Effect Of Percutaneous Electrical Stimulation Research Articles

Effect of percutaneous electrical stimulation at the Baliao point on preventing postpartum urinary retention after labor analgesia

BACKGROUND Anesthetic drugs used in labor analgesia also paralyze the bladder muscle by blocking the sacral plexus, thereby affecting maternal postpartum spontaneous urination and increasing the risk of postpartum urinary retention (PUR). AIM To analyze the effect of percutaneous electrical stimulation at the Baliao point combined with biofeedback therapy for PUR prevention. METHODS We selected 182 pregnant women who received labor analgesia in obstetrics between June 2022 and December 2023. They were divided into the combined therapy group (transcutaneous electrical stimulation of the Baliao point combined with biofeedback therapy) and the control group (biofeedback therapy alone). The first spontaneous urination time, first postpartum urine volume, bladder residual urine volume, postpartum hemorrhage volume, pre-urination waiting time, PUR incidence, adverse reactions, and the intervention’s clinical efficacy were compared between the two groups. RESULTS The first spontaneous urination time after delivery was more delayed (2.92 ± 1.04 h vs 3.61 ± 1.13 h, P < 0.001), with fewer initial postpartum urine (163.54 ± 24.67 mL vs 143.72 ± 23.95 mL, P < 0.001), more residual bladder urine (54.81 ± 10.78 mL vs 65.25 ± 13.52 mL, P < 0.001), more postpartum bleeding (323.15 ± 46.95 mL vs 348.12 ± 45.03 mL, P = 0.001), and longer waiting time for urination (0.94 ± 0.31 min vs 1.29 ± 0.42 min, P < 0.001), in the control group than in the combined therapy group. The control group also had higher PUR incidence (4.65% vs 15.85%, P = 0.016). Both groups had no adverse reactions, but the clinical total efficacy rate of the intervention was significantly higher in the combined therapy group than in the control group (95.35% vs 84.15%, P = 0.016). CONCLUSION Percutaneous electrical stimulation of the Baliao point combined with biofeedback can significantly promote postpartum micturition of parturients with labor analgesia, thereby effectively preventing PUR occurrence.

Effect of percutaneous electrical stimulation with high-frequency alternating currents at 30 kHz on the sensory-motor system.

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. 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. 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. 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. https://clinicaltrials.gov/ct2/show/NCT04884932, identifier NCT04884932.

Percutaneous Trigeminal Nerve Stimulation Induces Cerebral Vasodilation in a Dose-Dependent Manner.

The trigeminal nerve directly innervates key vascular structures both centrally and peripherally. Centrally, it is known to innervate the brainstem and cavernous sinus, whereas peripherally the trigemino-cerebrovascular network innervates the majority of the cerebral vasculature. Upon stimulation, it permits direct modulation of cerebral blood flow (CBF), making the trigeminal nerve a promising target for the management of cerebral vasospasm. However, trigeminally mediated cerebral vasodilation has not been applied to the treatment of vasospasm. To determine the effect of percutaneous electrical stimulation of the infraorbital branch of the trigeminal nerve (pTNS) on the cerebral vasculature. In order to determine the stimulus-response function of pTNS on cerebral vasodilation, CBF, arterial blood pressure, cerebrovascular resistance, intracranial pressure, cerebral perfusion pressure, cerebrospinal fluid calcitonin gene-related peptide (CGRP) concentrations, and the diameter of cerebral vessels were measured in healthy and subarachnoid hemorrhage (SAH) rats. The present study demonstrates, for the first time, that pTNS increases brain CGRP concentrations in a dose-dependent manner, thereby producing controllable cerebral vasodilation. This vasodilatory response appears to be independent of the pressor response induced by pTNS, as it is maintained even after transection of the spinal cord at the C5-C6 level and shown to be confined to the infraorbital nerve by administration of lidocaine or destroying it. Furthermore, such pTNS-induced vasodilatory response of cerebral vessels is retained after SAH-induced vasospasm. Our study demonstrates that pTNS is a promising vasodilator and increases CBF, cerebral perfusion, and CGRP concentration both in normal and vasoconstrictive conditions.

Effectiveness of percutaneous electrical nerve stimulation for musculoskeletal pain: A systematic review and meta-analysis.

