Ishikawa
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Yoshihito Funaki
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Shozo Furumoto
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Hiroshi Watabe
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
| | - Manabu Tashiro
- Cyclotron and Radioisotope Centre, Tohoku University, Miyagi, Japan
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Tamura Y, Ochiai K, Takahashi M, Takahashi H, Tomoe T, Sugiyama T, Otani N, Sugimura H, Toyoda S, Yasu T. Relationship Between Increased Oxygen Uptake and Lactate Production With Progressive Incremental Electrode Skeletal Muscle Stimulation: A Pilot Study. Cureus 2024; 16:e51919. [PMID: 38333497 PMCID: PMC10850931 DOI: 10.7759/cureus.51919] [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] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
Background Belt electrode skeletal muscle stimulation (B-SES) is an alternative exercise therapy for those with difficulty performing voluntary exercise. However, it is unknown whether oxygen uptake (VO2) in B-SES is comparable to cardiopulmonary exercise test (CPX) as assessed by voluntary exercise. This study aimed to evaluate oxygen uptake (VO2) and lactate (LA) production in incremental B-SES compared to ergometer CPX and to determine the relationship with ergometer CPX. Methods This study included 10 healthy young Japanese participants. Using a crossover design, all participants underwent incremental B-SES CPX and ergometer CPX using a 20 W ramp. Serum lactic acid concentration (LA) was measured serially before, during, and after B-SES. The tolerability of B-SES was adjusted with the change in LA level (⊿LA). Results Peak VO2 during B-SES (14.1±3.3 mL/kg/min) was significantly lower than ergometer peak VO2 (30.2±6.2 mL/kg/min, P<0.001). B-SES peak VO2 was similar to the anaerobic threshold (AT) VO2 on ergometer CPX (15.1±2.6 mL/kg/min). LA (Rest: 1.4±0.3, Peak: 2.8±0.8 mmol) and plasma noradrenalin (Rest: 0.2±0.1, Peak: 0.4±0.1 ng/mL) levels increased after B-SES. No significant correlation was observed between B-SES peak VO2 and ergometer CPX. However, after adjusting for B-SES, tolerability, it (peak VO2 of B-SES /⊿LA) correlated with peak VO2 (r=0.688, p=0.028) on the ergometer. Conclusion Peak VO2 of the passively progressive B-SES almost reached the AT value of the ergometer CPX without adverse events. Peak VO2 of B-SES adjusted with ⊿LA may be used to predict peak VO2 in ergometer CPX.
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Affiliation(s)
- Yuma Tamura
- Department of Rehabilitation, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Kaori Ochiai
- Department of Rehabilitation, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Momo Takahashi
- Department of Rehabilitation, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Harunori Takahashi
- Department of Rehabilitation, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Takashi Tomoe
- Department of Cardiology, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Takushi Sugiyama
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Naoyuki Otani
- Department of Cardiology, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Hiroyuki Sugimura
- Department of Cardiology, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, JPN
| | - Takanori Yasu
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
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Sanchez MJ, Mossayebi A, Sigaroodi S, Apaflo JN, Galvan MJ, Min K, Agullo FJ, Wagler A, Bajpeyi S. Effects of neuromuscular electrical stimulation on glycemic control: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1222532. [PMID: 37583429 PMCID: PMC10424918 DOI: 10.3389/fendo.2023.1222532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 07/12/2023] [Indexed: 08/17/2023] Open
Abstract
Background Physical inactivity increases the risk for metabolic diseases such as obesity and type 2 diabetes. Neuromuscular electrical stimulation (NMES) is an effective method to induce muscle contraction, particularly for populations with physical impairments and/or metabolic diseases. However, its effectiveness to improve glycemic control is unclear. This review aimed to determine the effectiveness of NMES on glycemic control. Methods Electronic search consisted of MEDLINE (PubMed), EMBASE, Cochrane Library, Google Scholar, and Web of Science to identify studies that investigated the effects of NMES on glycemic control for this systematic review. The meta-analysis consists of the studies designed as randomized controlled trials. Effect sizes were calculated as the standardized mean difference (SMD) and meta-analysis was conducted using a random-effects model. Results Thirty-five studies met the inclusion criteria for systematic review and of those, nine qualified for the meta-analysis. Existing evidence suggested that NMES effectively improves glycemic control predominantly in middle-aged and elderly population with type 2 diabetes, obesity, and spinal cord injury. The meta-analysis is comprised of 180 participants and reported that NMES intervention lowered fasting blood glucose (SMD: 0.48; 95% CI: 0.17 to 0.78; p=0.002; I²=0%). Additional analysis using the primary measures reported by each study to indicate glycemic control (i.e., OGTT, HOMA-IR, and fasting glucose) also confirmed a significant effect of NMES on improving glycemic control (SMD: 0.41; 95% CI, 0.09 to 0.72; p=0.01; I²=11%). NMES protocol varied across studies and requires standardization. Conclusion NMES could be considered as a therapeutic strategy to improve glycemic control in populations with physical impairments and/or metabolic disorders. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42020192491.
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Affiliation(s)
- Michael J. Sanchez
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States
| | - Ali Mossayebi
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States
| | - Solmaz Sigaroodi
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States
| | - Jehu N. Apaflo
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States
| | - Michelle J. Galvan
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States
| | - Kisuk Min
- Muscle Molecular Physiology Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States
| | | | - Amy Wagler
- Department of Mathematical Sciences, The University of Texas at El Paso, El Paso, TX, United States
| | - Sudip Bajpeyi
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States
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Tauchi Y, Ogino T, Morisawa T, Wada Y, Sakamoto R, Kanata Y, Domen K. Web-Based Questionnaire Survey on Heart Failure in Elderly Patients Using Outpatient Rehabilitation ― Actual Conditions of Cardiac Rehabilitation in Long-Term Care Insurance Systems ―. Circ Rep 2023; 5:133-143. [PMID: 37025936 PMCID: PMC10072896 DOI: 10.1253/circrep.cr-22-0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 03/12/2023] Open
Abstract
Background: The purpose of this study was to investigate the actual conditions of cardiac rehabilitation (CR) for elderly patients with heart failure (HF) in outpatient rehabilitation (OR) facilities using long-term care insurance systems. Methods and Results: This was a cross-sectional web-based questionnaire survey conducted at 1,258 facilities in the Kansai region (6 prefectures) of Japan from October to December 2021. In all, 184 facilities responded to the web-based questionnaire (response rate 14.8%). Of these facilities, 159 (86.4%) accepted patients with HF. Among the patients with HF, 94.3% were aged ≥75 years and 66.7% were classified as New York Heart Association functional class I/II. Facilities treating patients with HF generally provided exercise therapy, patient education, and disease management, which were components of CR. Many facilities not currently treating patients with HF responded positively stating they will accept HF patients in the future. However, a few facilities responded by stating that they are waiting for clearer evidence demonstrating the beneficial effect of OR on patients with HF. Conclusions: The present results show the possibility that outpatient CR can be performed for elderly patients with HF in other than medical insurance.
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Affiliation(s)
- Yuta Tauchi
- Department of Rehabilitation, Hyogo College of Medicine, Sasayama Medical Center
| | - Tomoyuki Ogino
- Department of Physical Therapy, Hyogo College of Medicine
| | | | - Yosuke Wada
- Department of Rehabilitation, Hyogo College of Medicine, Sasayama Medical Center
| | - Rie Sakamoto
- Department of Rehabilitation, Hyogo College of Medicine, Sasayama Medical Center
| | - Yoshihiro Kanata
- Department of Rehabilitation, Hyogo College of Medicine, Sasayama Medical Center
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine
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Effect of electromyostimulation training on intramuscular fat accumulation determined by ultrasonography in older adults. Eur J Appl Physiol 2023; 123:271-282. [PMID: 36260185 PMCID: PMC9580431 DOI: 10.1007/s00421-022-05074-3] [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: 05/21/2022] [Accepted: 10/11/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Electromyostimulation (EMS) induces a short-term change in muscle metabolism, and EMS training induces long-term improvements of muscle atrophy and function. However, the effects of EMS training on intramuscular fat in older adults are still poorly known. The purpose of this study was to examine whether the intramuscular fat index and biochemical parameters change with EMS training of the quadriceps femoris muscles in older adults. METHODS Nineteen non-obese older men and women performed EMS training of the quadriceps femoris for 12 weeks (3 times/week; single session for 30 min). The intramuscular fat content index was estimated by echo intensity of the vastus lateralis and rectus femoris muscles on ultrasonography, and muscle thickness was also measured. Muscle strength was assessed as the maximal voluntary contraction during isometric knee extension. Echo intensity, muscle thickness, and muscle strength were measured before and after EMS training. A rested/fasting blood samples were collected before and after EMS training for measuring plasma glucose, insulin, free fatty acid, triglyceride, and interleukin-6 concentrations. To examine the acute effect of a single-EMS session on biochemical parameters, blood samples were taken before and after the EMS session. RESULTS EMS training did not significantly change echo intensity in muscles, muscle thickness, muscle strength, or biochemical parameters. Regarding the acute effect on blood lipid concentrations, a single-EMS session increased free fatty acid and glucose concentrations. CONCLUSION EMS sessions had an acute effect of increasing free fatty acid and glucose concentrations, but EMS training intervention did not improve intramuscular fat content.
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Fallah F, Alijanpour M, Khafri S, Pournasrollah M, Talebi GA. The effect of neuromuscular electrical stimulation on serum glucose levels in children and adolescents with type-1 diabetes mellitus: a single group clinical trial. BMC Endocr Disord 2022; 22:246. [PMID: 36221091 PMCID: PMC9552160 DOI: 10.1186/s12902-022-01149-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the effect of Neuromuscular Electrical Stimulation (NMES) on serum glucose level in children and adolescents with type-1 diabetes. METHODS This before-after, single-group, clinical trial was conducted on 29 patients with type-1 diabetes mellitus with the age range of 7-18 years. The patients underwent NMES in two 20-minute phases on the quadriceps and hamstrings muscles, three sessions per week for a period of 8 weeks. Fasting Blood Sugar (FBS), measured in two ways, by glucometer and laboratory testing, was considered as the primary outcome and the glycated hemoglobin (HbA1c) and the total daily dose (TDD) of insulin were measured as the secondary outcomes. The laboratory FBS and HbA1c were measured 1 day before the intervention (as a baseline value) and then 2 and 6 weeks after the last session of intervention. FBS by glucometer and total daily dose of insulin were recorded daily from 2 weeks before the intervention to the last day of the intervention and consequently, the weekly average of these variables was calculated and used for statistical analysis. RESULTS The serum level of FBS (measured by glucometer) and the total daily dose of insulin reduced significantly 2 weeks after beginning of intervention. The laboratory serum level of FBS decreased significantly in the second week after the end of intervention compared to the baseline values. Although the HbA1c level decreased at follow-up period (2 and 6 weeks after the intervention), it was not significant. CONCLUSION It seems that 8 weeks of NMES has beneficial effects on the reduction of FBS and TDD of insulin therefore, it could be suggested as the contributory treatment in management of children and adolescents with type-1 diabetes. TRIAL REGISTRATION The study was registered at https://fa.irct.ir/user/trial/51739/view (IRCT20100523003998N1) in date of 25/10/2020.
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Affiliation(s)
- Fatemeh Fallah
- Department of Physiotherapy, Babol University of Medical Sciences, Babol, Iran
| | - Morteza Alijanpour
- Department of Pediatrics, Non-Communicable Pediatric Disease Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Soraya Khafri
- Social Determinates of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Pournasrollah
- The Clinical Research Development Unit of Amirkola Children's Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Ghadam Ali Talebi
- Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran.
