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Debeuf R, De Vlieger D, Defour A, Feyen K, Guida S, Cuypers L, Firouzi M, Tassenoy A, Swinnen E, Beckwée D, Leemans L. Electrotherapy in stroke rehabilitation can improve lower limb muscle characteristics: a systematic review and meta-analysis. Disabil Rehabil 2024:1-17. [PMID: 38557249 DOI: 10.1080/09638288.2024.2334444] [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: 10/31/2023] [Accepted: 03/16/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE This review assesses the effect of electrotherapy (e.g. functional electrical stimulation (FES), motor and sensor therapeutic electrical stimulation (TES)) on muscle strength and skeletal muscle characteristics in individuals post-stroke compared to conventional or sham therapy. METHODS A systematic literature search was conducted in MEDLINE, SCOPUS, and Web of Science, focusing on randomized controlled trials investigating the effect of electrotherapy. Data of interest was extracted from eligible studies, and risk of bias was assessed. RESULTS In total, 23 studies (933 people post-stroke) were included, of which 17, which mainly focus on patients in a chronic stage of stroke recovery and the implementation of FES, were incorporated in the meta-analysis. A significant increase in muscle strength was found favoring electrotherapy over conventional therapy (SMD 0.63, 95% CI 0.34-0.91, I2 = 37%, p = 0.07) and over sham therapy (SMD 0.44, 95% CI 0.20-0.68, I2 = 38%, p = 0.08). Three studies investigated the effect on muscle thickness and found a significant increase in favor of electrostimulation when compared to conventional therapy (MD 0.11 cm, 95% CI 0.06-0.16, I2 = 0%, p = 0.50). CONCLUSION Current evidence suggests electrotherapy in combination with physiotherapy has positive effects on lower limb muscle strength and skeletal muscle characteristics in patients recovering from stroke.
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Affiliation(s)
- Ruben Debeuf
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - Daan De Vlieger
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Arne Defour
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Karen Feyen
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Stefania Guida
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Lotte Cuypers
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Mahyar Firouzi
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
- Brain, Body and Cognition, Department of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - An Tassenoy
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Eva Swinnen
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - David Beckwée
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
| | - Lynn Leemans
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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Jones E, McLaughlin KA. A Novel Perspective on Neuronal Control of Anatomical Patterning, Remodeling, and Maintenance. Int J Mol Sci 2023; 24:13358. [PMID: 37686164 PMCID: PMC10488252 DOI: 10.3390/ijms241713358] [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: 07/20/2023] [Revised: 08/14/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
While the nervous system may be best known as the sensory communication center of an organism, recent research has revealed a myriad of multifaceted roles for both the CNS and PNS from early development to adult regeneration and remodeling. These systems work to orchestrate tissue pattern formation during embryonic development and continue shaping pattering through transitional periods such as metamorphosis and growth. During periods of injury or wounding, the nervous system has also been shown to influence remodeling and wound healing. The neuronal mechanisms responsible for these events are largely conserved across species, suggesting this evidence may be important in understanding and resolving many human defects and diseases. By unraveling these diverse roles, this paper highlights the necessity of broadening our perspective on the nervous system beyond its conventional functions. A comprehensive understanding of the complex interactions and contributions of the nervous system throughout development and adulthood has the potential to revolutionize therapeutic strategies and open new avenues for regenerative medicine and tissue engineering. This review highlights an important role for the nervous system during the patterning and maintenance of complex tissues and provides a potential avenue for advancing biomedical applications.
