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Galvão WR, Castro Silva LK, Formiga MF, Thé GAP, Faria CDCDM, Viana RT, Lima LAO. Cycling using functional electrical stimulation therapy to improve motor function and activity in post-stroke individuals in early subacute phase: a systematic review with meta-analysis. Biomed Eng Online 2024; 23:1. [PMID: 38167021 PMCID: PMC10762955 DOI: 10.1186/s12938-023-01195-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 12/16/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Stroke necessitates interventions to rehabilitate individuals with disabilities, and the application of functional electrical stimulation therapy (FEST) has demonstrated potential in this regard. This study aimed to analyze the efficacy and effectiveness of cycling using FEST to improve motor function and lower limb activity in post-stroke individuals. METHODS We performed a systematic review according to the recommendations of the PRISMA checklist, searching MEDLINE, Cochrane, EMBASE, LILACS, and PEDro databases by July 2022, without any date or language limitations. Studies were selected using the following terms: stroke, electrical stimulation therapy, cycling, and clinical trials. Randomized or quasi-randomized clinical trials that investigated the effectiveness of cycling using FEST combined with exercise programs and cycling using FEST alone for motor function and activity in subacute post-stroke individuals were included. The quality of included trials was assessed using the PEDro scores. Outcome data were extracted from eligible studies and combined in random-effects meta-analyses. The quality of evidence was determined according to the Grading of Recommendations Assessment, Development, and Evaluation system. RESULTS Five randomized clinical trials involving 187 participants were included. Moderate-quality evidence indicates that cycling using FEST combined with exercise programs promotes relevant benefits in trunk control (MD 9 points, 95% CI 0.36-17.64) and walking distance (MD 94.84 m, 95% CI 39.63-150.05, I = 0%), the other outcomes had similar benefits. Cycling using FEST alone compared to exercise programs promotes similar benefits in strength, balance, walking speed, walking distance, and activities of daily living. CONCLUSION This systematic review provides low- to moderate-quality evidence that cycling using FEST may be an effective strategy to consider in improving motor function and activity outcomes for post-stroke individuals in the early subacute phase. REVIEW REGISTRATION PROSPERO (CRD42022345282).
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Affiliation(s)
- Wagner Rodrigues Galvão
- Master Program in Physiotherapy and Functioning, Federal University of Ceará, Fortaleza, Brazil.
| | | | - Magno Ferreira Formiga
- Master Program in Physiotherapy and Functioning, Federal University of Ceará, Fortaleza, Brazil
| | | | | | - Ramon Távora Viana
- Department of Physiotherapy, Federal University of Ceará, Fortaleza, Brazil
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Siegel ML, Gullestad Binder EM, Dahl HSJ, Czajkowski NO, Critchfield KL, Høglend PA, Ulberg R. Therapeutic Atmosphere in Psychotherapy Sessions. Int J Environ Res Public Health 2020; 17:ijerph17114105. [PMID: 32526849 PMCID: PMC7312465 DOI: 10.3390/ijerph17114105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/28/2020] [Accepted: 06/02/2020] [Indexed: 11/22/2022]
Abstract
There is uncertainty concerning what the active ingredients in psychotherapy are. The First Experimental Study of Transference interpretations (FEST) was a randomized controlled trial of the effects of transference work (TW) in psychodynamic psychotherapy. Women with low quality of object relations (QOR) showed a large positive effect of transference work, while men with high QOR showed a slight negative effect. The present study aimed to expand the knowledge from the FEST by investigating the therapeutic atmosphere with Structural Analysis of Social Behavior (SASB). Two-way ANOVAs were conducted to investigate differences between SASB cluster scores between subgroups. The therapeutic atmosphere was characterized by Protect–Trust, Affirm–Disclose and Control–Submit. Multilevel modeling was used to assess the relationship between a therapist variable and outcomes for men and women. Contrary to expectations, no significant differences in therapeutic atmosphere between subgroups (with or without TW in women with low QOR and men with high QOR) were observed using the process measure SASB.
