Effects Of Surface Electrical Stimulation Research Articles

The effects of surface electrical stimulation plus voice therapy in Parkinson's disease.

This study aimed to assess the effects of surface electrical stimulation plus voice therapy on voice in dysphonic patients with idiopathic Parkinson's disease. Patients were assigned to 3 treatment groups (n = 28 per group) and received daily treatment for 3 weeks on 5 days a week. All three groups received voice therapy (usual care). In addition, two groups received surface electrical stimulation, either motor-level or sensory-level stimulation. A standardised measurement protocol to evaluate therapeutic effects included the Voice Handicap Index and videolaryngostroboscopy. Voice Handicap Index and videolaryngostroboscopic assessment showed statistically significant differences between baseline and post-treatment across all groups, without any post-treatment differences between the three groups. Intensive voice therapy (usual care) improved idiopathic Parkinson's disease patients' self-assessment of voice impairment and the videolaryngostroboscopic outcome score. However, surface electrical stimulation used as an add-on to usual care did not improve idiopathic Parkinson's disease patients' self-assessment of voice impairment or the videolaryngostroboscopic outcome scores any further.

Effects of surface electrical stimulation during sitting on pelvic floor muscle function and sexual function in women with stress urinary incontinence

ObjectiveDysfunction of the pelvic floor muscles (PFM) is associated with sexual dysfunction in women with stress urinary incontinence (SUI). The EasyK7 device was developed to stimulate the PFM by surface electrical stimulation during sitting (SESdS). We investigated the effects of SESdS on PFM function and sexual function in women with SUI.MethodsWomen with SUI were randomized into the SESdS and control groups. PFM function and sexual function were assessed using a perineometer and the pelvic organ prolapse–urinary incontinence sexual function questionnaire (PISQ), respectively. After 8 weeks, the groups were compared using either analysis of covariance with the baseline values as covariates or the paired Student's t-test.ResultsThe final analysis included 16 subjects from each group. There were significant differences between the SESdS and control groups after the intervention, as well as within the SESdS group between the pre- and post-intervention measurements. The P-values for the differences in PFM measurements between the groups, and between the pre- and post- intervention measurements within the SESdS group, were 0.001 and 0.004 for power, 0.015 and 0.011 for strength, and 0.012 and 0.034 for endurance, respectively. In addition, in the PISQ, there were significant differences between the groups and between the pre- and post-intervention measurements within the SESdS group in the partner-related domain (between groups: P=0.003; within SESdS group: P=0.024) and total score (between groups: P<0.001; within SESdS group: P=0.001).ConclusionSESdS can improve PFM function and sexual function in women with SUI.Trial RegistrationClinical Research Information Service Identifier: KCT0003357

Which pelvic floor muscle functions are associated with improved subjective and objective symptoms after 8 weeks of surface electrical stimulation in women with stress urinary incontinence?

ObjectiveStress urinary incontinence (SUI) is defined as involuntary urine loss during effort, sneezing, or coughing. We investigated which pelvic floor muscle (PFM) functions (muscle strength, power, and endurance) are associated with improvement in subjective and objective symptoms after 8 weeks of surface electrical stimulation (SES) training. This study was performed to determine the effects of SES in the seated position on PFM functions and subjective and objective symptoms, and to identify predictors of improved subjective and objective symptoms after 8 weeks of SES training via secondary analysis of females with SUI. Study designThe study was performed between August 2018 and December 2018. Patients with SUI were randomized into an SES group (n = 17) and a control group (n = 17). Both groups were assessed pre-intervention and after 8 weeks of intervention. The outcome measures were PFM functions (strength, power, and endurance) as measured via perineometry, the score on the urogenital distress inventory-6 (UDI-6), and the ultra-short perineal pad test result. ResultsSignificant differences in all PFM functions, the UDI-6 score, and the pad weight were evident both between the groups (SES vs. control group) and within the groups (pre-SES vs. post-SES). On regression of factors predicting relative changes in subjective and objective symptoms, the relative change in PFM power accounted for 15 and 13 % of the variance in the UDI-6 score (P < 0.05) and pad weight (P < 0.05), respectively. ConclusionsSES in a seated position improved both subjective and objective symptoms in females with SUI. PFM power, the UDI-6 score, and the pad weight test result should be considered when developing intervention guidelines to improve the subjective and objective symptoms of females with SUI.