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Affiliation(s)
| | - Kelly A. McLaughlin
- Department of Biology, Tufts University, 200 Boston Avenue, Suite 4700, Medford, MA 02155, USA;
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Kim JM, Tay MRJ, Rajeswaran DK, Tham SL, Lui WL, Kong KH. Changes in muscle architecture on ultrasound in patients early after stroke. NeuroRehabilitation 2021; 49:565-572. [PMID: 34806627 DOI: 10.3233/nre-210257] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Early muscle changes are believed to occur in patients with stroke. However, there are insufficient data on the changes in muscle mass and architecture of these patients. OBJECTIVES This study investigates differences in ultrasound-derived muscle architecture parameters of the hemiplegic upper and lower limbs in patients with subacute stroke. METHODS This is a prospective observational study, which recruited 40 adult patients who had experienced a first ever unilateral stroke (ischemic or hemorrhagic), with a duration of < 1 month post stroke. The brachialis, vastus lateralis and medial gastrocnemius on both the hemiplegic and normal side were evaluated via ultrasound. We recorded clinical variables including Motricity Index, Modified Ashworth Scale (MAS) and Functional Independence Measure (FIM)-walk. RESULTS We found reduced mean muscle thickness (p < 0.001) and increased echo intensity (p < 0.001) in the brachialis muscle, increased echo intensity (p = 0.002) in the vastus lateralis muscle, and reduced muscle thickness (p < 0.001) with increased echo intensity (p < 0.001) in the medial gastrocnemius muscle compared to the normal side. There were no significant correlations between ultrasound findings and Motricity Index. CONCLUSIONS We report changes in ultrasound-derived muscle architecture in the hemiplegic limbs of patients with subacute stroke, with consistent findings of decreased muscle mass and increased echo intensity.
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Affiliation(s)
- Jong Moon Kim
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital Rehabilitation Centre, Singapore
| | - Matthew Rong Jie Tay
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital Rehabilitation Centre, Singapore
| | - Deshan Kumar Rajeswaran
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital Rehabilitation Centre, Singapore
| | - Shuen-Loong Tham
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital Rehabilitation Centre, Singapore
| | - Wen Li Lui
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital Rehabilitation Centre, Singapore
| | - Keng He Kong
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital Rehabilitation Centre, Singapore
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Tanaka S, Ito D, Kimura Y, Ishiyama D, Suzuki M, Koyama S, Narita Y, Masuda H, Suzukawa K, Yamada M. Relationship between longitudinal changes in skeletal muscle characteristics over time and functional recovery during intensive rehabilitation of patients with subacute stroke. Top Stroke Rehabil 2021; 29:356-365. [PMID: 34180362 DOI: 10.1080/10749357.2021.1940724] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Stroke is a disease that easily impairs skeletal muscle characteristics, resulting in low quantity, low quality, and poor strength. However, the recovery process of skeletal muscles in patients with stroke is not well established. OBJECTIVES We aimed to determine the longitudinal changes in skeletal muscle characteristics in patients with stroke during intensive rehabilitation and examine their relationship with functional recovery. METHODS Eighty-five patients with stroke were prospectively recruited. We defined muscle quantity and quality as ultrasonographic muscle thickness and echo intensity, respectively, and muscle strength as knee extension strength. These skeletal muscle characteristics were compared at four time points: on admission, after 2 weeks, after 4 weeks, and at discharge. We also explored the relationship between changes in skeletal muscle characteristics and functional recovery. RESULTS Non-paretic knee extension torque (F = 5.838, P = .001), paretic quadriceps thickness (F = 2.943, P = .039), and paretic tibialis anterior thickness (F = 4.654, P = .004) improved over time, and changes in the paretic side quadriceps thickness were significantly associated with recovery for balance ability (odds ratio, 1.05; 95% confidence interval, 1.00-1.09; P = .048). CONCLUSIONS The present study revealed that knee extension muscle strength on the non-paretic side and quadriceps and tibialis anterior thickness on the paretic side significantly improved over time and that changes in the paretic side quadriceps thickness were associated with the recovery of balance ability.
