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Baker MC, Genovese MC, Alataris K. Reply. Arthritis Rheumatol 2023. [PMID: 37899493 DOI: 10.1002/art.42741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 10/31/2023]
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Park D, Kim Y. Kilohertz-frequency interferential current induces hypoalgesic effects more comfortably than TENS. Sci Rep 2023; 13:8644. [PMID: 37244893 DOI: 10.1038/s41598-023-35489-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/18/2023] [Indexed: 05/29/2023] Open
Abstract
Recent research on transcutaneous electrical stimulation has shown that inhibiting nerve conduction with a kilohertz frequency is both effective and safe. This study primarily aims to demonstrate the hypoalgesic effect on the tibial nerve using transcutaneous interferential-current nerve inhibition (TINI), which injects the kilohertz frequency produced by the interferential currents. Additionally, the secondary objective was to compare the analgesic effect and comfort of TINI and transcutaneous electrical nerve stimulation (TENS). Thirty-one healthy adults participated in this cross-over repeated measures study. The washout period was set to 24 h or more. Stimulus intensity was set just below the pain threshold level. TINI and TENS were applied for 20 min each. The ankle passive dorsiflexion range of motion, pressure pain threshold (PPT), and tactile threshold were measured at the baseline, pre-test, test (immediately before ceasing intervention), and post-test (30 min after ceasing intervention) sessions. After the interventions, the participants evaluated the level of discomfort for TINI and TENS on a 10 cm visual analog scale (VAS). As the results, PPT significantly increased compared to baseline in test and posttest sessions of TINI, but not in those of TENS. Also, participants reported that TENS was 36% more discomfort than TINI. The hypoalgesic effect was not significantly different between TINI and TENS. In conclusion, we found that TINI inhibited mechanical pain sensitivity and that the inhibitory effect persisted long after electrical stimulation ceased. Our study also shows that TINI provides the hypoalgesic effect more comfortably than TENS.
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Affiliation(s)
- Dahoon Park
- Department of Sports Rehabilitation, Cheongju University, Cheongju, South Korea
| | - Yushin Kim
- Department of Sports Rehabilitation, Cheongju University, Cheongju, South Korea.
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Kim Y, Cohen E. Combining transcutaneous interferential-current for nerve inhibition with a robotic assistant device for increasing ankle dorsiflexion in walking. Gait Posture 2023; 102:205-209. [PMID: 37043990 DOI: 10.1016/j.gaitpost.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 03/27/2023] [Accepted: 04/05/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND A kilohertz-frequency alternating current transcutaneously applied was introduced as a novel neuromodulation technology for nerve inhibition innervating antagonist muscles. Combining this electrical nerve inhibition with a robotic assistance device has been proposed but not investigated. RESEARCH QUESTION This study aimed to demonstrate the effect of combining electrical nerve inhibition with a wearable robotic device on increasing ankle dorsiflexion during walking. We hypothesized that the wearable robotic device would elicit a greater ankle dorsiflexion angle with the same force in walking by applying the transcutaneous interferential-current nerve inhibition (TINI) technique to the tibial nerve. METHODS Eleven healthy young adults performed three experimental conditions. The ankle assistance (AA) condition was walking while wearing an ankle device with operating dorsiflexion assistance during pre-swing and swing phases. For the ankle assistance with electrical stimulation (AE) condition, TINI on the tibial nerve was additionally applied from the AA condition. In the ankle non-assistance (AN) condition, participants wore the device, but assistance was not provided. The joint angles during walking were measured and digitized through a motion analysis system. RESULTS During a gait cycle, immediate changes in ankle joint motions were observed in the sagittal plane. In the pre-swing phase, ankle dorsiflexion angle was significantly greater in AE condition than AA and AN. There was no significant difference in joint angle between AA and AN. SIGNIFICANCE This study demonstrates the effectiveness of combining TINI with a wearable robotic ankle device in increasing dorsiflexion angle during the pre-swing phase. This finding provides the feasibility of using TINI as a neuromodulation technique for assisting functional movement in human walking.