The influence of surface EMG-triggered multichannel electrical stimulation on sensomotoric recovery in patients with lumbar disc herniation: study protocol for a randomized controlled trial (RECO)

BackgroundIntervertebral disc degeneration is one of the most common reasons for chronic low back pain and sensomotoric deficits, often treated by lumbar sequestrectomy. Nevertheless, the prognostic factors relevant for time and quality of recovery, of the surgical procedure, relative to conservative treatment, remain controversial and require further investigation. Surface electrical stimulation (SES) may be an influential intervention, already showing positive impact on motor and sensory recovery in different patient groups. Since mechanisms of SES still remain unclear, further inquiry is needed.Methods/DesignThis is a prospective, monocentric, randomized, controlled clinical trial. A total of 80 adult patients suffering from a lumbar disc herniation (LDH; 40 treated surgically, 40 conservatively) are allocated in a ratio of 1:1. Patients in the treatment group will receive surface electromyography (EMG)-triggered electrical stimulation for eight weeks, whereas patients in the control group will not obtain any additional treatment. The primary outcome parameter is defined as the cold detection threshold (CDT), determined by quantitative sensory testing (QST), 24 months after intervention. Secondary outcome parameters include the inquiry of sensory nerve function by two-point discrimination and QST, the assessment of motor nerve function by manual muscle testing, and validated scales and scores. These include: the Oswestry Disability Index (ODI) and the Core Outcome Measures Index (COMI) assessing the domains pain, back-specific function, work disability, and patient satisfaction; the EQ-5D investigating the patient’s generic health status; the painDETECT questionnaire (PD-Q) to identify neuropathic pain components; and the Beck Depression Inventory (BDI) to assess severity of depression. Moreover, neurological status, pain medication usage, and blood samples (CRP, TNFα, IL-1β, IL-6) will be evaluated. Study data generation (study site) and data storage, processing, and statistical analysis are clearly separated.DiscussionThe results of the RECO study will detect the effect of EMG-triggered multichannel SES on the improvement of mechanical and thermal sensitivity and the effect on motor recovery and pain, associated with clinical and laboratory parameters. Furthermore, data comparing surgical and conservative treatment can be collected. This will hopefully allow treatment recommendations for patients with LDH accompanied by a sensomotoric deficit.Trial registrationISRCTN, ISRCTN12741173. Registered on 15 January 2017.

Urodynamic effects of electrical stimulation of the detrusor spastic bladder after spinal cord injury

Objective To observe the clinical effect of surface electrical stimulation on bladder spasm among patients with spinal cord injury, and compare it with that of therapy combining electrical stimulation with bladder function training. Methods Forty-two patients with bladder spasm after spinal cord injury were randomly divided into an experimental group (n=21) and a control group (n=21). Patients in the experimental group were further divided into three subgroups: patients with cervical spinal injury (n=7), thoracic spinal injury (n=9) and lumbar spinal injury (n=5). Both the experimental group and control group were given normal bladder function recovery exercise, while the experimental group was given the extra electrical stimulation on the surface of the sacral nerve. Urodynamic tests including the maximum detrusor pressure, bladder capacity, residual urine volume and bladder compliance were conducted for both groups before the treatment, after the first and the second 18-days of treatment and during a follow-up visit 2 months after the intervention. Results After the first course of treatment, significant differences were found in all measurements in the experimental group and most measurements of the control group except for the residual urine volume. Significant differences were found in all measurements after the second course of treatment compared to those after the first course in both groups. After the two courses of treatment and during the follow-up visit the average residual urine volume of the experiment group was significantly better than that of the control group. After the second course of treatment the average maximum detrusor pressure and bladder compliance of the experimental group were significantly better than those of the control group. Conclusion Surface electrical stimulation significantly improves the urodynamics and bladder function of patients with bladder spasm after spinal cord injury and its therapeutic effect is greater for patients with cervical and thoracic spinal injury than for those with lumber spinal injury. Key words: Spinal cord injury; Detrusor contraction; Surface electrical stimulation; Urodynamics