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Affiliation(s)
- Shu Tanaka
- Department of Rehabilitation, Musashimurayama Hospital, Social Medical Corporation, Yamatokai Foundation, Tokyo, Japan.,Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Daisuke Ito
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Yosuke Kimura
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.,Department of Electrical Engineering, Health and Sports Technology Course, Kanto Gakuin University, Yokohama, Japan
| | - Daisuke Ishiyama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Mizue Suzuki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Shingo Koyama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Yuya Narita
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Hiroaki Masuda
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Katsumi Suzukawa
- Department of Rehabilitation, Musashimurayama Hospital, Social Medical Corporation, Yamatokai Foundation, Tokyo, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
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Furlan JC, Pakosh M, Craven BC, Popovic MR. Insights on the Potential Mechanisms of Action of Functional Electrical Stimulation Therapy in Combination With Task-Specific Training: A Scoping Review. Neuromodulation 2021; 25:1280-1288. [PMID: 34031937 DOI: 10.1111/ner.13403] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 03/12/2021] [Accepted: 03/30/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES This scoping review was undertaken to synthetize and appraise the literature on the potential mechanisms of action of functional electrical stimulation therapy in combination with task-specific training (FEST + TST) in the rehabilitation following stroke, spinal cord injury, traumatic brain injury, or multiple sclerosis. MATERIALS AND METHODS The literature search was performed using multiple databases (including APA, PsycInfo, Medline, PubMed, EMBASE, CCRCT, and Cochrane Database of Systematic Reviews) from 1946 to June 2020. The literature search used the following terms: (spinal cord injury, paraplegia, tetraplegia, quadriplegia, stroke, multiple sclerosis, traumatic brain injury, or acquired brain injury) AND (functional electrical stimulation or FES). The search included clinical and preclinical studies without limits to language. RESULTS Of the 8209 titles retrieved from the primary search, 57 publications fulfilled the inclusion and exclusion criteria for this scoping review. While most publications were clinical studies (n = 50), there were only seven preclinical studies using animal models. The results of this review suggest that FEST + TST can result in multiple effects on different elements from the muscle to the cerebral cortex. However, most studies were focused on the muscle changes after FEST + TST. CONCLUSIONS The results of this scoping review suggest that FEST + TST can result in multiple effects on different elements of the neuromuscular system, while most research studies were focused on the muscle changes after FEST + TST. Despite the efficacy of the FEST + TST in the neurorehabilitation after CNS injury or disease, the results of this review underline an important knowledge gap with regards to the actual mechanism of action of FEST + TST.
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Affiliation(s)
- Julio Cesar Furlan
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada.,Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,KITE - Research Institute, University Health Network, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Maureen Pakosh
- Library & Information Services, Rumsey Cardiac Centre Library, University Health Network, Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Beverley Catharine Craven
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada.,Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,KITE - Research Institute, University Health Network, Toronto, ON, Canada
| | - Milos Radomir Popovic
- KITE - Research Institute, University Health Network, Toronto, ON, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
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Suzuki K, Ito T, Okada Y, Hiraoka T, Hanayama K, Tsubahara A. Preventive Effects of Repetitive Peripheral Magnetic Stimulation on Muscle Atrophy in the Paretic Lower Limb of Acute Stroke Patients: A Pilot Study. Prog Rehabil Med 2020; 5:20200008. [PMID: 32789276 PMCID: PMC7365239 DOI: 10.2490/prm.20200008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/06/2020] [Indexed: 01/31/2023] Open
Abstract
Objective: The aim of this study was to investigate the effect of repetitive peripheral magnetic
stimulation (rPMS) on muscle atrophy prevention in the rectus femoris muscle (RF) of the
paretic limb in acute stroke patients. Methods: Twelve acute stroke patients with a National Institute of Health Stroke Scale score
>5 and a motor score of the paretic lower limb >2 at admission were divided into
an intervention group (rPMS: mean age, 75±6.4 years) and a conventional care group
(non-rPMS: mean age, 62±11.8 years). Baseline measurements were performed within 4 days
of stroke onset. In the rPMS group, treatment was applied to the paretic thigh only for
2 weeks, 5 days a week, in addition to conventional care. The cross-sectional area (CSA)
of the RF was assessed in both limbs using ultrasound at baseline and 2 weeks later.
Data on patient characteristics were collected from the clinical records to assess
correlations with the CSA rate of change. Results: Patients in the rPMS group were significantly older. Although the CSA of the RF did
not change significantly on either side in the rPMS group, there was a significant
decrease in the CSA on the paretic side in the non-rPMS group. However, no significant
difference was observed in the CSA rate of change in the rPMS and non-rPMS groups. The
CSA rate of change on the paretic side correlated negatively with age in the rPMS group.
Conclusions: Our results suggest that rPMS prevents muscle atrophy more effectively in patients in
their 60s than in patients more than 70 years old.
