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Al Amin R, Ali AS, Saab IM, Abbas RL. Immediate Neurophysiological effect of electrical stimulation via dry needling on H-reflex in post stroke spasticity. Physiother Theory Pract 2024; 40:1412-1420. [PMID: 36847265 DOI: 10.1080/09593985.2023.2182655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/15/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Many non-pharmacological interventions have been proposed for spasticity modulation in spastic stroke subjects. OBJECTIVE To investigate the immediate effect of dry needling (DN), electrical stimulation (ES), and dry needling with intramuscular electrical stimulation (DN+IMES) on H-reflex in post-stroke spasticity. METHODS Spastic subjects with stroke (N = 90) (55-85 years) were evaluated after 1 month of stroke onset using Modified Ashworth Scale (MAS) score ≥1. Subjects were randomly allocated to receive one session of DN - Soleus (N = 30), ES - posterior lateral side of the leg with 100 Hz and 250 μs pulse width (N = 30), or DN+IMES - Soleus (N = 30). MAS, H-reflex, maximum latency, H-amplitude, M-amplitude and H/M ratio, were recorded before and after one session of intervention. Relationships for each variable within group or the difference among groups were calculated by effect size. RESULTS Significant decrease in H/M ratio in Gastrocnemius and Soleus at post-treatment within DN group (P = .024 and P = .029, respectively), large effect size (d = 0.07 and 0.62, respectively); and DN+IMES group (P = .042 and P = .001, respectively), large effect size (d = 0.69 and 0.71, respectively). No significant differences in all variables at pre-treatment and post-treatment was recorded among ES, DN, and DN+IMES groups. Significant decrease in MAS was recorded at post-treatment compared to pre-treatment within ES group (P = .002), DN group (P = .0001), and DN+IMES group (P = .0001), but not significant (P > .05) among three groups at pre-treatment (P = .194) and post-treatment (P = .485). CONCLUSIONS Single session of DN, ES, and the DN+IMES can significantly modulate post-stroke spasticity by possible bottom-up regulation mechanisms.
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Affiliation(s)
- Ranim Al Amin
- Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Ahmed S Ali
- Department of Physical Therapy for Neurology, Faculty of Physical Therapy, Cairo University, Egypt
| | - Ibtissam M Saab
- Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Rami L Abbas
- Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
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Gunnarsson E, Rödby K, Seoane F. Seamlessly integrated textile electrodes and conductive routing in a garment for electrostimulation: design, manufacturing and evaluation. Sci Rep 2023; 13:17408. [PMID: 37833440 PMCID: PMC10575854 DOI: 10.1038/s41598-023-44622-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/10/2023] [Indexed: 10/15/2023] Open
Abstract
Electro-stimulation to alleviate spasticity, pain and to increase mobility has been used successfully for years. Usually, gelled electrodes are used for this. In a garment intended for repeated use such electrodes must be replaced. The Mollii-suit by the company Inerventions utilises dry conductive rubber electrodes. The electrodes work satisfactory, but the garment is cumbersome to fit on the body. In this paper we show that knitted dry electrodes can be used instead. The knitted electrodes present a lower friction against the skin and a garment is easily fitted to the body. The fabric is stretchable and provides a tight fit to the body ensuring electrical contact. We present three candidate textrodes and show how we choose the one with most favourable features for producing the garment. We validate the performance of the garment by measuring three electrical parameters: rise time (10-90%) of the applied voltage, net injected charge and the low frequency value of the skin-electrode impedance. It is concluded that the use of flat knitting intarsia technique can produce a garment with seamlessly integrated conductive leads and electrodes and that this garment delivers energy to the body as targeted and is beneficial from manufacturing and comfort perspectives.
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Affiliation(s)
- Emanuel Gunnarsson
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, Borås, Sweden.
| | - Kristian Rödby
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, Borås, Sweden
| | - Fernando Seoane
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, Borås, Sweden
- Institute for Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Care Technology, Karolinska University Hospital, 14157, Huddinge, Sweden
- Department of Clinical Physiology, Karolinska University Hospital, 14157, Huddinge, Sweden
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Rubio-Zarapuz A, Apolo-Arenas MD, Clemente-Suárez VJ, Costa AR, Pardo-Caballero D, Parraca JA. Acute Effects of a Session with The EXOPULSE Mollii Suit in a Fibromyalgia Patient: A Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2209. [PMID: 36767576 PMCID: PMC9915440 DOI: 10.3390/ijerph20032209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain and associated fatigue, sleep disturbances, and other cognitive and somatic symptoms. A multidisciplinary approach including pharmacological therapies along with behavioral therapy, exercise, patient education, and pain management is a possible solution for the treatment of this disease. The EXOPULSE Mollii® method (EXONEURAL NETWORK AB, Danderyd, Sweden) is an innovative approach for non-invasive and self-administered electrical stimulation with multiple electrodes incorporated in a full-body suit, with already proven benefits for other diseases. Therefore, the present case report study aims to evaluate the effects that a 60 min session with the EXOPULSE Mollii suit has on a female fibromyalgia patient. After the intervention, we can conclude that a 60 min session with the EXOPULSE Mollii suit has beneficial effects on pain perception, muscle oxygenation, parasympathetic modulation, and function in a female fibromyalgia patient.