A two-step model to optimise transcutaneous electrical stimulation of the human upper arm

Purpose – A novel model of the upper arm under transcutaneous electrical stimulation with multi-pad electrodes is presented and experimentally validated. The model aims at simulating and analysing the effects of surface electrical stimulation on biceps brachii. The paper aims to discuss these issues. Design/methodology/approach – Both the passive properties of tissues surrounding nerve bundles and the active characteristics of the nervous system are included. The output of the proposed model is nerve recruitment and muscle contraction. Findings – Simulations and experimental tests on six healthy young adults have been conducted and results show that the proposed model gives information on electrically elicited muscle contraction in accordance with in-vivo tests and literature on motor unit recruitment order. Tests with different electrodes configurations show that the spatial distribution of active electrodes is a critical factor in electrically elicited muscle contractions, and that multi-pad electrodes can optimise the stimulation effectiveness and patient comfort with sequences of biphasic pulses of 350 μs at 30 pulses/s and threshold values of 2 mA. Originality/value – Results encourage the use of the proposed model of the upper arm as a valid and viable solution for predicting the behaviour of the neuromuscular system when surface electrical stimulation is applied, thus optimising the design of neuroprosthetics.

Effects of surface and intravaginal electrical stimulation in the treatment of women with stress urinary incontinence: randomized controlled trial

ObjectiveTo evaluate the effects of surface electrical stimulation (SES) and to compare them with the effects of the intravaginal electrical stimulation (IVES) in women with stress urinary incontinence (SUI). Study designThis randomized controlled study included 48 women aged over 50 years, who complained of SUI evaluated according to two structured questions of King's Health Questionnaire (KHQ) and who had not previously undergone physical therapy for SUI. The calculation of the sample size estimated a sample of 45 volunteers with a significance level of 5% and statistical power of 90%. The women were randomized to: Surface Electrical Stimulation Group (SESG) (n=15), Intravaginal Electrical Stimulation Group (IVESG) (n=15) and Control Group (CG) (n=15). Subjects in the intervention groups were treated with the same parameters of electrical stimulation for 12 sessions. The SESG had four silicone electrodes fixed in the suprapubic and ischial tuberosity regions. The IVES group used an intravaginal electrode. The CG did not receive any treatment during the corresponding time. They were evaluated before and after treatment by a physical therapist who was blind to group allocation. The primary outcomes were urinary leakage, pressure and strength of pelvic floor muscle (PFM) contraction. The secondary outcome was quality of life (QOL) evaluated by KHQ. Forty-five women completed the study and were included in the analysis. Statistical analysis was performed using the Wilcoxon test for intragroup analysis and Kruskal–Wallis and Mann–Whitney tests for intergroup analysis (p<0.05). ResultsThere was significant improvement in urinary loss and pressure of contraction in the SESG and IVESG. PFM strength increased only in the IVESG. Intergroup analysis found differences after the treatment in: urinary leakage between the SESG and CG (p<0.001) and the IVESG and CG (p<0.001). Regarding QOL, there was significant reduction in the incontinence impact, limitations of daily activities, physical limitation, emotion, sleep and disposition and severity domains in the SESG (all p<0.02) and IVESG (all p<0.04) after the treatments. ConclusionSES and IVES are important treatments to improve the SUI. Both improved the QOL, urinary leakage, and strength and pressure of PFM contraction.