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Affiliation(s)
- Keita Suzuki
- Department of Public Health, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.,Department of Rehabilitation, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan
| | - Tomotaka Ito
- Department of Rehabilitation, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan.,Rehabilitation Center, Kawasaki Medical School Hospital, Kurashiki, Okayama, Japan
| | - Yuji Okada
- Rehabilitation Center, Kawasaki Medical School Hospital, Kurashiki, Okayama, Japan
| | - Takashi Hiraoka
- Department of Rehabilitation, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan.,Department of Rehabilitation Medicine, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Kozo Hanayama
- Department of Rehabilitation Medicine, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Akio Tsubahara
- Department of Rehabilitation, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan
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7
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Chang MY, Lee G, Jung YJ, Park JS. Effect of Neuromuscular Electrical Stimulation on Masseter Muscle Thickness and Maximal Bite Force Among Healthy Community-Dwelling Persons Aged 65 Years and Older: A Randomized, Double Blind, Placebo-Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113783. [PMID: 32466588 PMCID: PMC7312302 DOI: 10.3390/ijerph17113783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/25/2020] [Accepted: 05/25/2020] [Indexed: 12/16/2022]
Abstract
Aim: This study investigated the effect of neuromuscular electrical stimulation (NMES) on masseter muscle thickness and maximal bite force among healthy community-dwelling elderly persons older than 65 years. Materials and methods: A total of 40 participants were randomly assigned to the experimental and placebo groups. In the experimental group, NMES was applied to both masseter muscles, and electrical signals were gradually increased until the participants felt a grabbing sensation (range 6.0–7.5 mA) in the masseter muscle. The placebo group, in contrast, underwent NMES in the same manner and procedure as the experimental group with less electrical intensity (0.5 mA). All interventions were administered five times a week for six weeks, 20 min per day. The outcomes were masseter muscle thickness assessed using ultrasound and maximal bite force using a bite force meter. The level of significance was set as p < 0.05. Results: The experimental group showed a significant increase in both masseter muscle thickness and maximal bite force as compared with the placebo group (p = 0.002 and 0.019, respectively). Moreover, the degree of change in the masseter muscle thickness and maximal bite force significantly increased in the experimental and placebo groups (p < 0.001, both). Conclusions: This study demonstrated that NMES could be an effective modality for increasing masseter muscle thickness and maximal bite force in healthy older adults.
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Affiliation(s)
- Moon-Young Chang
- Department of Occupational Therapy, Inje University, Gimhae 50834, Korea;
| | - Gihyoun Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
| | - Young-Jin Jung
- Department of Radiological Science, Health Sciences Division, Dongseo University, Busan 47011, Korea;
- Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry, Dongseo University, Busan 47011, Korea
| | - Ji-Su Park
- Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry, Dongseo University, Busan 47011, Korea
- Correspondence: ; Tel.: +82-55-320-3685
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Nozoe M, Kanai M, Kubo H, Yamamoto M, Shimada S, Mase K. Non-paretic lower limb muscle wasting during acute phase is associated with dependent ambulation in patients with stroke. J Clin Neurosci 2020; 74:141-145. [PMID: 32081597 DOI: 10.1016/j.jocn.2020.02.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 02/10/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Muscle wasting in patients with stroke is a factor for a poor functional outcome. However, there have been few studies on the relationships between lower limb muscle wasting during the acute phase and dependent ambulation. This study examined whether lower limb muscle wasting during the acute phase is associated with the dependent ambulation status at 3 months after stroke. METHODS In this observational cohort study, we measured the quadriceps muscle thickness in the paretic and non-paretic limbs within 1 and 3 weeks after admission using ultrasonography in non-ambulatory patients with acute stroke. Patients were categorized into two groups based on their ambulation ability: dependent, functional ambulation category (FAC) 0-3 and independent, FAC 4-5) at 3 months after stroke. RESULTS In total, 55 patients were included and completed follow-up, and 28 patients (51%) had an ambulation status of dependent at 3 months after stroke. Significant differences in muscle wasting were observed in the non-paretic limb (-5.5% [8.7%] : -16.8% [13.6%], independent group: dependent group, respectively, P < 0.001), but not in the paretic limb (-15.0% [14.3%] : -18.7% [15.1%], P = 0.36). Even after adjusting for covariates, muscle wasting in the non-paretic limb was a significant independent predictor of dependent ambulation (adjusted odds ratio, 0.87; 95% confidence interval, 0.76-0.99, P = 0.033). CONCLUSION Post-stroke muscle wasting in the non-paretic lower limb during the acute phase is independently associated with dependent ambulation after stroke.