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11
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Oda H, Fujibayashi M, Matsumoto N, Nishiwaki M. Acute Effects of Low-Intensity Electrical Stimulation on Segmental Arterial Stiffness. Front Physiol 2022; 13:828670. [PMID: 35733993 PMCID: PMC9208204 DOI: 10.3389/fphys.2022.828670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/22/2022] [Indexed: 11/16/2022] Open
Abstract
Electrical muscle stimulation (EMS) has traditionally been employed to improve muscle strength and glucose uptake. EMS may also reduce arterial stiffness, but little is known about whether low-intensity EMS reduces systemic and/or regional arterial stiffness. This study aimed to examine the effects of low-intensity EMS of the lower limbs on segmental arterial stiffness. Fourteen healthy subjects participated in experiments under two different protocols (control resting trial (CT) and electrical stimulation trial (ET)) in random order on separate days. The EMS was applied to the lower limbs at 4 Hz for 20 min at an intensity corresponding to an elevation of approximately 15 beats/min in pulse rate (10.7 ± 4.7% of heart rate reserve). Arterial stiffness was assessed by cardio-ankle vascular index (CAVI), CAVI0, heart-ankle pulse wave velocity (haPWV), brachial-ankle pulse wave velocity (baPWV), heart-brachial pulse wave velocity (hbPWV), and carotid-femoral pulse wave velocity (cfPWV). In both trials, each parameter was measured at before (Pre) and 5 min (Post 1) and 30 min (Post 2) after trial. After the experiment, CT did not cause significant changes in any arterial stiffness parameters, whereas ET significantly reduced CAVI (from Pre to Post 1: −0.8 ± 0.5 unit p < 0.01), CAVI0 (from Pre to Post 1: −1.2 ± 0.8 unit p < 0.01), haPWV (from Pre to Post 1: −47 ± 35 cm/s p < 0.01), and baPWV (from Pre to Post 1: −120 ± 63 cm/s p < 0.01), but not hbPWV or cfPWV. Arm diastolic blood pressure (BP) at Post 2 was slightly but significantly increased in the CT compared to Pre or Post 1, but not in the ET. Conversely, ankle diastolic and mean BPs at Post 1 were significantly reduced compared to Pre and Post 2 in the ET (p < 0.01). These findings suggest that low-intensity EMS of the lower limbs reduces arterial stiffness, but only in sites that received EMS.
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Affiliation(s)
- Hiroyuki Oda
- Faculty of Health Science, Morinomiya University of Medical Science, Osaka, Japan
- Faculty of Engineering, Osaka Institute of Technology, Osaka, Japan
| | | | - Naoyuki Matsumoto
- Faculty of Environmental Symbiotic Science, Prefectural University of Kumamoto, Kumamoto, Japan
| | - Masato Nishiwaki
- Faculty of Engineering, Osaka Institute of Technology, Osaka, Japan
- *Correspondence: Masato Nishiwaki,
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12
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Cohen JN, Kuikman MA, Politis-Barber V, Stairs BE, Coates AM, Millar PJ, Burr JF. Blood flow restriction and stimulated muscle contractions do not improve metabolic or vascular outcomes following glucose ingestion in young, active individuals. J Appl Physiol (1985) 2022; 133:75-86. [DOI: 10.1152/japplphysiol.00178.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Glucose ingestion and absorption into the blood stream can challenge glycemic regulation and vascular endothelial function. Muscular contractions in exercise promote a return to homeostasis by increasing glucose uptake and blood flow. Similarly, muscle hypoxia supports glycemic regulation by increasing glucose oxidation. Blood flow restriction (BFR) induces muscle hypoxia during occlusion and reactive hyperemia upon release. Thus, in the absence of exercise, electric muscle stimulation (EMS) and BFR may offer circulatory and glucoregulatory improvements. In 13 healthy, active participants (27±3yr, 7 female) we tracked post-glucose (oral 100g) glycemic, cardiometabolic and vascular function measures over 120min following four interventions: 1) BFR, 2) EMS, 3) BFR+EMS or 4) Control. BFR was applied at 2min intervals for 30min (70% occlusion), EMS was continuous for 30min (maximum-tolerable intensity). Glycemic and insulinemic responses did not differ between interventions (partial η2=0.11-0.15, P=0.2); however, only BFR+EMS demonstrated cyclic effects on oxygen consumption, carbohydrate oxidation, muscle oxygenation, heart rate, and blood pressure (all P<0.01). Endothelial function was reduced 60min post-glucose ingestion across interventions and recovered by 120min (5.9±2.6% vs 8.4±2.7%; P<0.001). Estimated microvascular function was not meaningfully different. Leg blood flow increased during EMS and BFR+EMS (+656±519mL•min-1, +433±510mL•min-1; P<0.001); however, only remained elevated following BFR intervention 90min post-glucose (+94±94mL•min-1; P=0.02). Superimposition of EMS onto cyclic BFR did not preferentially improve post-glucose metabolic or vascular function amongst young, active participants. Cyclic BFR increased blood flow delivery 60min beyond intervention, and BFR+EMS selectively increased carbohydrate usage and reduced muscle oxygenation warranting future clinical assessments.
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Affiliation(s)
- Jeremy N. Cohen
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Megan A. Kuikman
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Valerie Politis-Barber
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Brienne E. Stairs
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Alexandra M. Coates
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Philip J. Millar
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Jamie F. Burr
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
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13
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Yoshiko A, Maeda H, Takahashi H, Koike T, Tanaka N, Akima H. Contribution of skeletal muscle and serum lipids to muscle contraction induced by neuromuscular electrical stimulation in older individuals. Physiol Rep 2022; 10:e15236. [PMID: 35312173 PMCID: PMC8935638 DOI: 10.14814/phy2.15236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/19/2022] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
Intramyocellular lipids (IMCL) stored in droplets in muscle cells and free fatty acids (FFA) from fat cells in the blood are the main substrates of adenosine triphosphate during continuous muscle contractions of relatively lower intensity. Although it is known that the lipid oxidative capacity decreases with aging, the effect of IMCL and FFA on muscle contraction in older individuals remains unclear. The purpose of this study was to investigate the contribution of skeletal muscle lipids and blood lipids as energy sources for muscle contraction in older individuals. Eighteen older individuals (mean age: 70.4 ± 3.5 years) underwent muscle contraction intervention induced by intermittent neuromuscular electrical stimulation (NMES) to the vastus lateralis for 30 min. Fasting blood samples were obtained and proton magnetic resonance spectroscopy (1H‐MRS) was performed before and after NMES, and the parameters (including IMCL and extramyocellular lipid [EMCL]) from 1H‐MRS, along with FFA and adiponectin levels, were analyzed using the blood samples of all participants. Levels of IMCL and EMCL did not change (p > 0.05); however, FFA and adiponectin levels decreased from 1.1 ± 0.5 mEq/L to 0.8 ± 0.2 mEq/L and 12.0 ± 5.3 μg/ml to 11.4 ± 5.0 μg/ml, after NMES (p < 0.05), respectively. These findings indicate that serum lipids, but not skeletal muscle lipids, are the energy substrate utilized during involuntary muscle contraction in older individuals.
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Affiliation(s)
- Akito Yoshiko
- Faculty of Liberal Arts and Sciences Chukyo University Toyota Aichi Japan
| | - Hisashi Maeda
- Graduate School of Medicine Nagoya University Nagoya Aichi Japan
| | - Hideyuki Takahashi
- Faculty of Health and Sport Sciences University of Tsukuba Tsukuba Ibaraki Japan
| | - Teruhiko Koike
- Graduate School of Medicine Nagoya University Nagoya Aichi Japan
- Research Center of Health, Physical Fitness & Sports Nagoya University Nagoya Aichi Japan
| | - Noriko Tanaka
- Research Center of Health, Physical Fitness & Sports Nagoya University Nagoya Aichi Japan
- Graduate School of Education and Human Development Nagoya University Nagoya Aichi Japan
| | - Hiroshi Akima
- Research Center of Health, Physical Fitness & Sports Nagoya University Nagoya Aichi Japan
- Graduate School of Education and Human Development Nagoya University Nagoya Aichi Japan
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14
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Galvan MJ, Sanchez MJ, McAinch AJ, Covington JD, Boyle JB, Bajpeyi S. Four weeks of electrical stimulation improves glucose tolerance in a sedentary overweight or obese Hispanic population. Endocr Connect 2022; 11:e210533. [PMID: 35007207 PMCID: PMC8859936 DOI: 10.1530/ec-21-0533] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/10/2022] [Indexed: 11/08/2022]
Abstract
INTRODUCTION/PURPOSE Most US adults (54%) do not meet the minimum exercise recommendations by the American College of Sports Medicine. Neuromuscular electrical stimulation (NMES) is a novel alternate strategy to induce muscle contraction. However, the effectiveness of NMES to improve insulin sensitivity and energy expenditure is unclear. The purpose of this study was to investigate the effects of 4 weeks of NMES on glucose tolerance in a sedentary overweight or obese population. METHODS Participants (n = 10; age: 36.8 ± 3.8 years; BMI = 32 ± 1.3 kg/m2) were randomized into either control or NMES group. All participants received bilateral quadriceps stimulation (12 sessions; 30 min/session; three times/week at 50 Hz and 300 µs pulse width) altering pulse amplitude to either provide low-intensity sensory level (control; tingling sensation) or at high-intensity neuromuscular level (NMES; maximum tolerable levels with visible muscle contraction). Glucose tolerance was assessed by a 3-h oral glucose tolerance test (OGTT), and substrate utilization was measured by indirect calorimetry and body composition via dual X-ray absorptiometry at baseline and after 4 weeks of NMES intervention. RESULTS Control and NMES groups had comparable fasting blood glucose, glucose tolerance, substrate utilization, and muscle mass at baseline. Four weeks of NMES resulted in a significant improvement in glucose tolerance measured by OGTT, whereas no change was observed in the control group. There was no change in substrate utilization and muscle mass in both control and NMES groups. CONCLUSION NMES is a novel and effective strategy to improve glucose tolerance in an at-risk overweight or obese sedentary population.
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Affiliation(s)
- Michelle J Galvan
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, University of Texas at El Paso, El Paso, Texas, USA
| | - Michael J Sanchez
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, University of Texas at El Paso, El Paso, Texas, USA
| | - Andrew J McAinch
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, Melbourne, Victoria, Australia
| | - Jeffrey D Covington
- Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Jason B Boyle
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, University of Texas at El Paso, El Paso, Texas, USA
| | - Sudip Bajpeyi
- Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, University of Texas at El Paso, El Paso, Texas, USA
- Correspondence should be addressed to S Bajpeyi:
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15
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Imaoka S, Kudou G, Tsugiyama K, Minata S, Teroh T, Ootsuka M, Furukawa M, Higashi T, Okita M. Efficacy of Belt Electrode Skeletal Muscle Electrical Stimulation in the Postoperative Rest Period in Patients with Diabetes who Have Undergone minor Amputations: A Randomized Controlled Trial. INT J LOW EXTR WOUND 2022:15347346221077491. [PMID: 35102749 DOI: 10.1177/15347346221077491] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to investigate whether belt electrode skeletal muscle electrical stimulation (B-SES) would improve postoperative lower limb function and walking ability in patients with diabetes who have undergone minor amputations. Diabetic patients who had undergone minor amputations were assigned randomly to a B-SES or control group. The B-SES group underwent conventional physical therapy for 20 min and B-SES for 20 min. The control group underwent only the 20-min conventional physical therapy. In both groups, rehabilitation was introduced by the physical therapists for 14 days from postoperative day 1. The outcome measures were range of motion in the ankle joint, knee extension muscle strength, ambulation status, and quality of life score. All these were evaluated before the intervention and 2 and 4 weeks after the intervention. From the 84 patients initially assessed, 32 were assigned to either the B-SES (N = 16) or control (N = 16) group. Preoperatively, there were no significant differences in all endpoints. The B-SES group showed significant improvement in the ankle dorsiflexion angle at 2 weeks postoperatively and knee joint extension strength at 4 weeks postoperatively. Postoperative B-SES with standard physical therapy might improve the range of motion of dorsiflexion of the ankle joint and extensor strength of the knee joint in patients with diabetes who have undergone minor amputations. B-SES is a useful tool to improve postoperative physical function in diabetic patients who have undergone minor amputations. A multicenter study is needed to determine the effective B-SES combined with regular physiotherapy for minor amputation.