Surface electrical stimulation in dysphagic parkinson patients: A randomized clinical trial

A new treatment for oropharyngeal dysphagia in Parkinson's disease was evaluated in the present study. Prospective randomized controlled trial. The study describes the effects of surface electrical stimulation (SES) of the neck (submental region) in dysphagic Parkinson patients using different intensities of electrical current. Quasi-random allocation was performed when assigning patients to treatment groups. Three groups consisting of dysphagic patients with idiopathic Parkinson's disease (N = 90) received daily treatment for 15 days with periods of no treatment during the weekend. All three received traditional logopedic dysphagia treatment. In addition, two groups received SES, either motor-level or sensory-level stimulation. A standardized measurement protocol, including fiber optic endoscopic evaluation of swallowing (FEES) and videofluoroscopy of swallowing (VFS), was performed before and after therapy. A team of experienced raters was blinded to the treatment group and to the moment of measurement. Intrarater and interrater reliability were calculated. Using proportional odds models (POMs), some of the visuoperceptual ordinal outcome variables showed significant improvement in all groups following treatment. Following 15 days of SES of the submental region, few significant effects were found, suggesting a therapy effect of traditional logopedic dysphagia treatment without any additional influence of SES. On the grounds of this study, it is concluded that further research is needed on the exact mechanism of SES and its effects on the neural pathways involved in swallowing.

Effects of surface electrical stimulation in older women with stress urinary incontinence: A randomized controlled pilot study

ObjectiveThe objective of this study was to evaluate the effects of surface electrical stimulation in elderly women with stress urinary incontinence (SUI) as compared to no treatment. Materials and methodsThis randomized controlled pilot study included women over the age of 60 years, with at least one episode of stress urinary leakage during the previous month. Fourteen women were allocated according to a computer generated randomization list in two groups: surface electrical stimulation (SES), and control group (CG). The women in the SES group were treated with surface electrical stimulation using four electrodes, during six weeks with two weekly sessions of 20min each. They were evaluated before and after treatment primary outcome, urinary leakage, and secondary outcomes, King's Health Questionnaire, pressure perineometry, and subjective satisfaction. ResultsFor the urinary leakage, there was a significant decrease in SES group after treatment (p=.017). Significant differences were observed between the SES group and CG in the evaluation after treatment (p<.01; effect size: −1.38; 95% confidence interval from 1.18 to 14.14). No significant differences were observed in both groups for the outcome pelvic floor muscle pressure. In the evaluation of quality of life, a significant reduction of score in the gravity domain was observed for the SES group after treatment (p=.017). ConclusionThe results of this study showed that surface electrical stimulation in elderly women with SUI can be an effective method for the improvement of urinary leakage.

Efectos de la electroestimulación superficial en las mujeres mayores con incontinencia urinaria de esfuerzo: estudio piloto aleatorio controlado

ObjectiveThe objective of this study was to evaluate the effects of surface electrical stimulation in elderly women with stress urinary incontinence (SUI) as compared to no treatment. Materials and methodsThis randomized controlled pilot study included women over the age of 60 years, with at least one episode of stress urinary leakage during the previous month. Fourteen women were allocated according to a computer generated randomization list in two groups: surface electrical stimulation (SES), and control group (CG). The women in the SES group were treated with surface electrical stimulation using four electrodes, during six weeks with two weekly sessions of 20minutes each. They were evaluated before and after treatment primary outcome, urinary leakage, and secondary outcomes, King's Health Questionnaire, pressure perineometry, and subjective satisfaction. ResultsFor the urinary leakage, there was a significant decrease in SES group after treatment (P=.017). Significant differences were observed between the SES group and CG in the evaluation after treatment (P<.01; effect size: -1,38; 95% confidence interval from 1,18 to 14,14). No significant differences were observed in both groups for the outcome pelvic floor muscle pressure. In the evaluation of quality of life, a significant reduction of score in the gravity domain was observed for the SES group after treatment (P=.017). ConclusionThe results of this study showed that surface electrical stimulation in elderly women with SUI can be an effective method for the improvement of urinary leakage.