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Affiliation(s)
- Masafumi Nozoe
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan.
| | - Masashi Kanai
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Hiroki Kubo
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Miho Yamamoto
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Shinichi Shimada
- Department of Neurosurgery, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Kyoshi Mase
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan
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Gong H, Jiang Q, Shen D, Gao J. Neuromuscular electrical stimulation improves exercise capacity in adult patients with chronic lung disease: a meta-analysis of English studies. J Thorac Dis 2018; 10:6722-6732. [PMID: 30746217 DOI: 10.21037/jtd.2018.11.133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Neuromuscular electrical stimulation (NMES) has been suggested as an alternative rehabilitative therapy to enhance exercise performance and skeletal muscle function in adult patients with chronic lung disease. However, the results of individual studies have been inconsistent. We performed a meta-analysis to evaluate the effectiveness of NMES with regard to increasing exercise capacity, quadriceps strength, muscle mass, cross-sectional area, and quality of life and decreasing dyspnea in adult patients with chronic lung disease. Methods A systematic search was conducted of the PubMed, Cochrane Library and EMBASE databases for randomized controlled trials (RCTs) published in English-language journals before January 2018. Data were extracted using standardized forms, and the weighted mean difference (WMD) or standardized mean difference (SMD) with 95% confidence intervals (CIs) was calculated. Results Eleven RCTs involving 368 patients were included in this meta-analysis. The pooled results showed that NMES significantly improved the 6-min walk distance (WMD: 37.93 m, 95% CI: 19.53-56.33 m; P<0.0001; P for heterogeneity =0.11; I2=47%) but not the incremental shuttle walk test (WMD: 18.18 m, 95% CI: -79.41 to 115.77 m, P=0.72; P for heterogeneity <0.0001, I2=94%) or endurance shuttle walk test (ESWT) (WMD: 96.73 m, 95% CI: -45.58 to 239.03 m, P=0.18; P heterogeneity =0.22, I2=34%). Moreover, NMES was associated with a significant improvement in quadriceps strength (SMD: 1.14, 95% CI: 0.86-1.43, P<0.00001; P heterogeneity =0.02, I2=58%). Conclusions This systemic review and meta-analysis provided evidence supporting the beneficial role of NMES in improving exercise capacity in patients with chronic respiratory disease.
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Affiliation(s)
- Haihong Gong
- Department of Respiratory Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Qinghe Jiang
- Department of Respiratory Disease, Liaocheng People's Hospital, Liaocheng 252000, China
| | - Dongchao Shen
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jinming Gao
- Department of Respiratory Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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10
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Nozoe M, Kamo A, Shimada S, Mase K. Neuromuscular electrical stimulation is ineffective for treating quadriceps muscle wasting with ruptured aneurysm: A case report. Ann Med Surg (Lond) 2018; 35:90-94. [PMID: 30294437 PMCID: PMC6170208 DOI: 10.1016/j.amsu.2018.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 08/31/2018] [Accepted: 09/15/2018] [Indexed: 11/25/2022] Open
Abstract
Introduction Neuromuscular electrical stimulation (NMES) is a preventive intervention for muscle wasting in patients with aneurysms during the acute phase; however, its efficacy still remains unclear. In this case study, we report the effects of NMES on quadriceps muscle wasting for a patient with ruptured middle cerebral artery aneurysms during the acute phase. Presentation of case A 66-year-old woman was admitted because of a ruptured middle cerebral artery aneurysm resulting from intracerebral hematoma with subarachnoid hemorrhage. The following day, the patient started undergoing 60–120-min NMES treatment for both her quadriceps muscles, which was continued for 10 days in 2 weeks. Quadriceps muscle thickness as measured by ultrasonography was decreased in both sides (26% and 35% for the right and left sides, respectively). The compound muscle action potential (CMAP) amplitude in the peroneal nerve was also decreased in both sides (73% vs 76%). Discussion The lack of efficacy of NMES in preventing muscle wasting is the decreased CMAP amplitude in this patient, which showed the possibility of existence of critical illness polyneuropathy. Conclusion NMES had no effect on quadriceps muscle wasting in a patient with ruptured middle cerebral artery aneurysms who had decreased CMAP amplitude in the peroneal nerve during the acute phase. NMES is not effective for patients with peripheral nerve conduction abnormalities. NMES is not effective for preventing muscle wasting and disability. NMES is not effective for patients with peripheral nerve conduction abnormalities. The efficacy of NMES is dependent on whether conduction abnormalities exist.