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Affiliation(s)
- Shinsuke Imaoka
- 38411Department of Physical Therapy, Oita Oka Hospital, Oita City, Oita Prefecture
| | - Genki Kudou
- 38411Department of Physical Therapy, Oita Oka Hospital, Oita City, Oita Prefecture
| | - Kohei Tsugiyama
- 38411Department of Physical Therapy, Oita Oka Hospital, Oita City, Oita Prefecture
| | - Shohei Minata
- 38411Department of Physical Therapy, Oita Oka Hospital, Oita City, Oita Prefecture
| | - Taisuke Teroh
- 38411Department of Physical Therapy, Oita Oka Hospital, Oita City, Oita Prefecture
| | - Mikiko Ootsuka
- 38411Department of Physical Therapy, Oita Oka Hospital, Oita City, Oita Prefecture
| | - Masahide Furukawa
- 38411Department of Plastic Surgery, Oita Oka Hospital, Oita City, Oita Prefecture
| | - Toshio Higashi
- 12961Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki Prefecture, Japan
| | - Minoru Okita
- 12961Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki Prefecture, Japan
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16
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ISHIKAWA M, MIURA H, TAMURA Y, MURAKAMI A. Effect of Electrical Muscle Stimulation on Vascular Endothelial Function during Prolonged Sitting. Phys Ther Res 2022; 25:127-133. [PMID: 36819917 PMCID: PMC9910348 DOI: 10.1298/ptr.e10191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 09/07/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE While prolonged sedentary behaviors (SBs) increase cardiovascular disease (CVD) risk, interrupting prolonged sitting (PS) with frequent light exercise reduces arterial functional decline. Skeletal muscle electrical stimulation (EMS) enhances peripheral circulation through passive muscle contraction, suggesting that EMS reduces CVD risk by providing an alternative to active exercise for prolonged SBs. This study aimed to investigate the effects of EMS to skeletal muscles during PS on the endothelial function of the brachial artery (BA). METHODS Study participants included 12 healthy adult men who were subjected to 15 min of supine rest, followed by 1 h of PS only (control [CON] trial), or 20 min of EMS to the lower extremities at 50% of the maximum tolerance intensity during PS (EMS trial). Flow-mediated dilation (FMD) of the BA was measured before and 30 min after PS, and normalized FMD (nFMD) was calculated. RESULTS The nFMD of the CON trial significantly decreased 30 min after PS completion (6.21% ± 1.13%) compared with that before PS (7.26% ± 0.73%), and there was no significant change in the EMS trial before and after PS. The EMS trial showed a significant increase in the nFMD 30 min after PS completion (1.14 ± 0.77) compared with that before PS (0.84 ± 0.43). However, no significant difference was observed in the CON trials. CONCLUSION Passive contraction of the lower extremity muscles by EMS increases BA nFMD, suggesting that prolonged sedentary lower extremity EMS use may reduce the risk of vascular endothelial dysfunction.
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Affiliation(s)
- Mizuki ISHIKAWA
- Department of Physical Therapy, Faculty of Health Science, Osaka Yukioka College of Health Science, Japan
| | - Hajime MIURA
- Laboratory for Applied Physiology, Institutes of Socio-Arts and Sciences, Tokushima University, Japan
| | - Yasuaki TAMURA
- Department of Rehabilitation Medicine, Tokushima Prefecture Naruto Hospital, Japan
| | - Ayako MURAKAMI
- Department of Health and Nutrition, Shikoku University, Japan
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17
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Ando S, Takagi Y, Watanabe H, Mochizuki K, Sudo M, Fujibayashi M, Tsurugano S, Sato K. Effects of electrical muscle stimulation on cerebral blood flow. BMC Neurosci 2021; 22:67. [PMID: 34775960 PMCID: PMC8591929 DOI: 10.1186/s12868-021-00670-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/29/2021] [Indexed: 01/16/2023] Open
Abstract
Background Electrical muscle stimulation (EMS) induces involuntary muscle contraction. Several studies have suggested that EMS has the potential to be an alternative method of voluntary exercise; however, its effects on cerebral blood flow (CBF) when applied to large lower limb muscles are poorly understood. Thus, the purpose of this study was to examine the effects of EMS on CBF, focusing on whether the effects differ between the internal carotid (ICA) and vertebral (VA) arteries. Methods The participants performed the experiments under EMS and control (rest) conditions in a randomized crossover design. The ICA and VA blood flow were measured before and during EMS or control. Heart rate, blood pressure, minute ventilation, oxygen uptake, and end-tidal partial pressure of carbon dioxide (PETCO2) were monitored and measured as well. Results The ICA blood flow increased during EMS [Pre: 330 ± 69 mL min−1; EMS: 371 ± 81 mL min−1, P = 0.001, effect size (Cohen’s d) = 0.55]. In contrast, the VA blood flow did not change during EMS (Pre: 125 ± 47 mL min−1; EMS: 130 ± 45 mL min−1, P = 0.26, effect size = 0.12). In the EMS condition, there was a significant positive linear correlation between ΔPETCO2 and ΔICA blood flow (R = 0.74, P = 0.02). No relationships were observed between ΔPETCO2 and ΔVA blood flow (linear: R = − 0.17, P = 0.66; quadratic: R = 0.43, P = 0.55). Conclusions The present results indicate that EMS increased ICA blood flow but not VA blood flow, suggesting that the effects of EMS on cerebral perfusion differ between anterior and posterior cerebral circulation, primarily due to the differences in cerebrovascular response to CO2.
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Affiliation(s)
- Soichi Ando
- Graduate School of Informatics and Engineering, The University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo, 182-8585, Japan.
| | - Yoko Takagi
- Graduate School of Informatics and Engineering, The University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo, 182-8585, Japan
| | - Hikaru Watanabe
- Faculty of Informatics and Engineering, The University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo, 182-8585, Japan
| | - Kodai Mochizuki
- Graduate School of Informatics and Engineering, The University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo, 182-8585, Japan
| | - Mizuki Sudo
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tobuki 150, Hachioji, Tokyo, 192-0001, Japan
| | | | - Shinobu Tsurugano
- Health Care Center, The University of Electro-Communication, 1-5-1 Chofugaoka, Chofu, Tokyo, 182-8585, Japan
| | - Kohei Sato
- Department of Arts and Sport Science, Tokyo Gakugei University, Tokyo, Japan
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Chen YC, Davies RG, Hengist A, Carroll HA, Perkin OJ, Betts JA, Thompson D. Effects of neuromuscular electrical stimulation on energy expenditure and postprandial metabolism in healthy men. Appl Physiol Nutr Metab 2021; 47:1-7. [PMID: 34403626 DOI: 10.1139/apnm-2021-0361] [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] [Indexed: 11/22/2022]
Abstract
It is unclear whether neuromuscular electrical stimulation (NMES) has meaningful metabolic effects when users have the opportunity to self-select the intensity to one that can be comfortably tolerated. Nine healthy men aged 28 ± 9 y (mean ± SD) with a body mass index 22.3 ± 2.3 kg/m2 completed 3 trials involving a 2-h oral glucose tolerance test whilst, in a randomised counterbalanced order, (1) sitting motionless (SIT), (2) standing motionless (STAND); and (3) sitting motionless with NMES of quadriceps and calves at a self-selected tolerable intensity. The mean (95% confidence interval [CI]) total energy expenditure was greater in the NMES trial (221 [180-262] kcal/2 h) and STAND trial (178 [164-191] kcal/2 h) than during SIT (159 [150-167] kcal/2 h) (both, p < 0.05). This was primarily driven by an increase in carbohydrate oxidation in the NMES and STAND trials compared with the SIT trial (p < 0.05). Postprandial insulin iAUC was lower in both NMES and STAND compared with SIT (16.4 [7.7-25.1], 17 [7-27] and 22.6 [10.8-34.4] nmol·120 min/L, respectively; both, p < 0.05). Compared with sitting, both NMES and STAND increased energy expenditure and whole-body carbohydrate oxidation and reduced postprandial insulin concentrations in healthy men, with more pronounced effects seen with NMES. Self-selected NMES is a potential strategy for improving metabolic health. This trial is registered at ClinicalTrials.gov (ID: NCT04389736). Novelty: NMES at a comfortable intensity enhances energy expenditure and carbohydrate oxidation, and reduces postprandial insulinemia. Thus, self-selected NMES represents a potential strategy to improve metabolic health.
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Affiliation(s)
- Yung-Chih Chen
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
- Department for Health, University of Bath, Bath, United Kingdom
| | | | - Aaron Hengist
- Department for Health, University of Bath, Bath, United Kingdom
| | - Harriet A Carroll
- Department for Health, University of Bath, Bath, United Kingdom
- Clinical Research Centre, Cardiovascular Research-Hypertension, Lund University, Malmo, Sweden
| | - Oliver J Perkin
- Department for Health, University of Bath, Bath, United Kingdom
| | - James A Betts
- Department for Health, University of Bath, Bath, United Kingdom
| | - Dylan Thompson
- Department for Health, University of Bath, Bath, United Kingdom
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19
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Hioki M, Kanehira N, Koike T, Saito A, Takahashi H, Shimaoka K, Sakakibara H, Oshida Y, Akima H. Effect of electromyostimulation on intramyocellular lipids of the vastus lateralis in older adults: a randomized controlled trial. BMC Musculoskelet Disord 2021; 22:569. [PMID: 34158031 PMCID: PMC8218407 DOI: 10.1186/s12891-021-04456-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 05/26/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Excessive intramyocellular lipid (IMCL) accumulation is a primary cause of skeletal muscle insulin resistance, especially in older adults, and interventions that reduce IMCL contents are important to improve insulin sensitivity. Electromyostimulation (EMS)-induced changes in IMCL content in older adults remain unknown. The purpose of this study was to clarify the effects of a single bout of EMS on the IMCL content of the vastus lateralis muscle in older adults. METHODS Twenty-two physically active, non-obese older men and women were randomly assigned to an EMS intervention group (69.0 ± 5.2 years, n = 12) or a control group (68.4 ± 3.5 years, n = 10). EMS was applied to the vastus lateralis (7 s on and 7 s off) for 30 min; control participants sat quietly for 30 min. IMCL content within the vastus lateralis was quantified with 1H-magnetic resonance spectroscopy (n = 7 per group). Fasting plasma glucose and insulin values were determined from blood samples collected before and after the EMS intervention. RESULTS EMS induced a significant reduction in plasma glucose (93.1 ± 9.6 to 89.5 ± 9.1 mg/dL, p < 0.01), but not IMCL content (15.7 ± 15.7 to 15.8 ± 13.1 mmol/kg wet weight, p = 0.49) or insulin (5.4 ± 2.4 to 4.7 ± 2.7 μIU/mL, p = 0.18). In the control group, no changes in IMCL content in the vastus lateralis was observed after prolonged quiet sitting. CONCLUSION EMS intervention for 30 min induces changes in plasma glucose, but no changes in IMCL content in older adults. TRIAL REGISTRATION University hospital Medical Information Network (UMIN) Center ID: UMIN000020126 . Retrospectively registered on December 222,015. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000023242.