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Affiliation(s)
- Yushin Kim
- Department of Sports Rehabilitation, Cheongju University, Cheongju, South Korea.
| | - Ezra Cohen
- Division of Pediatric Rheumatology, Boston University; Division of Immunology, Boston Children's Hospital, Boston, MA, United States
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Álvarez DMC, Serrano-Muñoz D, Fernández-Pérez JJ, Moreno JS, Gómez-Soriano J, Avendaño-Coy J. The effect on handgrip strength of low-frequency percutaneous electric stimulation applied to the median and cubital nerves: A randomized, double-blind controlled trial. Anat Rec (Hoboken) 2023; 306:720-727. [PMID: 35166034 DOI: 10.1002/ar.24887] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/17/2021] [Accepted: 01/10/2022] [Indexed: 11/12/2022]
Abstract
Percutaneous electrical nerve stimulation (PENS) consists of applying an electric current of <1,000 Hz to different neuromuscular structures through acupuncture needles. Currently, there is controversy surrounding the effect of PENS on muscle strength in the scientific literature. The main objective was to assess the effect of PENS applied to the median and cubital nerves on the maximum handgrip strength (MHS) compared to sham stimulation, as well as to determine the safety of the intervention. A parallel, randomized, double-blind controlled trial in a sample of 20 healthy subjects. Participants were randomly allocated in the experimental (n = 10) and control (n = 10) groups. A blinded researcher measured MHS. Measurements of MHS of the dominant hand were taken at four time points: preintervention, immediately postintervention, 24 hr after the intervention, and at a 10-day follow-up. A 10-Hz percutaneous electrical current stimulation was employed. The control group also received the same puncture method but with no electric stimulation. Compared to baseline, the MHS decreased 10.4% (SEM = 3.2, p = .02) in the PENS group at 24 hr postintervention, with no differences observed between baseline and at 10 days postintervention. No changes in grip strength were observed at any time point in the sham group. To sum up, PENS decreased MHS at 24 hr postintervention, which does not persist 10 days after the stimulation. PENS can be considered a safe technique. Trials with larger sample sizes are required to corroborate the findings of this study. Clinical Trials Registration: NCT, NCT04662229, filed on March 12th of 2020.
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Affiliation(s)
- David Martín-Caro Álvarez
- Faculty of Physiotherapy and Nursing of Toledo, Toledo Physiotherapy Research Group (GIFTO), Universidad de Castilla-La Mancha, Toledo, Spain
| | - Diego Serrano-Muñoz
- Faculty of Physiotherapy and Nursing of Toledo, Toledo Physiotherapy Research Group (GIFTO), Universidad de Castilla-La Mancha, Toledo, Spain
| | - Juan José Fernández-Pérez
- Faculty of Physiotherapy and Nursing of Toledo, Toledo Physiotherapy Research Group (GIFTO), Universidad de Castilla-La Mancha, Toledo, Spain
| | - Jaime Salom Moreno
- Faculty of Physiotherapy and Nursing of Toledo, Toledo Physiotherapy Research Group (GIFTO), Universidad de Castilla-La Mancha, Toledo, Spain
| | - Julio Gómez-Soriano
- Faculty of Physiotherapy and Nursing of Toledo, Toledo Physiotherapy Research Group (GIFTO), Universidad de Castilla-La Mancha, Toledo, Spain
| | - Juan Avendaño-Coy
- Faculty of Physiotherapy and Nursing of Toledo, Toledo Physiotherapy Research Group (GIFTO), Universidad de Castilla-La Mancha, Toledo, Spain
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Álvarez DMC, Serrano-Muñoz D, Fernández-Pérez JJ, Gómez-Soriano J, Avendaño-Coy J. Effect of percutaneous electrical stimulation with high-frequency alternating currents at 30 kHz on the sensory-motor system. Front Neurosci 2023; 17:1048986. [PMID: 36845426 PMCID: PMC9947497 DOI: 10.3389/fnins.2023.1048986] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/24/2023] [Indexed: 02/11/2023] Open
Abstract
Background Unmodulated high-frequency alternating currents (HFAC) are employed for producing peripheral nerves block. HFAC have been applied in humans with frequencies up to 20 kHz, whether transcutaneously, percutaneously, or via surgically-implanted electrodes. The aim of this study was to assess the effect of percutaneous HFAC, applied with ultrasound-guided needles at 30 kHz, on the sensory-motor nerve conduction of healthy volunteers. Methods A parallel, double-blind, randomized clinical trial with a placebo control was conducted. Percutaneous HFAC at 30 kHz or sham stimulation was applied via ultrasound-guided needles in 48 healthy volunteers (n = 24 in each group) for 20 min. The assessed outcome variables were pressure pain threshold (PPT), mechanical detection threshold (MDT), maximal finger flexion strength (MFFS), antidromic sensory nerve action potential (SNAP), hand temperature, and subjective sensations by the participants. The measurements were recorded pre-intervention, during the stimulation (at 15 min), immediately post-intervention (at 20 min), and 15 min after the end of treatment. Results The PPT increased in the active group compared with sham stimulation, both during the intervention [14.7%; 95% confidence interval (CI): 4.4-25.0], immediately post-intervention (16.9%; 95% CI: -7.2-26.5), and 15 min after the end of the stimulation (14.3%; 95% CI: 4.4-24.3) (p < 0.01). The proportion of participants who reported feelings of numbness and heaviness was significantly higher in the active group (46 and 50%, respectively) than in the sham group (8 and 18%, respectively) (p < 0.05). No intergroup differences were observed in the remaining outcome variables. No unexpected adverse effects derived from the electrical stimulation were reported. Conclusion Percutaneous stimulation with HFAC at 30 kHz applied to the median nerve increased the PPT and subjective perception of numbness and heaviness. Future research should evaluate its potential therapeutic effect in people with pain. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT04884932, identifier NCT04884932.
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Affiliation(s)
- David Martín-Caro Álvarez
- Toledo Physiotherapy Research Group (GIFTO), Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
| | | | - Juan José Fernández-Pérez
- Toledo Physiotherapy Research Group (GIFTO), Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Julio Gómez-Soriano
- Toledo Physiotherapy Research Group (GIFTO), Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Juan Avendaño-Coy
- Toledo Physiotherapy Research Group (GIFTO), Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
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Maris S, Brands M, Lenskens D, Braeken G, Kemnitz S, Vanhove H, Mc Laughlin M, Meesen R, Brône B, Stessel B. Transcutaneous electrical nerve inhibition using medium frequency alternating current. Sci Rep 2022; 12:14911. [PMID: 36050354 PMCID: PMC9437086 DOI: 10.1038/s41598-022-18974-3] [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: 02/15/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Transcutaneous medium-frequency alternating electrical current is defined as an alternating current between 1 and 10 kHz and is capable of producing an instant, reversible block. This study aims to evaluate the efficacy of sensory perception and force production of the index and middle finger after transcutaneous medium-frequency alternating electrical current stimulation of the distal median nerve. A single-center prospective interventional cohort study was conducted in adult healthy volunteers at the Jessa Hospital, Hasselt, Belgium. Two different electrodes (PALS & 3M) were placed on the distal median nerve, which was located using a Sonosite X-Porte Ultrasound transducer, with the first electrode being placed on the skin at the level of the transverse carpal ligament and the second electrode 7 cm proximally to the first electrode. The tactile sensation was evaluated with Semmes–Weinstein monofilament test and sensation of pressure/pain was evaluated with an algometer. Peak force production was assessed with an electronic dynamometer. All measurements were performed at baseline and tMFAEC stimulation frequencies of 2 and 10 kHz in a randomized manner. Statistical analysis was performed with a one-way ANOVA with repeated measures test or a Friedman rank sum test, followed by the Wilcoxon signed rank test adjusted with Bonferroni correction. A p-value < 0.05 was considered statistically significant. From 9 to 13th of April 2021, 25 healthy volunteers were included in the Jessa Hospital, Hasselt, Belgium. A statistically significant reduction in tactile sensation during 2 kHz and 10 kHz stimulation compared to baseline was observed (2.89 ± 0.22 (PALS2); 3.35 ± 0.25 (3M2) and 2.14 ± 0.12 (PALS10); 2.38 ± 0.12 (3M10) versus − 1.75 ± 0.09 (baseline), p < 0.0001). 3M electrodes showed a tendency towards the elevation of pressure pain threshold compared to baseline. No significant difference in mean peak forces of the index and middle fingers after transcutaneous medium-frequency alternating electrical current stimulation with 2 and 10 kHz was found. This study demonstrates that transcutaneous medium-frequency alternating electrical current stimulation on the distal median nerve inhibits tactile sensory nerve activity in the index and middle finger when stimulation of 2 kHz and, to a lesser extent, 10 kHz was applied. A reduction of motor nerve activity was not observed but force production measurements may be prone to error. Trial registration: clinicaltrials.gov on 01/04/2021. NCT-Number: NCT04827173.
