Comparison of Different Intensity Modes of Neuromuscular Electrical Stimulation in the Rehabilitation of Elderly Patients with Decompensated Chronic Heart Failure

Comparison of Effect of Three Different Surgical Procedures on Ankle Joint Function Rehabilitation of Patients with Hepple V Talus Osteochondral Injury

Objective

To discuss and compare the effects of three different surgical procedures on ankle function rehabilitation of patients with Hepple V talus osteochondral injury.

Methods

A total of 60 patients with Hepple V talus osteochondral injury admitted to our hospital from January 2020 to January 2021, among which 17 patients in study group 1 received microfracture surgery, 20 patients in study group 2 received osteochondral autologous transplantation, and 23 patients in study group 3 received with periosteal iliac bone transplantation. The range of motion (ROM) of the patients' angle was evaluated by the goniometer before and after the treatment. The ankle function was evaluated by the ankle-hindfoot score of American Orthopedic Foot and Ankle Society (AOFAS). The ankle joint pain was evaluated by visual analogue score (VAS). The surgical efficacy was evaluated 12 months after surgery, and complications and nursing satisfaction were observed and recorded.

Results

There was no significant difference in ROM, AOFAS score, and VAS score among the three groups before the treatment (P > 0.05). ROM and AOFAS score of the three groups were improved, and VAS score was decreased at 6 months and 12 months after treatment (P < 0.05). ROM and AOFAS score of group 2 and group 3 were higher than those of group 1, while the VAS score was lower than that of group 1, indicating significant difference (P < 0.05). There was no significant difference in ROM, AOFAS, and VAS score between group 2 and group 3 (P > 0.05). The surgical efficacy of group 2 and group 3 was higher than that of group 1, indicating statistical significance (P < 0.05), while there was no significant difference in the surgical significance between group 2 and group 3 (P > 0.05). There was no significant difference in complication rate among the three groups (P > 0.05), and the treatment satisfaction of group 2 and group 3 was higher than that of group 1, indicating statistical significance (P < 0.05), but there was no significant difference between group 2 and group 3 (P > 0.05).

Conclusion

Three different surgical procedures have good therapeutic effect for Hepple V talus osteochondral injury. Osteochondral autologous transplantation and periosteal iliac bone transplantation can reduce the pain of ankle joint, promote the effect of ankle joint function recovery, which can effectively improve patient satisfaction. It is suggested to choose the surgical procedure according to the actual situation of patients.

Effects of electrode size and placement on comfort and efficiency during low-intensity neuromuscular electrical stimulation of quadriceps, hamstrings and gluteal muscles

Background

Neuromuscular electrical stimulation (NMES) may prevent muscle atrophy, accelerate rehabilitation and enhance blood circulation. Yet, one major drawback is that patient compliance is impeded by the discomfort experienced. It is well-known that the size and placement of electrodes affect the comfort and effect during high-intensity NMES. However, during low-intensity NMES the effects of electrode size/placement are mostly unknown. Therefore, the purpose of this study was to investigate how electrode size and pragmatic placement affect comfort and effect of low-intensity NMES in the thigh and gluteal muscles.

Methods

On 15 healthy participants, NMES-intensity (mA) was increased until visible muscle contraction, applied with three electrode sizes (2 × 2 cm, 5 × 5 cm, 5 × 9 cm), in three different configurations on quadriceps and hamstrings (short-transverse (ST), long-transverse (LT), longitudinal (L)) and two configurations on gluteus maximus (short-longitudinal (SL) and long-longitudinal (LL)). Current–density (mA/cm²) required for contraction was calculated for each electrode size. Comfort was assessed with a numerical rating scale (NRS, 0–10). Significance was set to p < 0.05 and values were expressed as median (inter-quartile range).

Results

On quadriceps the LT-placement exhibited significantly better comfort and lower current intensity than the ST- and L-placements. On hamstrings the L-placement resulted in the best comfort together with the lowest intensity. On gluteus maximus the LL-placement demonstrated better comfort and required less intensity than SL-placement. On all muscles, the 5 × 5 cm and 5 × 9 cm electrodes were significantly more comfortable and required less current–density for contraction than the 2 × 2 cm electrode.

Conclusion

During low-intensity NMES-treatment, an optimized electrode size and practical placement on each individual muscle of quadriceps, hamstrings and gluteals is crucial for comfort and intensity needed for muscle contraction.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-022-00403-7.