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Affiliation(s)
- Maya Hioki
- Graduate School of Medicine, Nagoya University, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
| | - Nana Kanehira
- Department of Health and Nutrition, Tokaigakuen University, 2-901 Nakahira, Tenpaku, Nagoya, Aichi, 468-8514, Japan
| | - Teruhiko Koike
- Research Center of Health, Physical Fitness & Sports, Nagoya University, 1 Furo, Chikusa-ku, Nagoya, Aichi, 464-8601, Japan
| | - Akira Saito
- Center for Health and Sports Science, Kyushu Sangyo University, 2-3-1 Matsukadai, Higashi-ku, Fukuoka, Fukuoka, 813-8503, Japan
| | - Hideyuki Takahashi
- Japan Institute of Sports Sciences, 3-15-1 Nishigaoka, Kita-ku, Tokyo, 115-0056, Japan
| | - Kiyoshi Shimaoka
- Department of Human Wellness, Tokaigakuen University, 21-233 Nishinohora, Ukigai, Miyoshi, Aichi, 470-0207, Japan
| | - Hisataka Sakakibara
- Ichinomiya Kenshin College of Nursing, 5-4-1 Jouganndoori, Ichinomiya, Aichi, 491-0063, Japan
| | - Yoshiharu Oshida
- Research Center of Health, Physical Fitness & Sports, Nagoya University, 1 Furo, Chikusa-ku, Nagoya, Aichi, 464-8601, Japan
| | - Hiroshi Akima
- Research Center of Health, Physical Fitness & Sports, Nagoya University, 1 Furo, Chikusa-ku, Nagoya, Aichi, 464-8601, Japan
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20
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Bekki M, Matsuse H, Hashida R, Nago T, Iwanaga S, Kawaguchi T, Takano Y, Shiba N. Electrically Stimulated Eccentric Contractions during Walking Increases Oxygen Uptake. Kurume Med J 2021; 66:93-100. [PMID: 34135203 DOI: 10.2739/kurumemedj.ms662008] [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: 11/23/2022]
Abstract
Neuromuscular electrical stimulation (NMES) is used to increase not only muscle strength but also whole-body metabolism. A hybrid training system (HTS) in which NMES is synchronized to voluntary exercise by an articular motion sensor may increase exercise load during aerobic walking exercise. We assessed the metabolic cost during walking exercise (5 minutes at 4 km/h and 5.6 km/h) on a treadmill simultaneously combined with HTS (HTSW) or without HTS (CON). We evaluated oxygen uptake ( VO·2) and heart rate (HR) during HTSW or CON on different days in fifteen subjects. The values ofVO·2 during HTSW at 4 km/h and 5.6 km/h were signifi cantly greater than those during CON (16.6 ± 1.85 ml/min/kg vs 15.3 ± 1.48 ml/min/kg; p < 0.05, 21.0 ± 2.17 ml/min/kg vs 19.4 ± 2.13 ml/min/kg; p < 0.01, respectively). The values of HR during HTSW at 4 km/h, 5.6 km/h were significantly greater than those during CON (106.7 ± 8.1 bpm vs 101.7 ± 10.3 bpm; p < 0.05, 126.5 ± 11.1 bpm vs 121.5 ± 12.5 bpm; p < 0.05, respectively). HTS added significantly to the exercise load by 8.3 ± 12.0% or 9.1 ± 9.9% during aerobic walking exercise at 4 km/h or 5.6 km/h, respectively. HTS might be useful for health promotion by increasing metabolic cost during aerobic walking exercise without increasing the perceived difficulty.
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Affiliation(s)
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital
| | - Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital
| | - Takeshi Nago
- Division of Rehabilitation, Kurume University Hospital
| | - Sohei Iwanaga
- Division of Rehabilitation, Kurume University Hospital
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
| | - Yoshio Takano
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital
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21
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Hoshiai M, Ochiai K, Tamura Y, Tsurumi T, Terashima M, Tamiya H, Maeno E, Mizuguchi S, Tomoe T, Kawabe A, Uema A, Ueno A, Sugiyama T, Horie Y, Sugimura H, Koike R, Yasu T. Effects of whole-body neuromuscular electrical stimulation device on hemodynamics, arrhythmia, and sublingual microcirculation. Heart Vessels 2021; 36:844-852. [PMID: 33547929 PMCID: PMC8093154 DOI: 10.1007/s00380-020-01755-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/04/2020] [Indexed: 12/12/2022]
Abstract
Neuromuscular electrical stimulation has been used to treat cardiovascular diseases and other types of muscular dysfunction. A novel whole-body neuromuscular electrical stimulation (WB-NMES) wearable device may be beneficial when combined with voluntary exercises. This study aimed to investigate the safety and effects of the WB-NMES on hemodynamics, arrhythmia, and sublingual microcirculation. The study included 19 healthy Japanese volunteers, aged 22-33 years, who were not using any medication. Electrocardiogram (ECG), echocardiography, and blood sampling were conducted before a 20-min WB-NMES session and at 0 and 10 min after termination of WB-NMES. Their tolerable maximum intensity was recorded using numeric rating scale. Arrhythmia was not detected during neuromuscular electrical stimulation or during 10 min of recovery. Blood pressure, heart rate, left ventricular ejection fraction, and diastolic function remained unchanged; however, mild mitral regurgitation was transiently observed during WB-NMES in a single male participant. A decrease in blood glucose and an increase in blood lactate levels were observed, but no changes in blood fluidity, sublingual microcirculation, blood levels of noradrenaline, or oxidative stress were shown. WB-NMES is safe and effective for decreasing blood glucose and increasing blood lactate levels without changing the blood fluidity or microcirculation in healthy people.
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Affiliation(s)
- Megumi Hoshiai
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Kaori Ochiai
- Department of Rehabilitation, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Yuma Tamura
- Department of Rehabilitation, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Tomoki Tsurumi
- Department of Rehabilitation, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Masato Terashima
- Department of Rehabilitation, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Hajime Tamiya
- Department of Rehabilitation, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Eikou Maeno
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Satoshi Mizuguchi
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Takashi Tomoe
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Atsuhiko Kawabe
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Atsuko Uema
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Asuka Ueno
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Takushi Sugiyama
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Yasuto Horie
- Department of Cardiology, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Hiroyuki Sugimura
- Department of Cardiology, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Ryousuke Koike
- Department of Pulmonology, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan
| | - Takanori Yasu
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Nikko, Tochigi, Japan.
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22
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Luo YC, Huang SH, Pathak N, Chuang YH, Yang JM. An integrated systematic approach for investigating microcurrent electrical nerve stimulation (MENS) efficacy in STZ-induced diabetes mellitus. Life Sci 2021; 279:119650. [PMID: 34048807 DOI: 10.1016/j.lfs.2021.119650] [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: 03/22/2021] [Revised: 05/13/2021] [Accepted: 05/18/2021] [Indexed: 11/24/2022]
Abstract
Diabetes mellitus (DM) is a major metabolic disorder and an increasing health problem worldwide. Effective non-invasive therapies for DM are still lacking. Here, we have developed Microcurrent electrical nerve stimulation (MENS), a non-invasive therapy, and tested on 46 mice clustered into five groups, such as control, STZ-induced DM, and MENS treatment groups. Experimental results show that MENS treatment is able to improve seven biochemical indexes (e.g., hemoglobin A1c and glucose level). To investigate the mechanisms of MENS treatment on STZ-induced DM, we selected six representative samples to perform microarray experiments for several groups and developed an integrated Hierarchical System Biology Model (HiSBiM) to analyze these omics data. The results indicate that MENS can affect fatty acid metabolism pathways, peroxisome proliferator-activated receptor (PPAR) signaling pathway and cell cycle. Additionally, the DM biochemical indexes and omics data profiles of MENS treatment were found to be consistent. We then compared the therapeutic effects of MENS with anti-diabetic compounds (e.g., quercetin, metformin, and rosiglitazone), using the HiSBiM four-level biological functions and processes of multiple omics data. The results show MENS and these anti-diabetic compounds have similar effect pathways highly correlated to the diabetes processes, such as the PPAR signaling pathway, bile secretion, and insulin signaling pathways. We believe that MENS is an effective and non-invasive therapy for DM and our HiSBiM is an useful method for investigating multiple omics data.
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Affiliation(s)
- Yong-Chun Luo
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Sing-Han Huang
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Nikhil Pathak
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Yi-Hsuan Chuang
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Jinn-Moon Yang
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan; Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan; Center for Intelligent Drug Systems and Smart Bio-devices, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan.
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23
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Watanabe K, Takada T, Kawade S, Moritani T. Effect of exercise intensity on metabolic responses on combined application of electrical stimulation and voluntary exercise. Physiol Rep 2021; 9:e14758. [PMID: 33587340 PMCID: PMC7883830 DOI: 10.14814/phy2.14758] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/18/2021] [Accepted: 01/23/2021] [Indexed: 11/26/2022] Open
Abstract
The combined application of voluntary exercises and neuromuscular electrical stimulation (NMES) has been developed as a new type of exercise that can recruit motor units contributing to both aerobic and anaerobic energy metabolisms. We aimed to investigate the effect of voluntary exercise intensity on metabolic responses on the combination of voluntary exercise and NMES. In 13 volunteers, oxygen consumption and the blood lactate concentration were measured during (1) voluntary pedaling exercise at four different intensities: 50%, 75%, 100%, and 125% of the ventilatory threshold (VT) (VOL), (2) these voluntary exercises with superimposed NMES applied to the gluteus and thigh muscles (VOL+NMES), and (3) NMES only (NMES). Oxygen consumption and the blood lactate concentration in VOL+NMES were significantly greater than VOL at each exercise intensity (p < 0.05). Differences in oxygen consumption between VOL+NMES and VOL decreased with exercise intensity, and that at 125% VT was significantly lower than the net gain in oxygen consumption following NMES (p < 0.05). Differences in the blood lactate concentration between VOL+NMES and VOL increased with exercise intensity, and that at 50% VT was significantly lower than the net gain in the blood lactate concentration following NMES (p < 0.05). Our results suggest that voluntary exercise intensity has a critical impact on metabolic responses during the combined application of voluntary exercises and NMES. Superimposing NMES onto voluntary exercises at high exercise intensities may induce overlapping recruitment of motor units, leading to a markedly reduced benefit of additional metabolic responses on its superimposition.
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Affiliation(s)
- Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, Faculty of Liberal Arts and Sciences and School of International Liberal Studies, Chukyo University, Nagoya, Japan
| | | | | | - Toshio Moritani
- School of Health and Sport Sciences, Chukyo University, Toyota, Japan.,Faculty of Sociology, Kyoto Sangyo University, Kyoto, Japan
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24
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Xu X, Zhang H, Yan Y, Wang J, Guo L. Effects of electrical stimulation on skin surface. ACTA MECHANICA SINICA = LI XUE XUE BAO 2021; 37:1843-1871. [PMID: 33584001 PMCID: PMC7866966 DOI: 10.1007/s10409-020-01026-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/16/2020] [Accepted: 10/02/2020] [Indexed: 05/10/2023]
Abstract
ABSTRACT Skin is the largest organ in the body, and directly contact with the external environment. Articles on the role of micro-current and skin have emerged in recent years. The function of micro-current is various, including introducing various drugs into the skin locally or throughout the body, stimulating skin wounds healing through various currents, suppressing pain caused by various diseases, and promoting blood circulation for postoperative muscle rehabilitation, etc. This article reviews these efforts. Compared with various physical and chemical medical therapies, micro-current stimulation provides a relatively safe, non-invasive therapy with few side effects, giving modern medicine a more suitable treatment option. At the same time, the cost of the electrical stimulation generating device is relatively low, which makes it have wider space to and more clinical application value. The current micro-current stimulation technology has become more and more mature, but there are still many problems in its research. The design of the experiment and the selection of the current parameters not standardized and rigorous. Now, clear regulations are needed to regulate this field. Micro-current skin therapy has become a robust, reliable, and well-structured system.