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Affiliation(s)
- Marte L. Siegel
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373 Oslo, Norway; (H.S.J.D.); (N.O.C.)
- Correspondence: (M.L.S.); (E.M.G.B.)
| | - Eva M. Gullestad Binder
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373 Oslo, Norway; (H.S.J.D.); (N.O.C.)
- Correspondence: (M.L.S.); (E.M.G.B.)
| | - Hanne Sofie J. Dahl
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373 Oslo, Norway; (H.S.J.D.); (N.O.C.)
- Vestfold Hospital Trust, Halfdan Wilhelmsens alle 17, 3103 Tønsberg, Norway
| | - Nikolai O. Czajkowski
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373 Oslo, Norway; (H.S.J.D.); (N.O.C.)
| | - Kenneth L. Critchfield
- Department of Graduate Psychology, James Madison University, Harrisonburg, VA 22807, USA;
| | - Per A. Høglend
- Division of Mental Health and Addiction, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway; (P.A.H.); (R.U.)
| | - Randi Ulberg
- Division of Mental Health and Addiction, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway; (P.A.H.); (R.U.)
- Department of Psychiatry, Diakonhjemmet Hospital, Forskningsveien 7, 0370 Oslo, Norway
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Kapadia N, Zivanovic V, Moineau B, Downar J, Zariffa J, Popovic MR. Functional electrical stimulation of the facial muscles to improve symptoms in individuals with major depressive disorder: pilot feasibility study. Biomed Eng Online 2019; 18:109. [PMID: 31727068 PMCID: PMC6857333 DOI: 10.1186/s12938-019-0730-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 11/06/2019] [Indexed: 11/23/2022] Open
Abstract
Background Currently, the mainstay of treatment in patients diagnosed with major depressive disorder (MDD) requiring medical attention is second generation anti-depressants. However, about 40% of patients treated with second-generation anti-depressants do not respond to initial treatment and approximately 70% do not achieve remission during the first-step treatment. There are a few non-pharmacological options available, but none have shown consistently positive results. There is a need for an intervention that is relatively easy to administer, produces consistently positive results and is associated with minimal side effects. In the current study, we assessed the feasibility of using transcutaneous Functional Electrical Stimulation Therapy (FEST) of the facial muscles, as a tool for improving depressive symptoms in individuals with MDD. Results Ten (10) individuals with moderate to severe MDD received three FEST sessions/week for a minimum of 10 to a maximum of 40 sessions. All study participants completed the required 10 therapy sessions, and 5 of the 10 participants completed additional 30 (totalling 40) FEST sessions. There were no adverse events or concerns regarding compliance to therapy. We found statistically significant improvements on Hamilton Rating Scale for Depression (HDS) and Inventory of Depressive Symptomatology (IDS) measures. However, no significant improvements were found on Positive and Negative Affect Scale and 10-point Visual Analogue Scale scales. Participants reported improvements in sleeping patterns, and this correlated with statistically significant improvements on sleep parameters of HDS and IDS measures. Conclusion This study indicates that facial FEST is an acceptable, practical, and safe treatment in individuals with MDD. We provide preliminary evidence to show improvements in depressive symptoms following a minimum of 10 FEST sessions.
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Affiliation(s)
- Naaz Kapadia
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada. .,Rehabilitation Engineering Laboratory, Lyndhurst Centre, KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.
| | - Vera Zivanovic
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Bastien Moineau
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Myant Inc., Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Jonathan Downar
- Department of Psychiatry, University of Toronto, Toronto, Canada.,MRI Guided rTMS Clinic, Toronto Western Hospital, University Health Network, Toronto, Canada
| | - Jose Zariffa
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Rehabilitation Engineering Laboratory, Lyndhurst Centre, KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,Edward S. Rogers Sr. Department of Electrical and Computer Engineering, University of Toronto, Toronto, Canada
| | - Milos R Popovic
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
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