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Key Words
- CIM, critical illness myopathy
- CINM, CIP and CIM
- CIP, critical illness polyneuropathy
- CMAP, compound muscle action potential
- CSD, cross sectional diameter
- Case report
- Critical illness
- EDB, extensor digitorum brevis
- Electric stimulation therapy
- FSS-ICU, Functional Status Score for the ICU
- GCS, Glasgow coma scale
- ICU-AW, ICU-acquired weakness
- MCVs, motor conduction velocities
- MRC sum score, Medical Research Council sum score
- Muscle weakness
- NCV, nerve conduction velocity
- NMES, Neuromuscular electrical stimulation
- QMT, quadriceps muscle thickness
- RF, rectus femoris
- VI, vastus intermedius
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Affiliation(s)
- Masafumi Nozoe
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Japan
| | - Arisa Kamo
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Shinichi Shimada
- Department of Neurosurgery, Itami Kousei Neurosurgical Hospital, Itami, Japan
| | - Kyoshi Mase
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Japan
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Akazawa N, Harada K, Okawa N, Tamura K, Moriyama H. Muscle mass and intramuscular fat of the quadriceps are related to muscle strength in non-ambulatory chronic stroke survivors: A cross-sectional study. PLoS One 2018; 13:e0201789. [PMID: 30071100 PMCID: PMC6072321 DOI: 10.1371/journal.pone.0201789] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 07/23/2018] [Indexed: 11/18/2022] Open
Abstract
Objective Improving muscle mass and intramuscular fat in the mid-thigh increases the muscle strength of the paretic and non-paretic limbs in ambulatory chronic stroke survivors. There is a remarkable decrease in muscle mass and muscle strength and an increase in intramuscular fat in the quadriceps of both limbs of non-ambulatory compared with ambulatory survivors. Therefore, given that paretic lower extremity function does not recover sufficiently in the chronic phase, it may be helpful to improve muscle mass and intramuscular fat to increase muscle strength in the quadriceps of non-ambulatory chronic stroke survivors. However, these relationships remain unclear. The purpose of this study was to clarify the relationships between muscle strength, muscle mass, and intramuscular fat of the quadriceps in non-ambulatory chronic stroke survivors. Methods Study design: A cross-sectional study. Participants: Fifty non-ambulatory chronic stroke survivors. Main outcome measures: Quadriceps muscle strength was measured using a handheld dynamometer. Transverse ultrasound images were acquired using B-mode ultrasound imaging. Muscle mass and intramuscular fat of the quadriceps were assessed based on muscle thickness and echo intensity, respectively. Data analysis: Stepwise multiple regression analyses were used to identify the factors independently associated with the quadriceps muscle strength of the paretic and non-paretic limbs. To avoid multicollinearity, muscle thickness and echo intensity were entered into separate multiple regression models. Muscle thickness or echo intensity of the paretic or non-paretic limbs and other confounding factors were set as the independent variables. Results Muscle thickness was positively related and echo intensity was negatively related to the quadriceps muscle strength of the paretic and non-paretic limbs. Conclusions Muscle mass and intramuscular fat of the quadriceps are related to muscle strength in non-ambulatory chronic stroke survivors. Increasing muscle mass and decreasing intramuscular fat of the quadriceps of both limbs may improve muscle strength.
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Affiliation(s)
- Naoki Akazawa
- Department of Physical Therapy, Faculty of Health and Welfare, Tokushima Bunri University, Tokushima, Tokushima, Japan
- * E-mail:
| | - Kazuhiro Harada
- Department of Physical Therapy, Faculty of Health, Medical care, and Welfare, Kibi International University, Takahashi, Okayama, Japan
| | - Naomi Okawa
- Department of Rehabilitation, Kasei Tamura Hospital, Wakayama, Wakayama, Japan
| | - Kimiyuki Tamura
- Department of Rehabilitation, Kasei Tamura Hospital, Wakayama, Wakayama, Japan
| | - Hideki Moriyama
- Life and Medical Sciences Area, Health Sciences Discipline, Kobe University, Kobe, Hyogo, Japan
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