To evaluate the effects of percutaneous electrical stimulation (PENS) alone or as an adjunct with other interventions on pain and related disability in musculoskeletal pain conditions. Search of MEDLINE, EMBASE, AMED, CINAHL, EBSCO, PubMed, PEDro, Cochrane Library, SCOPUS and Web of Science databases. Randomized controlled trials where at least one group received any form of PENS for musculoskeletal condition. Studies had to include humans and collect outcomes on pain and related disability in musculoskeletal pain. Risk of bias was assessed by the Cochrane Guidelines, the quality of evidence by using the GRADE approach. Standardized mean differences (SMD) were calculated. Sixteen studies were included and included heterogeneous musculoskeletal conditions with short- or midterm follow-ups. PENS alone had a large effect (SMD -1.22, 95% CI -1.66 to -0.79) on pain and a small effect (SMD -0.33, 95% CI -0.61 to -0.06) on related disability at short-term as compared with sham. A moderate effect of PENS alone (SMD -0.71, 95% CI -1.23 to -0.19) on pain when compared with other interventions was observed. The inclusion of PENS with other interventions had a moderate effect for decreasing pain at short- (SMD -0.70, 95% CI -1.02 to -0.37) and midterm (SMD -0.68, 95% CI -1.10 to -0.27). No effect at midterm (SMD -0.21, 95% CI -0.52 to 0.10) on related disability was seen. The risk of bias was generally low; but the heterogenicity of the results downgraded the level of evidence. There is low level of evidence suggesting the effects of PENS alone or in combination for pain, but not related disability, in musculoskeletal pain. Therapy, level 1a. Registration number: CRD42019131331. This meta-analysis investigating the effectiveness of PENS for the management of pain and related disability in musculoskeletal pain conditions found that PENS could decrease level of pain intensity but not relateddisability in musculoskeletal pain disorders.

Effectiveness of transcutaneous electrical stimulation for refractory lower urinary tract symptoms in elderly female patients

Objective To assess the clinical effects of percutaneous electrical stimulation on refractory lower urinary tract symptoms in elderly female patients. Methods Elderly female patients with refractory lower urinary tract symptoms from July 2016 to December 2017 were recruited.According to cystoscopy results, patients were divided into an interstitial cystitis group, a suspected interstitial cystitis group and an overactive bladder group.All patients received 3 courses of transcutaneous low-frequency electrical stimulation treatment in the suprapubic bladder area, with 40 min per time, 4 times per day, 7 days per course.Bladder diaries, pain scores and overactive bladder symptom scores were recorded before and after treatment. Results A total of 27 patients with a mean age of 74.3 years were enrolled.Under the cystoscope with water dilatation, 9 cases were found to have mucosal bleeding, with mast cells detected in mucosal specimens examined via electron microscopy(in the interstitial cystitis group), 5 cases had superficial mucosal congestion(in the suspected interstitial cystitis group)and 13 cases showed normal imaging(in the overactive bladder group). In the interstitial cystitis group, the 24-h urinary frequency improved from 15.4±2.5 times before treatment to 11.9±2.0 times after treatment(P 0.05]. In the suspected interstitial cystitis group, the 24-h urinary frequency improved from (11.8±1.5) times before treatment to (8.4±1.1) times after treatment, and pain scores decreased from (6.4±1.1) to (4.2±1.1)(P<0.05). In the overactive bladder group, the 24-h urinary frequency improved from (19.2±2.0) times before treatment to (15.9±1.3) times after treatment(P<0.05), and the overactive bladder symptom score(OABSS)decreased from (8.9±1.6) to (5.9±1.6)(P<0.05). Conclusions Percutaneous electrical stimulation is an easy, safe and effective treatment in elderly females with refractory lower urinary tract symptoms, and should be encouraged in clinical practice. Key words: Urinary, incontinence; Electrical stimulation therapy

Effect of Percutaneous Electrical Stimulation of the Leg Muscles under Acute Normobaric Hypoxic Environment on Blood Glucose Concentration

Effect of Percutaneous Electrical Stimulation of the Leg Muscles under Acute Normobaric Hypoxic Environment on Blood Glucose Concentration

Transcutaneous electrical acupoint stimulation (TEAS) ameliorates chemotherapy-induced bone marrow suppression in lung cancer patients.