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Affiliation(s)
- Xinkai Xu
- State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing, 100190 China
- School of Engineering Science, University of Chinese Academy of Sciences, Beijing, 100049 China
| | - Han Zhang
- School of Engineering Science, University of Chinese Academy of Sciences, Beijing, 100049 China
- Key Laboratory of Noise and Vibration, Institute of Acoustics, Chinese Academy of Sciences, Beijing, 100190 China
- State Key Laboratory of Acoustics, Institute of Acoustics, Chinese Academy of Sciences, Beijing, 100190 China
| | - Yan Yan
- Cosmetic Technology Center, Chinese Academy of Inspection and Quarantine, Beijing, 100176 China
| | - Jianru Wang
- Xi’an Aerospace Propulsion Institute, Xi’an, 710100 China
| | - Liang Guo
- State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing, 100190 China
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25
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Tomida K, Nakae H. Efficacy of belt electrode skeletal muscle electrical stimulation on muscle flexibility of lower limbs: A randomized controlled pilot trial. Medicine (Baltimore) 2020; 99:e23156. [PMID: 33217822 PMCID: PMC7676588 DOI: 10.1097/md.0000000000023156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Muscular contracture may be caused by immobility-induced muscle atrophy and skeletal muscle hypoxia. Belt electrode skeletal muscle electrical stimulation (B-SES) is a new type of neuromuscular electrical stimulation that can simultaneously contract the lower limb muscle groups, in contrast to the conventional pad-type electrodes. B-SES can suppress muscular atrophy and relieve hypoxia of the skeletal muscle and is considered an appropriate strategy for preventing muscular contracture. However, the effect of B-SES on muscle flexibility has not been verified. This study aimed to compare the immediate effects of B-SES on skeletal muscle flexibility using different stimulation modes before the clinical study. METHODS We conducted a randomized controlled pilot trial with cross-over analysis of 10 healthy subjects. The participants were subjected to three stimulus conditions (Disuse B-SES, Metabolic B-SES, and Control) with a minimal interval of 1 day between interventions, and the lower limb flexibility before and after the B-SES intervention was evaluated. Lower extremity flexibility was evaluated based on the hamstring muscle stiffness and sit-and-reach distance. For each endpoint, within-group comparisons were performed before and after the intervention and were compared between the groups using paired t-tests. Changes in each endpoint before and after the intervention were analyzed using repeated-measures analysis of variance and the Bonferroni method. The significance level was 0.05. RESULTS Ten healthy individuals participated in all three interventions with a washout period between each intervention. In the Metabolic B-SES group, the sit-and-reach distance after the intervention was significantly higher than that before the intervention (P < 0.05). A comparison of the change in the sit-and-reach distance among the three groups before subsequent tests showed that the Metabolic B-SES group had a significantly increased sit-and-reach distance compared with the control group (P < 0.05). CONCLUSION Metabolic B-SES was effective for the immediate improvement of flexibility of the lower limb muscles. Therefore, Metabolic B-SES may be useful as a strategy for preventing muscular contracture.
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Affiliation(s)
- Kouki Tomida
- Department of Physical Therapy, Akita Rehabilitation College, 1-4-80, Barajima
- Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Akita University 1-1-1 Hondo Akita, Japan
| | - Hajime Nakae
- Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Akita University 1-1-1 Hondo Akita, Japan
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26
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High-Intensity Focused Ultrasound Ablation Combined with Electrical Passive Exercise for Fast Removal of Body Fat. Plast Reconstr Surg 2020; 145:1427-1438. [PMID: 32195859 DOI: 10.1097/prs.0000000000006826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND High-intensity focused ultrasound (HIFU) lipolysis still lacks treatment efficacy. The authors hypothesized that electrical stimulation of muscular groups can enhance the metabolism of free lipids released from HIFU-ablated adipocytes. METHODS Five-month-old, male Landrace swine, with an average initial weight of 95 kg, were divided randomly into sham, HIFU only, HIFU plus electrical stimulation I, and HIFU plus electrical stimulation II groups. Subcutaneous adipose tissue of the porcine abdomen was treated once by HIFU on days 1 of weeks 1, 3, and 5, and electrical stimulation of the quadriceps was performed once on the day 1 of weeks 1 through 6. The numbers of ultrasonic sonications were 70 per treatment for the HIFU-only and HIFU plus electrical stimulation I groups and 400 for the HIFU plus electrical stimulation II group. The measured data are expressed as medians (ranges). RESULTS The body weights of all pigs increased gradually with time. The waist circumferences below the sheath decreased from 97.7 ± 6.0 cm in week 1 and 97.9 ± 5.3 cm in week 3 to 96.4 ± 10.0 cm in week 6, and from 105.3 ± 5.1 cm and 101.2 ± 7.4 cm to 100.5 ± 6.1 cm for the HIFU plus electrical stimulation I and II groups, respectively, whereas they increased for the sham and HIFU-only groups. The reductions in the adipose tissue thickness were 0.59, 1.46, and 2.18 mm for the HIFU-only, HIFU plus electrical stimulation I, and HIFU plus electrical stimulation II groups, respectively, when the sham group increased by 1.42 mm. Follow-up blood analyses demonstrated no significant changes in lipid panel parameters from baseline values. CONCLUSION HIFU plus electrical stimulation can induce a substantial reduction in the waist circumference of pigs.
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27
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O'Connor D, Lennon O, Minogue C, Caulfield B. Design considerations for the development of neuromuscular electrical stimulation (NMES) exercise in cancer rehabilitation. Disabil Rehabil 2020; 43:3117-3126. [PMID: 32116053 DOI: 10.1080/09638288.2020.1726510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aim: The aim of this narrative review is to explore design considerations for effective neuromuscular electrical stimulation exercise prescription in cancer rehabilitation, with simultaneous consideration for fundamental principles of exercise training and the current state of the art in neuromuscular electrical stimulation technologies and application methodologies.Method: Narrative review.Results: First, we consider the key neuromuscular electrical stimulation exercise design considerations, with a focus on training objectives and individual training requirements and constraints for individuals with cancer. Here, we contend that concurrent, low and high frequency neuromuscular electrical stimulation exercise, individually prescribed and progressed may be optimal for enhancing physical function. Second, we review the appropriate literature to identify the most appropriate stimulation parameters (pulse frequency, intensity, duration and duty cycle) to deliver effective neuromuscular electrical stimulation in cancer rehabilitation.Conclusions: We propose an informed and innovative neuromuscular electrical stimulation exercise intervention design and provide practical information for clinicians and practitioners who may work with and implement neuromuscular electrical stimulation exercise in cancer.Implications for rehabilitationNeuromuscular electrical stimulation is an emerging technology in cancer rehabilitation to help provide an aerobic and muscle strengthening exercise stimulus.Neuromuscular electrical stimulation may help improve aerobic exercise capacity, muscle strength and augment quality of life.Current prescription in cancer lacks adherence to the fundamental principles of exercise training, which may negatively affect adherence.
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Affiliation(s)
- Dominic O'Connor
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Olive Lennon
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | | | - Brian Caulfield
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
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28
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Tang X, Daneshmandi L, Awale G, Nair LS, Laurencin CT. Skeletal Muscle Regenerative Engineering. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2019; 5:233-251. [PMID: 33778155 DOI: 10.1007/s40883-019-00102-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Skeletal muscles have the intrinsic ability to regenerate after minor injury, but under certain circumstances such as severe trauma from accidents, chronic diseases or battlefield injuries the regeneration process is limited. Skeletal muscle regenerative engineering has emerged as a promising approach to address this clinical issue. The regenerative engineering approach involves the convergence of advanced materials science, stem cell science, physical forces, insights from developmental biology, and clinical translation. This article reviews recent studies showing the potential of the convergences of technologies involving biomaterials, stem cells and bioactive factors in concert with clinical translation, in promoting skeletal muscle regeneration. Several types of biomaterials such as electrospun nanofibers, hydrogels, patterned scaffolds, decellularized tissues, and conductive matrices are being investigated. Detailed discussions are given on how these biomaterials can interact with cells and modulate their behavior through physical, chemical and mechanical cues. In addition, the application of physical forces such as mechanical and electrical stimulation are reviewed as strategies that can further enhance muscle contractility and functionality. The review also discusses established animal models to evaluate regeneration in two clinically relevant muscle injuries; volumetric muscle loss (VML) and muscle atrophy upon rotator cuff injury. Regenerative engineering approaches using advanced biomaterials, cells, and physical forces, developmental cues along with insights from immunology, genetics and other aspects of clinical translation hold significant potential to develop promising strategies to support skeletal muscle regeneration.
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Affiliation(s)
- Xiaoyan Tang
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, CT 06030, USA.,Department of Orthopaedic Surgery, UConn Health, Farmington, CT 06030, USA.,Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, UConn Health, Farmington, CT 06030, USA.,Department of Materials Science and Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Leila Daneshmandi
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, CT 06030, USA.,Department of Orthopaedic Surgery, UConn Health, Farmington, CT 06030, USA.,Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, UConn Health, Farmington, CT 06030, USA.,Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Guleid Awale
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, CT 06030, USA.,Department of Orthopaedic Surgery, UConn Health, Farmington, CT 06030, USA.,Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, UConn Health, Farmington, CT 06030, USA.,Department of Chemical and Biomolecular Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Lakshmi S Nair
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, CT 06030, USA.,Department of Orthopaedic Surgery, UConn Health, Farmington, CT 06030, USA.,Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, UConn Health, Farmington, CT 06030, USA.,Department of Materials Science and Engineering, University of Connecticut, Storrs, CT 06269, USA.,Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Cato T Laurencin
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, CT 06030, USA.,Department of Orthopaedic Surgery, UConn Health, Farmington, CT 06030, USA.,Raymond and Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, UConn Health, Farmington, CT 06030, USA.,Department of Materials Science and Engineering, University of Connecticut, Storrs, CT 06269, USA.,Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA.,Department of Chemical and Biomolecular Engineering, University of Connecticut, Storrs, CT 06269, USA
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29
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Birelli B, Oliveira M, Santos ADO, Manso W, Vicente A, Etchebehere E. SPECT/CT with 99mTc-sestamibi for the evaluation of skeletal muscle perfusion after electrical muscle stimulation in athletes. Radiol Bras 2019; 52:92-96. [PMID: 31019337 PMCID: PMC6472863 DOI: 10.1590/0100-3984.2018.0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
Objective The purpose of this study was to evaluate the effects of electrical muscle
stimulation (EMS) on muscles, using 99mTc-sestamibi SPECT/CT. Materials and Methods We prospectively enrolled 20 consecutive male professional water polo
players. The mean age was 25 years (range, 18-36 years). All athletes
underwent 99mTc-sestamibi SPECT/CT of the thigh (rectus femoris
and vastus medialis muscle groups) before and after EMS. Images were
quantified to identify increases in perfusion after EMS. Results Before EMS, there were no significant differences between the right and left
thigh (rectus femoris and vastus medialis muscles) in terms of perfusion
(p = 0.4). However, the comparison between the pre- and
post-EMS analyses of the same muscle groups showed significant differences
in radiotracer uptake (p < 0.001), with a mean increase
in perfusion of 128% for the rectus femoris muscle group (95% CI: 0.86-1.61)
and 118% for the vastus medialis muscle group (95% CI: 0.96-1.79). Conclusion 99mTc-sestamibi SPECT/CT is an objective means of evaluating blood
flow in muscles submitted to EMS, which appears to promote significant
increases in such blood flow.
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Affiliation(s)
| | | | | | | | | | - Elba Etchebehere
- Campinas State University, Brazil; Sírio-Libanês Hospital, Brazil
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30
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Watanabe K, Yoshida T, Ishikawa T, Kawade S, Moritani T. Effect of the Combination of Whole-Body Neuromuscular Electrical Stimulation and Voluntary Exercise on Metabolic Responses in Human. Front Physiol 2019; 10:291. [PMID: 30949069 PMCID: PMC6436608 DOI: 10.3389/fphys.2019.00291] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 03/05/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose Since neuromuscular electrical stimulation (NMES) can recruit high-threshold motor units and enhance glucose metabolism, the combination of NMES and voluntary low-intensity exercise would induce both anerobic and aerobic energy consumptions and this type of exercise could be more efficient and effective than conventional exercise regimens. We aimed to investigate metabolic responses and muscle fatigue during whole body NMES (WB-NMES), voluntary exercise, and their combination. Methods The blood lactate concentration and maximal voluntary contraction were measured before and after specified exercises: WB-NMES (E), voluntary exercise (V), and their combination (VE), and expired gas was sampled during the exercises in thirteen healthy young men. Each exercise was conducted for 15 min and interval between exercise was > 48h. Results Energy expenditure and V˙O2 relative to the body mass during VE were significantly higher than during V and E (p < 0.05). The Respiratory gas exchange ratio (RER) during both E and VE was higher than during V (p < 0.05), and the blood lactate concentration after VE was significantly higher than after V and E (p < 0.05). Although V˙O2 relative to the body mass was 18.6 ± 3.1 ml/min/kg and the metabolic equivalent was 5.31 ± 0.89 Mets, the blood lactate concentration reached 7.5 ± 2.7 mmol/L after VE. Conclusion These results suggest that the combination of WB-NMES and voluntary exercise can enhance the metabolic response to a level equivalent to high intensity exercise under the net physiological burden of low-middle intensity exercises.