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Affiliation(s)
- Seppe Maris
- Department of Anaesthesiology and Pain Medicine, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium. .,Faculty of Medicine and Life Sciences, BIOMED Research Institute, UHasselt, Agoralaan Gebouw C, 3590, Diepenbeek, Belgium.
| | - Michiel Brands
- Department of Anaesthesiology and Pain Medicine, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Daniele Lenskens
- Department of Anaesthesiology and Pain Medicine, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium.,Department of Anaesthesiology and Pain Medicine, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Geert Braeken
- Department of Anaesthesiology and Pain Medicine, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Stefan Kemnitz
- Faculty of Medicine and Life Sciences, BIOMED Research Institute, UHasselt, Agoralaan Gebouw C, 3590, Diepenbeek, Belgium
| | - Herbert Vanhove
- Faculty of Medicine and Life Sciences, BIOMED Research Institute, UHasselt, Agoralaan Gebouw C, 3590, Diepenbeek, Belgium
| | - Myles Mc Laughlin
- Exp ORL, Department of Neurosciences, The Leuven Brain Institute, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Raf Meesen
- Neuroplasticity and Movement Control Research Group, Rehabilitation Research Institute (REVAL), Hasselt University, Agoralaan Gebouw A, 3590, Diepenbeek, Belgium.,Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Department of Movement Sciences, KU Leuven, Herestraat 49, 3500, Leuven, Belgium
| | - Bert Brône
- Faculty of Medicine and Life Sciences, BIOMED Research Institute, UHasselt, Agoralaan Gebouw C, 3590, Diepenbeek, Belgium
| | - Björn Stessel
- Department of Anaesthesiology and Pain Medicine, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium.,Faculty of Medicine and Life Sciences, BIOMED Research Institute, UHasselt, Agoralaan Gebouw C, 3590, Diepenbeek, Belgium
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Álvarez DMC, Serrano-Muñoz D, Fernández-Pérez JJ, Gómez-Soriano J, Avendaño-Coy J. Effect of Percutaneous Electric Stimulation with High-Frequency Alternating Currents on the Sensory-Motor System of Healthy Volunteers: A Double-Blind Randomized Controlled Study. J Clin Med 2022; 11:jcm11071832. [PMID: 35407438 PMCID: PMC8999650 DOI: 10.3390/jcm11071832] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/17/2022] [Accepted: 03/24/2022] [Indexed: 02/05/2023] Open
Abstract
Former studies investigated the application of high-frequency alternating currents (HFAC) in humans for blocking the peripheral nervous system. The present trial aims to assess the effect of HFAC on the motor response, somatosensory thresholds, and peripheral nerve conduction when applied percutaneously using frequencies of 10 kHz and 20 kHz in healthy volunteers. A parallel, placebo-controlled, double-blind, randomized clinical trial was conducted. Ultrasound-guided HFAC at 10 kHz and 20 kHz and sham stimulation were delivered to the median nerve of 60 healthy volunteers for 20 min. The main assessed variables were the maximum isometric flexion strength (MFFS) of the index finger, myotonometry, pressure pain threshold (PPT), mechanical detection threshold (MDT), and sensory nerve action potential (SNAP). A decrease in the MFFS is observed immediately postintervention compared to baseline, both in the 10 kHz group (−8.5%; 95% CI −14.9 to −2.1) and the 20 kHz group (−12.0%; 95% CI −18.3 to −5.6). The between-group comparison of changes in MFFS show a greater reduction of −10.8% (95% CI −19.8 to −1.8) immediately postintervention in the 20 kHz compared to the sham stimulation group. The percutaneous stimulation applying 20 kHz HFAC to the median nerve produces a reversible postintervention reduction in strength with no adverse effects.