To investigate the effect of percutaneous electrical stimulation on chemotherapy-induced bone marrow suppression in patients with lung cancer. From December 2014 to August 2015, one hundred ninety-one non-small cell lung cancer patients with chemotherapy naive were randomly divided into control group, medication group, and transcutaneous electrical acupoint stimulation (TEAS) group. Patients with the control group received routine nursing care, the medication group was treated by oral administration of prophylactic agents, and TEAS group received electrical stimulation of acupoints including Dazhui (DU14), Geshu (BL17), Zusanli (ST36), Sanyinjiao (SP6), and Hegu (LI4). The primary end point was the blood routine indexes and secondary end point was the degree of comfort. The white blood cell in the TEAS group was significantly higher than the control group on day 8 and day 14 (P<0.05). The platelet count in the TEAS group was significantly higher than control group on day 5, day 8 and day 11 (P<0.05). The comfort score in the TEAS group was significantly higher than control group on day 8 (P<0.05). Percutaneous electrical stimulation of acupoints could prevent chemotherapy-induced bone marrow suppression in lung cancer patients and ensure a smooth continuation of chemotherapy.

54P Correlation of Raman and NIR spectroscopy for diagnosis of peripheral lung cancer

Background: TCM syndrome typing of chemotherapy-induced bone marrow suppression is Qi and blood deficiency and Qi and Yin deficiency [15]. According to the TCM channel and collateral theory, Dazhui (DU14), Geshu (BL17), Zusanli (ST36), Sanyinjiao (SP6), and Hegu (LI4) play a role in enriching blood and treating leucopenia. Although the literature reports no incompatibility between these acupoints, their combined effects have not been studied yet. The objective is to investigate the effect of percutaneous electrical stimulation on chemotherapy-induced bone marrow suppression in patients with lung cancer. Methods: From December 2014 to August 2015, one hundred ninety-one non-small cell lung cancer patients with chemotherapy naive were randomly divided into transcutaneous electrical acupoint stimulation (TEAS) group, medication group, and control group. Patients with TEAS group received electrical stimulation of acupoints including Dazhui (DU14), Geshu (BL17), Zusanli (ST36), Sanyinjiao (SP6), and Hegu (LI4), the medication group was treated by oral administration of prophylactic agents, and the control group received routine nursing care. The primary end point was the blood routine indexes and secondary end point was the degree of comfort. Results: The white blood cell in the TEAS group was significantly higher than the control group on day 8 and day 14 (P < 0.05). The platelet count in the TEAS group was significantly higher than control group on day 5, day 8 and day 11 (P < 0.05). The comfort score in the TEAS group was significantly higher than control group on day 8 (P < 0.05). Conclusions: Percutaneous electrical stimulation of acupoints could prevent chemotherapy-induced bone marrow suppression in lung cancer patients and ensure a smooth continuation of chemotherapy. Legal entity responsible for the study: Lili Hou Funding: Shanghai Health Talent Development Fund Disclosure: All authors have declared no conflicts of interest.

Reconstructive Effects of Percutaneous Electrical Stimulation Combined with GGT Composite on Large Bone Defect in Rats

Previous studies have shown the electromagnetic stimulation improves bone remodeling and bone healing. However, the effect of percutaneous electrical stimulation (ES) was not directly explored. The purpose of this study was to evaluate effect of ES on improvement of bone repair. Twenty-four adult male Sprague-Dawley rats were used for cranial implantation. We used a composite comprising genipin cross-linked gelatin mixed with tricalcium phosphate (GGT). Bone defects of all rats were filled with the GGT composites, and the rats were assigned into six groups after operation. The first three groups underwent 4, 8, and 12 weeks of ES, and the anode was connected to the backward of the defect on the neck; the cathode was connected to the front of the defect on the head. Rats were under inhalation anesthesia during the stimulation. The other three groups only received inhalation anesthesia without ES, as control groups. All the rats were examined afterward at 4, 8, and 12 weeks. Radiographic examinations including X-ray and micro-CT showed the progressive bone regeneration in the both ES and non-ES groups. The amount of the newly formed bone increased with the time between implantation and examination in the ES and non-ES groups and was higher in the ES groups. Besides, the new bone growth trended on bilateral sides in ES groups and accumulated in U-shape in non-ES groups. The results indicated that ES could improve bone repair, and the effect is higher around the cathode.