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Affiliation(s)
- Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of International Liberal Studies, Chukyo University, Nagoya, Japan
| | - Takahiro Yoshida
- Laboratory of Neuromuscular Biomechanics, School of International Liberal Studies, Chukyo University, Nagoya, Japan
| | - Tomoki Ishikawa
- Laboratory of Neuromuscular Biomechanics, School of International Liberal Studies, Chukyo University, Nagoya, Japan
| | | | - Toshio Moritani
- School of Social Science Health and Sport Sciences, Chukyo University, Toyota, Japan.,Faculty of Sociology, Kyoto Sangyo University, Kyoto, Japan
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Miyamoto T, Iwakura T, Matsuoka N, Iwamoto M, Takenaka M, Akamatsu Y, Moritani T. Impact of prolonged neuromuscular electrical stimulation on metabolic profile and cognition-related blood parameters in type 2 diabetes: A randomized controlled cross-over trial. Diabetes Res Clin Pract 2018; 142:37-45. [PMID: 29802953 DOI: 10.1016/j.diabres.2018.05.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 05/02/2018] [Accepted: 05/17/2018] [Indexed: 10/16/2022]
Abstract
AIMS This study aimed to examine the effect of prolonged neuromuscular electrical stimulation (NMES) on the metabolic profile and cognition-related blood parameters in patients with type 2 diabetes mellitus (T2DM). METHODS Fourteen patients with T2DM (63.2 ± 3.0 years, 76.1 ± 3.5 kg) participated in a randomized controlled cross-over study, in which 8-week-long NMES interventions were performed on both legs. The NMES training protocol consisted of 40-min sessions, 5 days per week, for 8 weeks. The relative changes in glucose and lipid profiles, and cognition-related blood parameters were evaluated. RESULTS NMES training induced significant changes in the fasting glucose concentration (p < 0.05) and percent body fat (p < 0.05), although there were no significant changes in HbA1c and blood lipid levels (p ≥ 0.05). The change in plasma brain-derived neurotrophic factor (BDNF) levels was significantly higher in the NMES period than in the control period (p < 0.05). CONCLUSIONS This study showed that an 8-week NMES training program could induce greater changes in the blood glucose concentration, percent body fat, and plasma BDNF levels than the control intervention in patients with T2DM. NMES training might prove to be an alternative exercise method for patients who might have difficulties in performing adequate voluntary exercise.
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Affiliation(s)
- Toshiaki Miyamoto
- School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Japan.
| | - Toshio Iwakura
- Department of Diabetes and Endocrinology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Naoki Matsuoka
- Department of Diabetes and Endocrinology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masako Iwamoto
- Nutrition Management Department, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Mariko Takenaka
- Nutrition Management Department, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yasunori Akamatsu
- Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
| | - Toshio Moritani
- Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
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McGregor G, Ennis S, Powell R, Hamborg T, Raymond NT, Owen W, Aldridge N, Evans G, Goodby J, Hewins S, Banerjee P, Krishnan NS, Ting SMS, Zehnder D. Feasibility and effects of intra-dialytic low-frequency electrical muscle stimulation and cycle training: A pilot randomized controlled trial. PLoS One 2018; 13:e0200354. [PMID: 29995947 PMCID: PMC6040736 DOI: 10.1371/journal.pone.0200354] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 06/22/2018] [Indexed: 12/29/2022] Open
Abstract
Background and objectives Exercise capacity is reduced in chronic kidney failure (CKF). Intra-dialytic cycling is beneficial, but comorbidity and fatigue can prevent this type of training. Low–frequency electrical muscle stimulation (LF-EMS) of the quadriceps and hamstrings elicits a cardiovascular training stimulus and may be a suitable alternative. The main objectives of this trial were to assess the feasibility and efficacy of intra-dialytic LF-EMS vs. cycling Design, setting, participants, and measurements Assessor blind, parallel group, randomized controlled pilot study with sixty-four stable patients on maintenance hemodialysis. Participants were randomized to 10 weeks of 1) intra-dialytic cycling, 2) intra-dialytic LF-EMS, or 3) non-exercise control. Exercise was performed for up to one hour three times per week. Cycling workload was set at 40–60% oxygen uptake (VO2) reserve, and LF-EMS at maximum tolerable intensity. The control group did not complete any intra-dialytic exercise. Feasibility of intra-dialytic LF-EMS and cycling was the primary outcome, assessed by monitoring recruitment, retention and tolerability. At baseline and 10 weeks, secondary outcomes including cardio-respiratory reserve, muscle strength, and cardio-arterial structure and function were assessed. Results Fifty-one (of 64 randomized) participants completed the study (LF-EMS = 17 [77%], cycling = 16 [80%], control = 18 [82%]). Intra-dialytic LF-EMS and cycling were feasible and well tolerated (9% and 5% intolerance respectively, P = 0.9). At 10-weeks, cardio-respiratory reserve (VO2 peak) (Difference vs. control: LF-EMS +2.0 [95% CI, 0.3 to 3.7] ml.kg-1.min-1, P = 0.02, and cycling +3.0 [95% CI, 1.2 to 4.7] ml.kg-1.min-1, P = 0.001) and leg strength (Difference vs. control: LF-EMS, +94 [95% CI, 35.6 to 152.3] N, P = 0.002 and cycling, +65.1 [95% CI, 6.4 to 123.8] N, P = 0.002) were improved. Arterial structure and function were unaffected. Conclusions Ten weeks of intra-dialytic LF-EMS or cycling improved cardio-respiratory reserve and muscular strength. For patients who are unable or unwilling to cycle during dialysis, LF-EMS is a feasible alternative.
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Affiliation(s)
- Gordon McGregor
- Health & Life Sciences Faculty Research Centre, Coventry University, Coventry, United Kingdom
- Department of Nephrology, University Hospital, Coventry, United Kingdom
- * E-mail:
| | - Stuart Ennis
- Cardiff Centre for Exercise & Health, Cardiff Metropolitan University, Cardiff, United Kingdom
- Department of Cardiac Rehabilitation, Centre for Exercise & Health, University Hospital, Coventry, United Kingdom
| | - Richard Powell
- Department of Cardiac Rehabilitation, Centre for Exercise & Health, University Hospital, Coventry, United Kingdom
| | - Thomas Hamborg
- Statistics and Epidemiology, Division of Health Sciences, Warwick Medical School, University of Warwick, Warwick, United Kingdom
| | - Neil T. Raymond
- Department of Nephrology, University Hospital, Coventry, United Kingdom
| | - William Owen
- Department of Cardiac Rehabilitation, Centre for Exercise & Health, University Hospital, Coventry, United Kingdom
| | - Nicolas Aldridge
- Department of Nephrology, University Hospital, Coventry, United Kingdom
| | - Gail Evans
- Department of Nephrology, University Hospital, Coventry, United Kingdom
| | - Josie Goodby
- Department of Nephrology, University Hospital, Coventry, United Kingdom
| | - Sue Hewins
- Department of Nephrology, University Hospital, Coventry, United Kingdom
| | | | - Nithya S. Krishnan
- Department of Nephrology, University Hospital, Coventry, United Kingdom
- Warwick Medical School, University of Warwick, Warwick, United Kingdom
| | - Stephen M. S. Ting
- Department of Nephrology, University Hospital, Coventry, United Kingdom
- Warwick Medical School, University of Warwick, Warwick, United Kingdom
| | - Daniel Zehnder
- Department of Nephrology, University Hospital, Coventry, United Kingdom
- Department of Acute Medicine, North Cumbria University Hospital NHS Trust, Carlisle, United Kingdom
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Watanabe K, Kawade S, Moritani T. Effect of electrode position of low intensity neuromuscular electrical stimulation on the evoked force in the quadriceps femoris muscle. BMC Res Notes 2017; 10:300. [PMID: 28728611 PMCID: PMC5520376 DOI: 10.1186/s13104-017-2630-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 07/17/2017] [Indexed: 12/03/2022] Open
Abstract
Objective The present study aimed to test the effect of the electrode position and inter-electrode distance on the evoked force by neuromuscular electrical stimulation (NMES) with a low current intensity and a single pair of electrodes. Knee extensor forces during NMES to quadriceps femoris muscles were compared among four different electrode configurations in seven healthy men. Electrodes were located at 10 cm proximal and 15 cm distal (P10-D15), 10 cm proximal and 10 cm distal (P10-D10), 5 cm proximal and 15 cm distal, and 5 cm proximal and 10 cm distal (P5-D10) to the center of the longitudinal axis of the quadriceps femoris muscles. Results The evoked force–time area for P5-D10 was significantly higher than those for P10-D15 and P10-D10 (p < 0.05). When using NMES devices with a low current intensity, a shorter inter-electrode distance and relatively distal locations can promote greater evoked forces in the quadriceps femoris muscles.
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Affiliation(s)
- Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of International Liberal Studies, Chukyo University, Yagotohonmachi, Showa-ku, Nagoya, 466-8666, Japan.
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Benrick A, Kokosar M, Hu M, Larsson M, Maliqueo M, Marcondes RR, Soligo M, Protto V, Jerlhag E, Sazonova A, Behre CJ, Højlund K, Thorén P, Stener-Victorin E. Autonomic nervous system activation mediates the increase in whole-body glucose uptake in response to electroacupuncture. FASEB J 2017; 31:3288-3297. [PMID: 28404742 DOI: 10.1096/fj.201601381r] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/27/2017] [Indexed: 12/15/2022]
Abstract
A single bout of low-frequency electroacupuncture (EA) causing muscle contractions increases whole-body glucose uptake in insulin-resistant rats. We explored the underlying mechanism of this finding and whether it can be translated into clinical settings. Changes in glucose infusion rate (GIR) were measured by euglycemic-hyperinsulinemic clamp during and after 45 min of low-frequency EA in 21 overweight/obese women with polycystic ovary syndrome (PCOS) and 21 controls matched for age, weight, and body mass index (experiment 1) and in rats receiving autonomic receptor blockers (experiment 2). GIR was higher after EA in controls and women with PCOS. Plasma serotonin levels and homovanillic acid, markers of vagal activity, decreased in both controls and patients with PCOS. Adipose tissue expression of pro-nerve growth factor (proNGF) decreased, and the mature NGF/proNGF ratio increased after EA in PCOS, but not in controls, suggesting increased sympathetic-driven adipose tissue metabolism. Administration of α-/β-adrenergic receptor blockers in rats blocked the increase in GIR in response to EA. Muscarinic and dopamine receptor antagonist also blocked the response but with slower onset. In conclusion, a single bout of EA increases whole-body glucose uptake by activation of the sympathetic and partly the parasympathetic nervous systems, which could have important clinical implications for the treatment of insulin resistance.-Benrick, A., Kokosar, M., Hu, M., Larsson, M., Maliqueo, M., Marcondes, R. R., Soligo, M., Protto, V., Jerlhag, E., Sazonova, A., Behre, C. J., Højlund, K., Thorén, P., Stener-Victorin, E. Autonomic nervous system activation mediates the increase in whole-body glucose uptake in response to electroacupuncture.