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Mo J, Priefer R. Medical Devices for Tremor Suppression: Current Status and Future Directions. BIOSENSORS-BASEL 2021; 11:bios11040099. [PMID: 33808056 PMCID: PMC8065649 DOI: 10.3390/bios11040099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 01/14/2023]
Abstract
Tremors are the most prevalent movement disorder that interferes with the patient’s daily living, and physical activities, ultimately leading to a reduced quality of life. Due to the pathophysiology of tremor, developing effective pharmacotherapies, which are only suboptimal in the management of tremor, has many challenges. Thus, a range of therapies are necessary in managing this progressive, aging-associated disorder. Surgical interventions such as deep brain stimulation are able to provide durable tremor control. However, due to high costs, patient and practitioner preference, and perceived high risks, their utilization is minimized. Medical devices are placed in a unique position to bridge this gap between lifestyle interventions, pharmacotherapies, and surgical treatments to provide safe and effective tremor suppression. Herein, we review the mechanisms of action, safety and efficacy profiles, and clinical applications of different medical devices that are currently available or have been previously investigated for tremor suppression. These devices are primarily noninvasive, which can be a beneficial addition to the patient’s existing pharmacotherapy and/or lifestyle intervention.
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Markosian C, Taruvai VS, Mammis A. Neuromodulatory hacking: a review of the technology and security risks of spinal cord stimulation. Acta Neurochir (Wien) 2020; 162:3213-3219. [PMID: 33009931 DOI: 10.1007/s00701-020-04592-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/22/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Spinal cord stimulation (SCS) is a neuromodulatory technique used to relieve chronic pain. Previous instances of malicious remote control of implantable medical devices, including insulin delivery pumps and implantable cardiac defibrillators, have been documented. Though no cases of neuromodulatory hacking have been recorded outside of the academic setting, an understanding of SCS technology and the possible consequences of manipulation is important in promoting safety. METHODS We review the components and implantation protocol of a SCS system, the functionality and technological specifications for SCS systems in the global market based on their device manuals, and patient- and clinician-specific adjustable factors. Furthermore, we assess documented instances of implantable medical device hacking and speculate on the potential harms of targeting SCS systems. RESULTS SCS systems from Abbott Laboratories, Boston Scientific, Medtronic, and Nevro have unique functionality and technological specifications. Six parameters in device control can potentially be targeted and elicit various harms, including loss of therapeutic effect, accelerated battery drainage, paresthesia in unintended locations, muscle weakness or dysfunction, tissue burn, and electrical shock. CONCLUSIONS Based on the history of implantable medical device hacking, SCS systems may also be susceptible to manipulation. As the prevalence of SCS use increases and SCS systems continuously evolve in the direction of wireless control and compatibility with mobile devices, appropriate measures should be taken by manufacturers and governmental agencies to ensure safety.
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Affiliation(s)
- Christopher Markosian
- Department of Neurological Surgery, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 8100, Newark, NJ, 07103, USA.
| | - Varun S Taruvai
- Department of Neurological Surgery, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 8100, Newark, NJ, 07103, USA
| | - Antonios Mammis
- Department of Neurological Surgery, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 8100, Newark, NJ, 07103, USA
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Serrano-Muñoz D, Avendaño-Coy J, Simón-Martínez C, Taylor J, Gómez-Soriano J. 20-kHz alternating current stimulation: effects on motor and somatosensory thresholds. J Neuroeng Rehabil 2020; 17:22. [PMID: 32075666 PMCID: PMC7031925 DOI: 10.1186/s12984-020-00661-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 02/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND High frequency alternating current (HFAC) stimulation have been shown to produce a peripheral nerve conduction block. Currently, all the studies applying HFAC stimulation in clinical studies, have employed frequencies below 10 kHz. The main aim of this work was to investigate the neuromodulatory effect of transcutaneous 20 kHz stimulation on somatosensory and pain thresholds, and maximal handgrip strength. METHODS A randomized, crossover, single-blinded, placebo-controlled trial was conducted following recruitment of fourteen healthy volunteers. Transcutaneous stimulation at 20 kHz and sham stimulation were applied over the ulnar and median nerves of fourteen healthy volunteers for 20 min. Maximal handgrip strength (MHS), mechanical detection threshold (MDT) and pressure pain threshold (PPT) were registered prior to, during (15 min), immediately after the end (20 min), and 10 min following stimulation. RESULTS The 20 kHz stimulation showed a lower MHS during the stimulation at the 15 min (30.1 kgs SE 2.8) and at 20 min (31.8 kgs, SE 2.8) when compared to sham stimulation (35.1 kgs, SE 3.4; p < 0.001 and 34.2 kgs, SE 3.4; p = 0.03, respectively). The 20 kHz stimulation resulted in a slight increase in MDT at 15 min (0.25 mN; 0.25-2.00) when compared to the sham stimulation (0.25 mN; 0.25-0.25; p = 0.02), and no effects were showed for PPT. CONCLUSIONS High-frequency stimulation at 20 kHz suggests a partial block of nerve activity. Studies in subjects with neurological disorders characterized by nerve hyperactivity are needed to confirm the clinical impact of this non-invasive electrical stimulation technique. TRIAL REGISTRATION NCT, NCT02837458. Registered on 12 April 2017.