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Affiliation(s)
- Alejandro Rubio-Zarapuz
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain
| | - María Dolores Apolo-Arenas
- Facultad de Medicina y Ciencias de la Salud, Research Group FhysioH, Universidad de Extremadura, 06006 Badajoz, Spain
| | | | - Ana Rodrigues Costa
- Departamento de Ciências Médicas e da Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
| | - David Pardo-Caballero
- AlgeaSalud, Clinica Neurorrehabilitación Deportiva, Avenida de Elvas, 06006 Badajoz, Spain
| | - Jose A. Parraca
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7004-516 Évora, Portugal
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Mikhailova Y, Pozdeeva A, Suleimanova A, Leukhin A, Toschev A, Lukmanov T, Fatyhova E, Magid E, Lavrov I, Talanov M. Neurointerface with oscillator motifs for inhibitory effect over antagonist muscles. Front Neurosci 2023; 17:1113867. [PMID: 37034155 PMCID: PMC10079922 DOI: 10.3389/fnins.2023.1113867] [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: 12/01/2022] [Accepted: 03/02/2023] [Indexed: 04/11/2023] Open
Abstract
The effect of inhibitory management is usually underestimated in artificial control systems, using biological analogy. According to our hypothesis, the muscle hypertonus could be effectively compensated via stimulation by bio-plausible patterns. We proposed an approach for the compensatory stimulation device as implementation of previously presented architecture of the neurointerface, where (1) the neuroport is implemented as a DAC and stimulator, (2) neuroterminal is used for neurosimulation of a set of oscillator motifs on one-board computer. In the set of experiments with five volunteers, we measured the efficacy of motor neuron inhibition via the antagonist muscle or nerve stimulation registering muscle force with and without antagonist stimulation. For the agonist activation, we used both voluntary activity and electrical stimulation. In the case of stimulation of both the agonist and the antagonist muscles and nerves, we experimented with delays between muscle stimulation in the range of 0-20 ms. We registered the subjective discomfort rate. We did not identify any significant difference between the antagonist muscle and nerve stimulation in both voluntary activity and electrical stimulation of cases showing agonist activity. We determined the most effective delay between the stimulation of the agonist and the antagonist muscles and nerves as 10-20 ms.
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Affiliation(s)
- Yulia Mikhailova
- B-Rain Labs LLC, Kazan, Russia
- Neuromorphic Computing and Neurosimulations Laboratory, Intelligent Robotics Department, Institute of Information Technologies and Intelligent Systems, Kazan Federal University, Kazan, Russia
| | - Anna Pozdeeva
- B-Rain Labs LLC, Kazan, Russia
- Kazan Federal University, Kazan, Russia
| | | | - Alexey Leukhin
- B-Rain Labs LLC, Kazan, Russia
- Neuromorphic Computing and Neurosimulations Laboratory, Intelligent Robotics Department, Institute of Information Technologies and Intelligent Systems, Kazan Federal University, Kazan, Russia
| | - Alexander Toschev
- B-Rain Labs LLC, Kazan, Russia
- Neuromorphic Computing and Neurosimulations Laboratory, Intelligent Robotics Department, Institute of Information Technologies and Intelligent Systems, Kazan Federal University, Kazan, Russia
| | - Timur Lukmanov
- Children's Republican Clinical Hospital, Ministry of Health of the Republic of Tatarstan, Kazan, Russia
| | - Elsa Fatyhova
- Children's Republican Clinical Hospital, Ministry of Health of the Republic of Tatarstan, Kazan, Russia
| | - Evgeni Magid
- School of Electronic Engineering, Tikhonov Moscow Institute of Electronics and Mathematics, HSE University, Moscow, Russia
- Intelligent Robotics Department, Institute of Information Technologies and Intelligent Systems, Kazan Federal University, Kazan, Russia
| | - Igor Lavrov
- Department of Neurology, Mayo Clinic, Rochester, NY, United States
- Skolkovo Institute of Science and Technology, Moscow, Russia
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Max Talanov
- Neuromorphic Computing and Neurosimulations Laboratory, Intelligent Robotics Department, Institute of Information Technologies and Intelligent Systems, Kazan Federal University, Kazan, Russia
- Institute for Artificial Intelligence R&D, Novi Sad, Serbia
- *Correspondence: Max Talanov
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Immediate effects of transcutaneous electrical nerve stimulation on gait patterns in chronic stroke survivors: A single group, pretest-posttest clinical trial. Hum Mov Sci 2022; 83:102948. [DOI: 10.1016/j.humov.2022.102948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 11/21/2022]