The Effect of Surface Electrical Stimulation on Swallowing in Dysphagic Parkinson Patients

Surface electrical stimulation has been applied on a large scale to treat oropharyngeal dysphagia. Patients suffering from oropharyngeal dysphagia in the presence of Parkinson’s disease have been treated with surface electrical stimulation. Because of controversial reports on this treatment, a pilot study was set up. This study describes the effects of a single session of surface electrical stimulation using different electrode positions in ten patients with idiopathic Parkinson’s disease (median Hoehn and Yahr score: II) and oropharyngeal dysphagia compared to ten age- and gender-matched healthy control subjects during videofluoroscopy of swallowing. Three different electrode positions were applied in random order per subject. For each electrode position, the electrical current was respectively turned “on” and “off” in random order. Temporal, spatial, and visuoperceptual variables were scored by experienced raters who were blinded to the group, electrode position, and status (on/off) of the electrical current. Interrater and interrater reliabilities were calculated. Only a few significant effects of a single session of surface electrical stimulation using different electrode positions in dysphagic Parkinson patients could be observed in this study. Furthermore, significant results for temporal and spatial variables were found regardless of the status of the electrical current in both groups suggesting placebo effects. Following adjustment for electrical current status as well as electrode positions (both not significant, P > 0.05) in the statistical model, significant group differences between Parkinson patients and healthy control subjects emerged. Further studies are necessary to evaluate the potential therapeutic effect and mechanism of electrical stimulation in dysphagic patients with Parkinson’s disease.

Functional Changes in the Care-needing Elderly after Surface Electrical Stimulation to the Abdomen.

Strength of the trunk muscles is a key component of motor control, but it declines easily with the process of aging and/or disuse. To investigate the effects of surface electrical stimulation (ES) to the abdominal muscles and the motor performance for care-needing elderly. Controlled trial. Twenty-one elderly people (60-90 years) with care-needing, who were admitted to a nursing home or hospital for daily care and their score of Barthel Index had been stable from 55.3 ± 19.4 to 55.3 ± 19.8 during 3 months before intervention. Common physical/occupational therapy was performed for all of the subjects during the study period. ES was applied to the abdomen of 15 subjects (ES group) twice a day for 8 weeks. Functional measurements were performed before and after beginning of the study with some parameters as follows: grip strength; movement time for sitting up (MSU); maximum walking speed (WS). No significant differences between two groups were noted for characteristics at baseline. In the ES group, MSU (from 21.1 ± 21.4 to 10.4 ± 8.3 sec) significantly improved (p < 0.05) after 8weeks. WS (from 17.7 ± 12.1 to 24.3 ± 15.3 m/min) were also improved (p < 0.05) after 8 weeks. A limitation of this study was the small sample size. ES to the abdominal area has the potential to improve motor function in the care-needing elderly through reinforcement of the abdominal muscles.

Stimulating Swallowing: Essential Central and Peripheral Nervous System Targets

Stimulating Swallowing: Essential Central and Peripheral Nervous System Targets

Effect of Surface Electrical Stimulation of Suprahyoid Muscles on Hyolaryngeal Movement