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Affiliation(s)
- Anna Benrick
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,School of Health and Education, University of Skövde, Skövde, Sweden
| | - Milana Kokosar
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Min Hu
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Martin Larsson
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Manuel Maliqueo
- Endocrinology and Metabolism Laboratory, West Division, School of Medicine, University of Chile, Santiago, Chile
| | - Rodrigo Rodrigues Marcondes
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.,Disciplina de Ginecologia, Laboratório de Ginecologia Estrutural e Molecular (LIM 58), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marzia Soligo
- Institute of Translational Pharmacology, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - Virginia Protto
- Institute of Translational Pharmacology, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - Elisabet Jerlhag
- Department of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Antonina Sazonova
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carl Johan Behre
- Department of Cardiology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kurt Højlund
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Peter Thorén
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Sewa Y, Tomita K, Okuno Y, Ose H, Imura S. Respiratory flow and vital signs associated with the intensity of functional electrical stimulation delivered to human abdominal muscles during quiet breathing. J Phys Ther Sci 2017; 28:3337-3341. [PMID: 28174447 PMCID: PMC5276756 DOI: 10.1589/jpts.28.3337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 08/09/2016] [Indexed: 02/02/2023] Open
Abstract
[Purpose] The purpose of this study was to examine the effects of increasing the
intensity of functional electrical stimulation delivered to abdominal muscles during quiet
breathing on respiratory flow, vital signs and pain in healthy subjects. [Subjects and
Methods] Electrical stimulation was delivered bilaterally using one pair of
high-conductivity gel-skin plate electrodes, placed on both sides of the abdomen, to nine
healthy males. Subjects were required to breathe normally through a face mask for 2
minutes while in a supine position. The stimulation intensity was incrementally increased
by 10 mA until reaching 100 mA. Respiratory parameters, vital signs and pain based on the
visual analog scale were measured for each intensity of electrical stimulation. [Results]
Transcutaneous oxygen saturation showed a slight upward trend in association with
increasing stimulation intensity, but there were no significant changes in pulse or blood
pressure. Respiratory flow, tidal volume, and minute ventilation increased significantly
as the stimulation intensity rose. [Conclusion] This study revealed that functional
electrical stimulation can be safely delivered to human abdominal muscles without causing
vital sign abnormalities. It was also found that the appropriate intensity level of
electrical stimulation for achieving effects on respiratory flow while also minimizing
pain is 60–80 mA.
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Affiliation(s)
- Yoko Sewa
- Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, Japan
| | - Kazuhide Tomita
- Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, Japan; Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Japan
| | - Yukako Okuno
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Japan
| | - Hirotaka Ose
- Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, Japan
| | - Shigeyuki Imura
- Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, Japan; Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Japan
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Catalogna M, Doenyas-Barak K, Sagi R, Abu-Hamad R, Nevo U, Ben-Jacob E, Efrati S. Effect of Peripheral Electrical Stimulation (PES) on Nocturnal Blood Glucose in Type 2 Diabetes: A Randomized Crossover Pilot Study. PLoS One 2016; 11:e0168805. [PMID: 27997608 PMCID: PMC5173375 DOI: 10.1371/journal.pone.0168805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 12/04/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Regulation of hepatic glucose production has been a target for antidiabetic drug development, due to its major contribution to glucose homeostasis. Previous pre-clinical study demonstrated that peripheral electrical stimulation (PES) may stimulate glucose utilization and improve hepatic insulin sensitivity. The aim of the present study was to evaluate safety, tolerability, and the glucose-lowering effect of this approach in patients with type 2 diabetes (T2DM). METHODS Twelve patients with T2DM were recruited for an open label, interventional, randomized trial. Eleven patients underwent, in a crossover design, an active, and a no-intervention control periods, separated with a two-week washout phase. During the active period, the patients received a daily lower extremity PES treatment (1.33Hz/16Hz burst mode), for 14 days. Study endpoints included changes in glucose levels, number of hypoglycemic episodes, and other potential side effects. Endpoints were analyzed based on continuous glucose meter readings, and laboratory evaluation. RESULTS We found that during the active period, the most significant effect was on nocturnal glucose control (P < 0.0004), as well as on pre-meal mean glucose levels (P < 0.02). The mean daily glucose levels were also decreased although it did not reach clinical significance (P = 0.07). A reduction in serum cortisol (P < 0.01) but not in insulin was also detected after 2 weeks of treatment. No adverse events were recorded. CONCLUSIONS These results indicate that repeated PES treatment, even for a very short duration, can improve blood glucose control, possibly by suppressing hepatic glucose production. This effect may be mediated via hypothalamic-pituitary-adrenal axis modulation. TRIAL REGISTRATION ClinicalTrials.gov NCT02727790.
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Affiliation(s)
- Merav Catalogna
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Keren Doenyas-Barak
- Research and Development Unit, Assaf Harofeh Medical Center, Zerifin, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roi Sagi
- Research and Development Unit, Assaf Harofeh Medical Center, Zerifin, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ramzia Abu-Hamad
- Research and Development Unit, Assaf Harofeh Medical Center, Zerifin, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Uri Nevo
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Eshel Ben-Jacob
- School of Physics and Astronomy, Raymond & Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Shai Efrati
- Research and Development Unit, Assaf Harofeh Medical Center, Zerifin, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Miyamoto T, Kamada H, Tamaki A, Moritani T. Low-intensity electrical muscle stimulation induces significant increases in muscle strength and cardiorespiratory fitness. Eur J Sport Sci 2016; 16:1104-10. [DOI: 10.1080/17461391.2016.1151944] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Numata H, Nakase J, Inaki A, Mochizuki T, Oshima T, Takata Y, Kinuya S, Tsuchiya H. Effects of the belt electrode skeletal muscle electrical stimulation system on lower extremity skeletal muscle activity: Evaluation using positron emission tomography. J Orthop Sci 2016; 21:53-6. [PMID: 26755387 DOI: 10.1016/j.jos.2015.09.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 08/10/2015] [Accepted: 09/01/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Lower-extremity muscle weakness in athletes after lower limb trauma or surgery can hinder their return to sports, and the associated muscle atrophy may lead to deterioration in performance after returning to sports. Recently, belt electrode skeletal muscle electrical stimulation (B-SES) which can contract all the lower limb skeletal muscles simultaneously was developed. However, no study has evaluated skeletal muscle activity with B-SES. Since only superficial muscles as well as a limited number of muscles can be investigated using electromyography, we investigated whether positron emission tomography (PET) can evaluate the activity of all the skeletal muscles in the body simultaneously. The purpose of this study was to evaluate the effectiveness of the B-SES system using PET. METHODS Twelve healthy males (mean age, 24.3 years) were divided into two groups. The subjects in the control group remained in a sitting position for 10 min, and [(18)F] fluorodeoxyglucose (FDG) was intravenously injected. In the exercise group, subjects exercised using the B-SES system for 20 min daily for three consecutive days as a pre-test exercise. On the measurement day, they exercised for 10 min, received an injection of FDG, and exercised for another 10 min. PET-computed tomography images were obtained in each group 60 min after the FDG injection. Regions of interest were drawn in each lower-extremity muscle. We compared each skeletal muscle metabolism using the standardized uptake value. RESULTS In the exercise group, FDG accumulation in the gluteus maximus, gluteus medius, gluteus minimus, quadriceps femoris, sartorius, and hamstrings was significantly higher than the muscles in the control (P < 0.05). CONCLUSION Exercise with B-SES increased the skeletal muscle activity of the gluteal muscles as well as the most lower-extremity muscles simultaneously.
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Affiliation(s)
- Hitoaki Numata
- Department of Orthopaedic Surgery, Kanazawa University, Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Junsuke Nakase
- Department of Orthopaedic Surgery, Kanazawa University, Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan.
| | - Anri Inaki
- Department of Nuclear Medicine/Biotracer Medicine, Kanazawa University, Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Takafumi Mochizuki
- Kanazawa Advanced Medical Center, 13-1 Takara-machi, Kanazawa, Ishikawa 920-0934, Japan
| | - Takeshi Oshima
- Department of Orthopaedic Surgery, Kanazawa University, Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Yasushi Takata
- Department of Orthopaedic Surgery, Kanazawa University, Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Seigo Kinuya
- Department of Nuclear Medicine/Biotracer Medicine, Kanazawa University, Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University, Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
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Igaki Y, Mizutani F, Yasukawa T. Oxygen Consumption of Contractile C2C12 Myotubes Investigated by Scanning Electrochemical Microscopy. CHEM LETT 2015. [DOI: 10.1246/cl.150371] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Yuki Igaki
- Graduate School of Material Science, University of Hyogo
| | - Fumio Mizutani
- Graduate School of Material Science, University of Hyogo
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Zhiyuan W, Ming Y, Jie J, Yi W, Tiansheng H, Mingfen L, Zhijie H, Zhenzhen G, Pang LMC. Effect of transcutaneous electrical nerve stimulation at acupoints on patients with type 2 diabetes mellitus: a randomized controlled trial. J TRADIT CHIN MED 2015; 35:134-40. [PMID: 25975045 DOI: 10.1016/s0254-6272(15)30020-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To examine whether transcutaneous electric nerve stimulation at acupoints (Acu-TENS) improved the biochemical and physical indices of patients with type 2 diabetes mellitus (T2DM). METHODS Ninety subjects with T2DM were divided randomly into a control group (n = 30), aerobic exercise group (n = 30), or Acu-TENS group (n = 30). In addition to conventional diabetes drug treatment, patients in the Acu-TENS group received acupoint stimulation, the aerobic exercise group engaged in walking exercises, and the control group was given sham electrical stimulation. All groups were treated for 30 min for each session and five times a week for 2 months. The indices of glycosylated hemoglobin, 2 h postprandial glucose, fasting serum insulin, triglyceride, total cholesterol, and body mass index were assessed at pre-treatment, post-treatment, and follow-up, which was 2 months after treatment. RESULTS The indices of the control group were not changed (P > 0.05) at the three time points. At the pre-treatment measurement, there were significant differences (P > 0.05) in indices among the three groups. At post-treatment, each index of the two groups was lower than that of the control group (P < 0.05), and improved in comparison with the pre-treatment measurement (P < 0.05). In follow-up, each index of the aerobic exercise group and Acu-TENS group increased, but was still decreased compared with the pre-treatment value (P < 0.05), excluding body mass index. CONCLUSION Acu-TENS could improve the state of patients with T2DM and be used as a therapy in clinical application.
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Herzig D, Maffiuletti NA, Eser P. The Application of Neuromuscular Electrical Stimulation Training in Various Non-neurologic Patient Populations: A Narrative Review. PM R 2015; 7:1167-1178. [DOI: 10.1016/j.pmrj.2015.03.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 03/24/2015] [Accepted: 03/27/2015] [Indexed: 12/16/2022]
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Miyamoto T, Fukuda K, Watanabe K, Hidaka M, Moritani T. Gender difference in metabolic responses to surface electrical muscle stimulation in type 2 diabetes. J Electromyogr Kinesiol 2015; 25:136-42. [DOI: 10.1016/j.jelekin.2014.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 06/27/2014] [Accepted: 06/30/2014] [Indexed: 11/16/2022] Open
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Watanabe K, Taniguchi Y, Moritani T. Metabolic and cardiovascular responses during voluntary pedaling exercise with electrical muscle stimulation. Eur J Appl Physiol 2014; 114:1801-7. [PMID: 24867595 DOI: 10.1007/s00421-014-2906-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 05/03/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE We aimed to test the effect of additional electrical muscle stimulation (EMS) during moderate-intensity voluntary pedaling exercise on metabolic and cardiovascular responses. METHODS Eleven healthy male subjects performed moderate-intensity pedaling exercise at a constant workload (80% of ventilatory threshold) for 20 min while EMS was applied to thigh muscles from 5 to 10 min and from 15 to 20 min during the exercise. RESULTS A significantly higher oxygen uptake (VO₂), heart rate, and respiratory gas exchange ratio were observed during the exercise periods with EMS despite the constant workload. These changes were accompanied by an elevated blood lactate concentration, suggesting the existence of additional fast-twitch motor unit (MU) recruitment during the exercise with EMS. CONCLUSION Our data suggest that the use of intermittent EMS during a constant load exercise mimics the high-intensity interval training, possibly due to additional fast-twitch MU recruitment and co-contractions of the quadriceps and hamstrings muscles, leading to higher anaerobic metabolism and a lower mechanical efficiency.