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Pennati GV, Bergling H, Carment L, Borg J, Lindberg PG, Palmcrantz S. Effects of 60 Min Electrostimulation With the EXOPULSE Mollii Suit on Objective Signs of Spasticity. Front Neurol 2021; 12:706610. [PMID: 34721255 PMCID: PMC8554021 DOI: 10.3389/fneur.2021.706610] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 09/06/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The EXOPULSE Mollii method is an innovative full-body suit approach for non-invasive electrical stimulation, primarily designed to reduce disabling spasticity and improve motor function through the mechanism of reciprocal inhibition. This study aimed to evaluate the effectiveness of one session of stimulation with the EXOPULSE Mollii suit at different stimulation frequencies on objective signs of spasticity and clinical measures, and the subjective perceptions of the intervention. Methods: Twenty patients in the chronic phase after stroke were enrolled in a cross-over, double-blind controlled study. Electrical stimulation delivered through EXOPULSE Mollii was applied for 60 min at two active frequencies (20 and 30 Hz) and in OFF-settings (placebo) in a randomized order, every second day. Spasticity was assessed with controlled-velocity passive muscle stretches using the NeuroFlexor hand and foot modules. Surface electromyography (EMG) for characterizing flexor carpi radialis, medial gastrocnemius, and soleus muscles activation, Modified Ashworth Scale and range of motion were used as complementary tests. Finally, a questionnaire was used to assess the participants' perceptions of using the EXOPULSE Mollii suit. Results: At group level, analyses showed no significant effect of stimulation at any frequency on NeuroFlexor neural component (NC) and EMG amplitude in the upper or lower extremities (p > 0.35). Nevertheless, the effect was highly variable at the individual level, with eight patients exhibiting reduced NC (>1 N) in the upper extremity after stimulation at 30 Hz, 5 at 20 Hz and 3 in OFF settings. All these patients presented severe spasticity at baseline, i.e., NC > 8 N. Modified Ashworth ratings of spasticity and range of motion did not change significantly after stimulation at any frequency. Finally, 75% of participants reported an overall feeling of well-being during stimulation, with 25% patients describing a muscle-relaxing effect on the affected hand and/or foot at both 20 and 30 Hz. Conclusions: The 60 min of electrical stimulation with EXOPULSE Mollii suit did not reduce spasticity consistently in the upper and lower extremities in the chronic phase after stroke. Findings suggest a need for further studies in patients with severe spasticity after stroke including repeated stimulation sessions. Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT04076878, identifier: NCT04076878.
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Affiliation(s)
- Gaia Valentina Pennati
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Rehabilitation Medicine, Stockholm, Sweden
| | - Hanna Bergling
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Rehabilitation Medicine, Stockholm, Sweden
| | - Loïc Carment
- Institut de Psychiatrie et Neurosciences de Paris, Inserm U1266, Université de Paris, Paris, France
| | - Jörgen Borg
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Rehabilitation Medicine, Stockholm, Sweden
| | - Påvel G Lindberg
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Rehabilitation Medicine, Stockholm, Sweden.,Institut de Psychiatrie et Neurosciences de Paris, Inserm U1266, Université de Paris, Paris, France
| | - Susanne Palmcrantz
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Rehabilitation Medicine, Stockholm, Sweden
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Mahmood A, Veluswamy SK, Hombali A, Mullick A, N M, Solomon JM. Effect of Transcutaneous Electrical Nerve Stimulation on Spasticity in Adults With Stroke: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2019; 100:751-768. [DOI: 10.1016/j.apmr.2018.10.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 10/15/2018] [Accepted: 10/27/2018] [Indexed: 10/27/2022]
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8
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Gozani SN, Ferree TC, Moynihan M, Kong X. Impact of transcutaneous electrical nerve stimulation on sleep in chronic low back pain: a real-world retrospective cohort study. J Pain Res 2019; 12:743-752. [PMID: 30881088 PMCID: PMC6394244 DOI: 10.2147/jpr.s196129] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Objective The purpose of this study was to determine if transcutaneous electrical nerve stimulation (TENS) improves sleep in chronic low back pain (CLBP). Background There is uncertainty over the effectiveness of TENS in CLBP. In most studies, pain intensity has been the primary outcome measure. Although sleep abnormalities are common in CLBP, sleep outcomes have not been evaluated in most studies of TENS effectiveness. Subjective and objective sleep measures are often inconsistent in CLBP, suggesting that perception of sleep and actual sleep may differ. Methods This retrospective cohort study evaluated TENS for CLBP over 10 weeks. The source database included demographics, pain characteristics, pain intensity and interference on an 11-point numerical rating scale, adherence and actigraphic sleep