Acute effect of percutaneous electrical stimulation of knee extensor muscles on isokinetic torque and power production performance

The aim of the present study was to examine the acute effect of a brief submaximal percutaneous electrical stimulation (PES) of the knee extensor (KE) muscles as a conditioning activity on the isokinetic peak torque (PT) and average power (AP). Eighteen male students aged 20-25 years performed maximal voluntary concentric isokinetic knee extensions at angular velocities of 60 and 180°/s in control (CON) trial (without prior PES application), followed by a PES trial after 30 min rest period. In PES trial, a conditioning submaximal (25% of the maximal voluntary isometric contraction force) isometric tetanic contraction of the KE muscles was induced by a 7 s direct PES at 100 Hz, interspersed after 3 min with testing of voluntary isokinetic performance. No significant differences in isokinetic knee extension PT and AP were observed between PES and CON trial at 60°/s. However, a significantly greater (p < 0.05) isokinetic PT (8.9%) and AP (8.2%) were observed in PES trial compared to CON trial at 180°/s. In conclusion, application of a brief high-frequency submaximal PES may enhance isokinetic strength and power of the KE at a moderate but not at a low angular velocity.

Effects of submental electrical stimulation during sleep on upper airway patency in patients with obstructive sleep apnea.

We examined the effects of percutaneous electrical stimulation of the genioglossus in six patients with obstructive sleep apnea syndrome (OSAS) during sleep and investigated the possible applicability of this procedure as a treatment of OSAS. Six patients with OSAS were polysomnographically studied in the supine position during all-night sessions with and without electrical stimulation of the genioglossus. Using an apnea demand-type stimulator that we developed, electrical pulses of 0.5 ms (repetition rate, 50 Hz) and 15 to 40 V were delivered through bipolar electrodes (10 mm in diameter) attached to the skin of the submental region when apnea lasted more than 5 s, and was stopped immediately after breathing resumed or after 10 s at the longest. With submental stimulation, the apnea index, apnea time/total sleep time, longest apnea duration, and the number of times per hour that oxygen saturation dropped below 85% decreased significantly compared with those on control nights. The lowest arterial oxygen saturation and the duration of sleep stages III and IV increased significantly. The stimulation employed did not cause arousal, and it did not affect blood pressure or heart rate significantly. These findings show that submental stimulation decreases the incidence of apnea episodes and promotes deeper sleep without accompanying serious side effects, suggesting that the apnea demand-type stimulator may be a noninvasive and effective treatment for OSAS.

Effects of therapeutic percutaneous electrical stimulation of atrophic human quadriceps on muscle composition, protein synthesis and contractile properties

The effects of percutaneous electrical stimulation (70 V, 300 microseconds pulses at 30 Hz) on muscle composition and rate of protein synthesis were studied in seven patients with quadriceps atrophy secondary to unilateral osteoarthritis of the knee (stimulated group). Quadriceps were stimulated on the affected side for 1 h per day. The results were compared to those from seven patients who did not use a muscle stimulator (control group), in whom muscle biopsy at surgery provided evidence of wasting of tissue protein on the side of osteoarthritis (normal leg 608 +/- 266 micrograms protein micrograms-1 DNA, affected leg 256 +/- 100 micrograms protein micrograms-1 DNA, means +/- SD, P less than 0.05; type I fibre diameters: normal 53.2 +/- 6.7 microns, affected 43.8 +/- 4.0 microns, P less than 0.05). In patients who had received stimulation there was no residual difference between the legs in either muscle protein concentration (normal 411 +/- 168 micrograms protein micrograms-1 DNA, affected 373 +/- 112 micrograms protein micrograms-1 DNA) or fibre diameter (type I diameters: normal 56.1 +/- 7.8 microns, affected 58.0 +/- 10.7 microns). Stimulation did not influence the ratios of muscle force elicited by acute stimulation at 20 and 50 Hz (normal 75 +/- 15%, affected 79 +/- 15%), or rates of muscle relaxation (percentage losses of tetanic force 10 ms-1: normal 7.66 +/- 1.2%, affected 8.67 +/- 2.2%).(ABSTRACT TRUNCATED AT 250 WORDS)