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Affiliation(s)
- Diego Serrano-Muñoz
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, 45071, Toledo, Spain.,Toledo Physiotherapy Research Group (GIFTO), Faculty of Physiotherapy and Nursery, Castilla La Mancha University, 45071, Toledo, Spain
| | - Juan Avendaño-Coy
- Toledo Physiotherapy Research Group (GIFTO), Faculty of Physiotherapy and Nursery, Castilla La Mancha University, 45071, Toledo, Spain.
| | - Cristina Simón-Martínez
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, 3000, Leuven, Belgium
| | - Julian Taylor
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, 45071, Toledo, Spain
| | - Julio Gómez-Soriano
- Toledo Physiotherapy Research Group (GIFTO), Faculty of Physiotherapy and Nursery, Castilla La Mancha University, 45071, Toledo, Spain
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Kim Y, Bulea TC, Park HS. Transcutaneous high-frequency alternating current for rapid reversible muscle force reduction below pain threshold. J Neural Eng 2019; 16:066013. [PMID: 31344687 DOI: 10.1088/1741-2552/ab35ce] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The development of non-invasive, quickly reversible techniques for controlling undesired muscle force production (e.g. spasticity) could expand rehabilitation approaches in those with pathology by increasing the type and intensity of exercises that can be performed. High-frequency alternating current (HFAC) has been previously established as a viable method for blocking neural conduction in peripheral nerves. However, clinical application of HFAC for nerve conduction block is limited due to the invasiveness of surgical procedures and the painful onset response. This study aimed to examine the use of transcutaneous HFAC (tHFAC) at various stimulation frequencies to address these shortfalls. APPROACH Ten individuals participated in the study. Surface electrodes were utilized to apply tHFAC (0.5-12 kHz) to the median and ulnar nerves. Individual pain threshold was determined by gradual increase of stimulation amplitude. Subjects then performed a force-matching task by producing grip forces up to the maximal voluntary contraction level with and without application of tHFAC below the pain threshold. MAIN RESULTS Pain threshold current amplitude increased linearly with stimulation frequency. Statistical analysis showed that both stimulation frequency and charge injected per phase had significant effects (p < 0.05) on grip force reduction. At the group level, application of tHFAC below pain threshold reduced grip force by a maximum of 40.7% ± 8.1%. Baseline grip force trials interspersed between tHFAC trials showed consistent grip force, indicating that fatigue was not a factor in force reduction. SIGNIFICANCE Our results demonstrate the effectiveness of tHFAC at reducing muscle force when applied below the pain threshold, suggesting its potential clinical viability. Future studies are necessary to further elucidate the mechanism of force reduction before clinical application.
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Affiliation(s)
- Yushin Kim
- Major of Sports Health Rehabilitation, Cheongju University, Cheongju, Republic of Korea
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Serrano-Muñoz D, Gómez-Soriano J, Bravo-Esteban E, Ávila-Martín G, Galán-Arriero I, Taylor J, Avendaño-Coy J. Soleus H-reflex modulation following transcutaneous high- and low-frequency spinal stimulation in healthy volunteers. J Electromyogr Kinesiol 2019; 46:1-7. [DOI: 10.1016/j.jelekin.2019.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/04/2019] [Accepted: 03/06/2019] [Indexed: 12/22/2022] Open
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