data from real-world TENS users. Key inclusion criteria were CLBP with self-reported history of back injury and baseline pain interference with sleep ≥4. Study participants were stratified into improved and unimproved groups based on changes in pain interference with sleep (improved ≥1-point decrease). Actigraphic sleep metrics were compared between the two groups for weeks 1–2 and weeks 9–10. Results The inclusion criteria were met by 554 TENS users. There were 282 (50.9%) participants in the improved group and 272 (49.1%) in the unimproved group. The two groups had similar baseline characteristics and high TENS adherence. At the weeks 1–2 assessment, there were no differences among actigraphic sleep. At the weeks 9–10 assessment, there was a difference in total sleep time, with the improved group sleeping 29 minutes longer. In addition, the periodic leg movement (PLM) index was lower in the improved group. Conclusion Regular TENS improved self-reported and objective sleep measures in individuals with CLBP. When compared to the unimproved group, the improved group had longer total sleep time and fewer PLMs. Sleep may be an important outcome for TENS effectiveness in CLBP.
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Affiliation(s)
| | | | | | - Xuan Kong
- NeuroMetrix, Inc., Waltham, MA 02451, USA,
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9
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Is somatosensory electrical stimulation effective in relieving spasticity? A systematic review. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2019; 19:317-325. [PMID: 31475939 PMCID: PMC6737545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Spasticity is a sensorimotor disorder widely recognized as one of the features that contribute to patients' disability. Transcutaneous electric neural stimulation (TENS/SES) has been adopted in spasticity rehabilitation as an alternative to pharmacological agents. Although previous studies have reported clinical benefits of TENS/SES in relieving spasticity, there is no clarity on how and whether this therapeutic modality affects specific neural circuitries. Thus, this systematic review aimed to verify the efficacy of TENS/SES in the control of spasticity and its consequences in spinal and corticospinal excitability. This study was carried out according to PRISMA recommendations using SCOPUS, PubMed, BVS, Google Scholar and BASE databases screening, which provided 483 references. Six additional records were found from other sources. All these records were submitted to a filtering process following the eligibility criteria, and 44 studies were selected for further analysis. Ten were replicas. Consequently, 34 studies were read in full with the aim of checking their eligibility criterion, which resulted in 10 manuscripts for qualitative synthesis. Even though they evaluated the effects of TENS/SES both at the spinal and/or corticospinal levels, the electrophysiological results seem to be inconsistent, corroborating the lack of agreement between them and with clinical outcomes.
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Kwong PW, Ng GY, Chung RC, Ng SS. Transcutaneous electrical nerve stimulation improves walking capacity and reduces spasticity in stroke survivors: a systematic review and meta-analysis. Clin Rehabil 2017; 32:1203-1219. [PMID: 29232981 DOI: 10.1177/0269215517745349] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To evaluate (1) the effectiveness of transcutaneous electrical nerve stimulation (TENS) at improving lower extremity motor recovery in stroke survivors and (2) the optimal stimulation parameters for TENS. REVIEW METHODS A systematic search was conducted for studies published up to October 2017 using eight electronic databases (CINAHL, ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, PEDro, PubMed and Web of Science). Randomized controlled trials that evaluated the effectiveness of the application of TENS at improving lower extremity motor recovery in stroke survivors were assessed for inclusion. Outcomes of interest included plantar flexor spasticity, muscle strength, walking capacity and balance. RESULTS In all, 11 studies met the inclusion criteria which involved 439 stroke survivors. The meta-analysis showed that TENS improved walking capacity, as measured by either gait speed or the Timed Up and Go Test (Hedges' g = 0.392; 95% confidence interval (CI) = 0.178 to 0.606) compared to the placebo or no-treatment control groups. TENS also reduced paretic plantar flexor spasticity, as measured using the Modified Ashworth Scale and Composite Spasticity Scale (Hedges' g = -0.884; 95% CI = -1.140 to -0.625). The effect of TENS on walking capacity in studies involving 60 minutes per sessions was significant (Hedges' g = 0.468; 95% CI = 0.201-0.734) but not in study with shorter sessions (20 or 30 minutes) (Hedges' g = 0.254; 95% CI = -0.106-0.614). CONCLUSION The results support the use of repeated applications of TENS as an adjunct therapy for improving walking capacity and reducing spasticity in stroke survivors.