PREVENTION OF DISUSE MUSCLE ATROPHY BY MEANS OF ELECTRICAL STIMULATION: MAINTENANCE OF PROTEIN SYNTHESIS

The effect of percutaneous electrical stimulation in preventing immobilisation-induced muscle atrophy was determined from measurements of quadriceps mass, composition, and rate of protein synthesis in seven men who had a fracture of one tibia immobilised in a long-leg cast for 6 weeks. These features were compared with those of fourteen men with similar injuries who did not use an electrical stimulator. In men who did not use the stimulator, quardriceps cross-sectional area (CSA) at midthigh, measured by ultrasonography, fell by a mean (SD) 17 (10)% and the rate of muscle protein synthesis was 23 (10)% lower on the immobilised than on the control side (0·037 [0·016] vs 0·048 [0·02]%/h). In contrast, in those who used the stimulator, quadriceps CSA (55·5 [7·3]) cm 2 control leg, 50·9 [9·0] cm 2 immobilised leg) and the rate of muscle protein synthesis (0·053 [0·009] %/h control leg, 0·059 [0·012] %/h immobilised leg) were similar on the two sides. The results suggest that brief periods of low-voltage percutaneous electrical stimulation will reduce quadriceps atrophy secondary to knee immobilisation, and that the mechanism includes prevention of the fall in muscle protein synthesis that usually occurs on immobilisation.

Therapeutic Electrical Stimulation of the Lower Limb by Epimysial Electrodes

The problem of inadequate hip stability prevents many patients with head trauma, stroke, or spinal injury from balancing on one limb in order to take a step. There is no adequate orthotic substitute for hip instability, and electrical stimulation with surface electrodes cannot effectively activate the deep hip muscles. This report describes a clinical program in which electrical stimulation via surgically placed electrodes is combined with routine tendon lengthening and transfers and physical therapy. The electrodes are fixed to the epimysium and the leads directed subcutaneously to exit the skin at a common site for attachment to a commercially available stimulator. Preliminary results indicate that functional muscle contractions of the deep hip muscles can be obtained with epimysial electrodes and that stimulation can be used to augment walking ability. The results demonstrate the safety and effectiveness of percutaneous electrical stimulation and contribute to the development of a practical, implanted stimulation system for patients who do not regain hip instability after an upper motor neuron lesion.

Effects of percutaneous electrical stimulation on functional ability, plasma creatine kinase, and pectoralis musculature of normal and genetically dystrophic chickens

The breast musculature of genetically dystrophic Line 413 and genetically related normal Line 412 chickens were treated in three separate trials with high-frequency electrical stimulation (ES). Beginning on days 7 or 14 ex ovo, each bird received three ES treatments per week. Each stimulation cycle repeated five times per day consisted of 15 s “on” followed by 50 s “off.” In the third trial only, the birds were additionally treated beginning day 3 ex ovo with either leucine (100 mg/kg) or the proteinase inhibitor Ep475 (10 mg/kg). ES significantly delayed the onset of righting disability in the dystrophic chickens. However, this improvement was temporary and could be masked by single treatments of either leucine or Ep475. Plasma creatine kinase activities were increased generally in both the stimulated normal and dystrophic birds. In two trials ES increased the relative muscle mass, and in one trial increased protein. ES had little effect on normal muscle mass or protein. However, ES treatment together with either leucine or Ep475 appeared to improve both normal and dystrophic muscle mass and protein. Furthermore ES decreased dystrophic muscle calcium but not acetylcholinesterase activity. On the other hand, ES had no effect on the total normal muscle calcium but increased normal acetylcholinesterase values. In both normal and dystrophic muscle samples, ES treatment in combination with leucine appeared to increase the mean muscle fiber diameters and number of myonuclei, and in the case of the dystrophic muscle, appeared to decrease the relative proportion of vacuolated, degenerating, and intensely oxidative histochemical fibers. In general, stimulation (especially in combination with leucine) appears to alter in varying degrees the phenotypic expression of the muscle disease exhibited in the dystrophic chicken.