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Affiliation(s)
- Kohei Watanabe
- School of International Liberal Studies, Chukyo University, Nagoya, Japan,
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Minogue CM, Caulfield BM, Lowery MM. Whole body oxygen uptake and evoked torque during subtetanic isometric electrical stimulation of the quadriceps muscles in a single 30-minute session. Arch Phys Med Rehabil 2014; 95:1750-8. [PMID: 24769070 DOI: 10.1016/j.apmr.2014.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/14/2014] [Accepted: 04/04/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the time course of fatigue in torque output and oxygen uptake during isometric subtetanic neuromuscular electrical stimulation (NMES) to facilitate the design of NMES-based rehabilitation protocols that can accumulate a defined aerobic exercise volume within a given time period. DESIGN Single-arm intervention study with within-subject comparisons. SETTING University research laboratory. PARTICIPANTS Volunteer sample of healthy men (N=11; mean age, 34.2 ± 11.5 y; range, 19-53 y; body mass, 79.1 ± 11.7 kg; range, 58-100 kg). INTERVENTION A single 30-minute session of continuous bilateral isometric quadriceps NMES at 4 Hz evoking a mean twitch amplitude of 12% of the maximum voluntary contraction. MAIN OUTCOME MEASURES Whole body oxygen consumption rate (V˙o2), and evoked torque were measured simultaneously throughout. RESULTS Mean increment in V˙o2 was 596 ± 238 mL/min, and average exercise intensity during the session was 3 ±.47 metabolic equivalents. The V˙o2 and torque declined slowly at a rate of -.54%±.31% and -.47%±.57% per minute, respectively. CONCLUSIONS Despite having a higher incremental V˙o2, the observed fatigue rate was considerably less than that previously reported during intermittent isometric tetanic stimulation, suggesting that subtetanic isometric NMES is more sustainable for exercise interventions aimed at accumulating a therapeutic aerobic exercise volume.
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Affiliation(s)
- Conor M Minogue
- School of Electrical, Electronic and Communications Engineering, University College, Dublin, Ireland.
| | - Brian M Caulfield
- School of Public Health, Physiotherapy and Population Science, University College, Dublin, Ireland
| | - Madeleine M Lowery
- School of Electrical, Electronic and Communications Engineering, University College, Dublin, Ireland
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Minogue CM, Caulfield BM, Lowery MM. Whole body oxygen uptake and evoked knee torque in response to low frequency electrical stimulation of the quadriceps muscles: V•O2 frequency response to NMES. J Neuroeng Rehabil 2013; 10:63. [PMID: 23809189 PMCID: PMC3704694 DOI: 10.1186/1743-0003-10-63] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 06/06/2013] [Indexed: 11/17/2022] Open
Abstract
Background There is emerging evidence that isometric Neuromuscular Electrical Stimulation (NMES) may offer a way to elicit therapeutically significant increases in whole-body oxygen uptake in order to deliver aerobic exercise to patients unable to exercise volitionally, with consequent gains in cardiovascular health. The optimal stimulation frequency to elicit a significant and sustained pulmonary oxygen uptake has not been determined. The aim of this study was to examine the frequency response of the oxygen uptake and evoked torque due to NMES of the quadriceps muscles across a range of low frequencies spanning the twitch to tetanus transition. Methods Ten healthy male subjects underwent bilateral NMES of the quadriceps muscles comprising eight 4 minute bouts of intermittent stimulation at selected frequencies in the range 1 to 12 Hz, interspersed with 4 minutes rest periods. Respiratory gases and knee extensor torque were simultaneously monitored throughout. Multiple linear regression was used to fit the resulting data to an energetic model which expressed the energy rate in terms of the pulse frequency, the torque time integral and a factor representing the accumulated force developed per unit time. Results Additional oxygen uptake increased over the frequency range to a maximum of 564 (SD 114) ml min-1 at 12 Hz, and the respiratory exchange ratio was close to unity from 4 to 12 Hz. While the highest induced torque occurred at 12 Hz, the peak of the force development factor occurred at 6 Hz. The regression model accounted for 88% of the variability in the observed energetic response. Conclusions Taking into account the requirement to avoid prolonged tetanic contractions and to minimize evoked torque, the results suggest that the ideal frequency for sustainable aerobic exercise is 4 to 5 Hz, which coincided in this study with the frequency above which significant twitch force summation occurred.
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Affiliation(s)
- Conor M Minogue
- School of Electrical, Electronic and Communications Engineering, University College, Dublin, Ireland.
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Miyamoto T, Fukuda K, Kimura T, Matsubara Y, Tsuda K, Moritani T. Effect of percutaneous electrical muscle stimulation on postprandial hyperglycemia in type 2 diabetes. Diabetes Res Clin Pract 2012; 96:306-12. [PMID: 22296854 DOI: 10.1016/j.diabres.2012.01.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Revised: 10/14/2011] [Accepted: 01/03/2012] [Indexed: 10/14/2022]
Abstract
AIMS The aim of this study was to examine whether percutaneous electrical muscle stimulation (EMS) attenuates postprandial hyperglycemia in type 2 diabetes. METHODS Eleven patients with type 2 diabetes participated in two experimental sessions; one was a 30-min EMS 30 min after a breakfast (EMS trial) and the other was a complete rest after a breakfast (Control trial). In each trial, blood was sampled before and at 30, 60, 90, and 120 min after the meal. RESULTS Postprandial glucose level was significantly attenuated in EMS trial at 60, 90, and 120 min after a meal (p<0.05). The C-peptide concentration was also significantly lowered in EMS trial (p<0.01). On the other hand, there was no significant increase in creatine phosphokinase (CPK) concentration in each trial. CONCLUSIONS The present results provide first evidence indicating that EMS is a new exercise method for treating postprandial hyperglycemia in individuals with type 2 diabetes, especially who cannot perform adequate voluntary exercise because of excessive obesity, orthopedic diseases, or severe diabetic complications.
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Affiliation(s)
- Toshiaki Miyamoto
- Graduate School of Human and Environmental Studies, Kyoto University, Yoshida, Sakyo-ku, Kyoto, Japan
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Electrical muscle stimulation: an effective form of exercise and early mobilization to preserve muscle strength in critically ill patients. Crit Care Res Pract 2012; 2012:432752. [PMID: 22545212 PMCID: PMC3321528 DOI: 10.1155/2012/432752] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 01/10/2012] [Accepted: 01/24/2012] [Indexed: 11/17/2022] Open
Abstract
Purpose. This is a secondary analysis of previously published data to investigate the effects of electrical muscle stimulation (EMS) on strength of various muscle groups in critically ill patients. Methods. One hundred forty-two consecutive patients, with APACHE II score ≥ 13, were randomly assigned to the EMS or the control group. EMS sessions were applied daily on vastus lateralis, vastus medialis, and peroneus longus of both lower extremities. Various muscle groups were evaluated with the Medical Research Council (MRC) scale for muscle strength. Handgrip strength assessment was also employed. Results. Twenty four patients in the EMS group and 28 patients in the control group were finally evaluated. EMS patients achieved higher MRC scores than controls (P ≤ 0.05) in wrist flexion, hip flexion, knee extension, and ankle dorsiflexion. Collectively, the EMS group performed higher (P < 0.01) in the legs and overall. Handgrip strength correlated (P ≤ 0.01) with the upper and lower extremities' muscle strength and the overall MRC scores. Conclusions. EMS has beneficial effects on the strength of critically ill patients mainly affecting muscle groups stimulated, while it may also affect muscle groups not involved presenting itself as a potential effective means of muscle strength preservation and early mobilization in this patient population.
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Tominaga A, Ishizaki N, Naruse Y, Kitakoji H, Yamamura Y. Repeated Application of Low-Frequency Electroacupuncture Improves High-Fructose Diet-Induced Insulin Resistance in Rats. Acupunct Med 2011; 29:276-83. [DOI: 10.1136/acupmed-2011-010006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background Insulin resistance is frequently present in obesity and during the development of type 2 diabetes mellitus. Objective The purpose of the present study was to investigate the effect of electroacupuncture (EA) on high-fructose diet (HFD)-induced insulin resistance. Methods Male Wistar rats were fed HFD for 4 weeks and developed insulin resistance. Insulin sensitivity was assessed by clamp. The number of animals was seven, eight and seven in the control, HFD and HFD+EA groups, respectively. AMP-activated protein kinase (AMPK) and glucose transporter 4 (GLUT4) in skeletal muscle were measured by Western blotting analysis (n=7 in each group). EA stimulation was carried out 12 times over 4 weeks at an intensity of 1–3 mA and a frequency of 2/15 Hz in a conscious state without restraint. Results There was no significant difference in mean body weight and fasting blood glucose concentration between groups at the end of the experiment. The mean glucose infusion rate during the clamp was significantly lower in the HFD group than in controls (p<0.05). There was no significant difference in expression of GLUT4 in skeletal muscle in the control and each group. Phosphorylated AMPKα (Thr172) in skeletal muscle showed a significant increase immediately after the final EA stimulation when compared with the control group (p<0.05). Conclusion Repeated application of EA is capable of improving diet-induced insulin resistance, probably through activation of AMPK signalling pathways in skeletal muscle. These results suggest that repeated application of EA may have beneficial effects on diet-induced insulin resistance.
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Affiliation(s)
- Atsushi Tominaga
- Department of Clinical Acupuncture and Moxibustion, Meiji University of Integrative Medicine, Kyoto, Japan
| | - Naoto Ishizaki
- Department of Clinical Acupuncture and Moxibustion, Meiji University of Integrative Medicine, Kyoto, Japan
| | - Yoshihisa Naruse
- Department of Anatomy, Meiji University of Integrative Medicine, Kyoto, Japan
| | - Hiroshi Kitakoji
- Department of Clinical Acupuncture and Moxibustion, Meiji University of Integrative Medicine, Kyoto, Japan
| | - Yoshiharu Yamamura
- Department of Internal Medicine, Meiji University of Integrative Medicine, Kyoto, Japan
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Hasegawa S, Kobayashi M, Arai R, Tamaki A, Nakamura T, Moritani T. Effect of early implementation of electrical muscle stimulation to prevent muscle atrophy and weakness in patients after anterior cruciate ligament reconstruction. J Electromyogr Kinesiol 2011; 21:622-30. [PMID: 21334221 DOI: 10.1016/j.jelekin.2011.01.005] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Revised: 01/25/2011] [Accepted: 01/25/2011] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Following anterior cruciate ligament (ACL) reconstruction, restricted weight bearing and immobilization results in thigh and calf muscle atrophy and weakness. The purpose of this study was to assess the effect of electrical muscle stimulation (EMS) on prevention of muscle atrophy in patients during the early rehabilitation stage after ACL reconstruction. METHODS Twenty patients with acute ACL tears were divided into two groups randomly. The control group (CON group) participated in only the usual rehabilitation program. In addition to this protocol, the electrical muscle stimulation group (EMS group) received EMS training using the wave form of 20 Hz exponential pulse from the 2nd post-operative day to 4 weeks after the surgery. RESULTS Muscle thickness of vastus lateralis and calf increased significantly 4 weeks after surgery in the EMS group, while it decreased significantly in the CON group. The decline of knee extension strength was significantly less in the EMS group than in the CON group at 4 weeks after the surgery, and the EMS group showed greater recovery of knee extension strength at 3 months after surgery. CONCLUSIONS EMS implemented during the early rehabilitation stage is effective in maintaining and increasing muscle thickness and strength in the operated limb.
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Affiliation(s)
- Satoshi Hasegawa
- Graduate School of Human and Environmental Studies, Kyoto University, Japan
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