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Affiliation(s)
- Patrick Wh Kwong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Gabriel Yf Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Raymond Ck Chung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Shamay Sm Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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11
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Chang MC. Reduced foot pain after spasticity control with alcohol block in a patient with chronic hemiparetic stroke: a case report. J Phys Ther Sci 2017; 29:767-770. [PMID: 28533627 PMCID: PMC5430290 DOI: 10.1589/jpts.29.767] [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: 12/03/2016] [Accepted: 12/28/2016] [Indexed: 01/04/2023] Open
Abstract
[Purpose] This study report a case of a patient with hemiparetic stroke who showed significantly reduced foot pain when ankle spasticity was reduced using nerve and motor point blocks with 20% ethyl alcohol. [Subject and Methods] A 58-year-old woman with left hemiparesis following intracranial hemorrhage five years previously presented with pain in the left fifth metatarsal head for two years (numeric rating scale[NRS]: 8). Erythema and edema were observed on the lateral aspect of the head of the fifth metatarsal bone. She was diagnosed with a Tailor's bunion. Spasticity was observed in the left ankle plantar flexor and ankle supinator (Modified Ashworth Scale: 1+). Using 20% ethyl alcohol, a block in the medial and lateral motor branches to the gastrocnemius muscle of the left tibial nerve and the motor point of the left posterior tibialis muscle was performed. [Results] After the alcohol block, spasticity had almost disappeared and foot pain was significantly reduced (NRS: 1). Results from the foot pressure measurement system test showed foot contact pressure was highly distributed to the lateral forefoot pre-block. After the block, the distribution of foot contract pressure was similar to normal distribution. [Conclusion] Clinicians should consider the possibility that spasticity can contribute to foot pain.
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Affiliation(s)
- Min Cheol Chang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Republic of Korea
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Karasuno H, Ogihara H, Morishita K, Yokoi Y, Fujiwara T, Ogoma Y, Abe K. The combined effects of transcutaneous electrical nerve stimulation (TENS) and stretching on muscle hardness and pressure pain threshold. J Phys Ther Sci 2016; 28:1124-30. [PMID: 27190439 PMCID: PMC4868199 DOI: 10.1589/jpts.28.1124] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 12/22/2015] [Indexed: 01/16/2023] Open
Abstract
[Purpose] This study aimed to clarify the immediate effects of a combined transcutaneous electrical nerve stimulation and stretching protocol. [Subjects] Fifteen healthy young males volunteered to participate in this study. The inclusion criterion was a straight leg raising range of motion of less than 70 degrees. [Methods] Subjects performed two protocols: 1) stretching (S group) of the medial hamstrings, and 2) tanscutaneous electrical nerve stimulation (100 Hz) with stretching (TS group). The TS group included a 20-minute electrical stimulation period followed by 10 minutes of stretching. The S group performed 10 minutes of stretching. Muscle hardness, pressure pain threshold, and straight leg raising range of motion were analyzed to evaluate the effects. The data were collected before transcutaneous electrical nerve stimulation (T1), before stretching (T2), immediately after stretching (T3), and 10 minutes after stretching (T4). [Results] Combined transcutaneous electrical nerve stimulation and stretching had significantly beneficial effects on muscle hardness, pressure pain threshold, and straight leg raising range of motion at T2, T3, and T4 compared with T1. [Conclusion] These results support the belief that transcutaneous electrical nerve stimulation combined with stretching is effective in reducing pain and decreasing muscle hardness, thus increasing range of motion.
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Affiliation(s)
- Hiroshi Karasuno
- Faculty of Social Work Studies, Division of Physical
Therapy, Josai International University, Japan
| | | | | | - Yuka Yokoi
- Koriyama Institute of Health Sciences, Japan
| | - Takayuki Fujiwara
- Koriyama Institute of Health Sciences, Japan
- Interdisciplinary Graduate School of Science and
Technology, Shinshu University, Japan
| | - Yoshiro Ogoma
- Interdisciplinary Graduate School of Science and
Technology, Shinshu University, Japan
| | - Koji Abe
- Interdisciplinary Graduate School of Science and
Technology, Shinshu University, Japan
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