Objective. This study aims to investigate the movements of hyolaryngeal structures during the surface electrical stimulation of suprahyoid muscles and to compare these with movements during liquid swallowing. Materials and methods. Twelve volunteers without dysphagia participated in this study. Volunteers swallowed 5mL of diluted barium liquid, which was recorded videofluoroscopically. They then received surface electrical stimulation at midpoints between the chin and the bilateral edges of the hyoid, and movements were again recorded. Two-dimensional motion analysis was performed and displacements of the hyoid and of subglottic air-column and epiglottic rotations were calculated. Movements caused by surface stimulation were compared to those during liquid swallowing. Results. Elevation and anterior excursion of the hyoid by electrical stimulation were 66.8% and 45.2% of those during liquid swallowing, respectively, and rotation of the epiglottis by electrical stimulation was 24.0% of that during liquid swallowing. Elevation and anterior excursion of the subglottic air column during liquid swallowing were 24.1mm and 4.6mm, respectively, compared with 9.6mm and 1.9mm during electrical stimulation. All the movements during electrical stimulation were significantly smaller than those that occurred during liquid swallowing (p<0.05). Trajectories of the hyoid and larynx during electrical stimulation were smaller than but similar to those that occurred during liquid swallowing. Conclusion. This study suggests that surface electrical stimulation of suprahyoid muscles causes the elevation and anterior excursion of hyolaryngeal structures, as is observed during normal physiologic swallowing, although the movements involved were smaller. Further studies are required to determine the effect of synchronized electrical stimulation on dysphagia patients with reduced laryngeal elevation to allow the development of a swallow-assisting neural orthosis.

Effortful Swallowing Training Coupled with Electrical Stimulation Leads to an Increase in Hyoid Elevation During Swallowing

We tested the effects of surface electrical stimulation on hyoid elevation during swallowing in healthy volunteers. Sixteen people were recruited and randomly divided into two groups. Electrical stimulation was applied to the skin above the infrahyoid muscle in the experimental group. The stimulation current was adjusted until muscle contraction occurred and the hyoid bone became depressed. Participants were asked to swallow forcefully so as to elevate the hyolaryngeal complex when the stimulation began. The same experiment was performed in the control group except the intensity of stimulation was adjusted to just above the sensory threshold. The two groups received ten 20-min treatments over 2 weeks. We recorded the myoelectrical activity of the submental muscles and the amount of hyoid bone movement at three time points (pretreatment, immediately post-treatment, and 2 weeks after treatment). In the experimental group, the amount of y-axis hyoid bone excursion was increased immediately post-treatment, but this effect faded within 2 weeks following the treatment. Myoelectrical activity was not affected by either treatment regimen. We concluded that effortful swallowing coupled with electrical stimulation increases the degree of hyoid elevation in healthy volunteers. It needs to be evaluated for its long-term effectiveness in increasing the elevation of hyolaryngeal complex.

The Effect of Surface Electrical Stimulation on Vocal Fold Position

Closure of the true and false vocal folds is a normal part of airway protection during swallowing. Individuals with reduced or delayed true vocal fold closure can be at risk for aspiration and may benefit from intervention to ameliorate the problem. Surface electrical stimulation is currently used during therapy for dysphagia, despite limited knowledge of its physiological effects. Prospective single effects study. The immediate physiological effect of surface stimulation on true vocal fold angle was examined at rest in 27 healthy adults using 10 different electrode placements on the submental and neck regions. Fiberoptic nasolaryngoscopic recordings during passive inspiration were used to measure change in true vocal fold angle with stimulation. Vocal fold angles changed only to a small extent during two electrode placements (P < or = .05). When two sets of electrodes were placed vertically on the neck, the mean true vocal fold abduction was 2.4 degrees; while horizontal placements of electrodes in the submental region produced a mean adduction of 2.8 degrees (P = .03). Surface electrical stimulation to the submental and neck regions does not produce immediate true vocal fold adduction adequate for airway protection during swallowing, and one position may produce a slight increase in true vocal fold opening.

The effect of surface electrical stimulation on hyolaryngeal movement in normal individuals at rest and during swallowing

Surface electrical stimulation is currently used in therapy for swallowing problems, although little is known about its physiological effects on neck muscles or swallowing. Previously, when one surface electrode placement was used in dysphagic patients at rest, it lowered the hyolaryngeal complex. Here we examined the effects of nine other placements in normal volunteers to determine 1) whether movements induced by surface stimulation using other placements differ, and 2) whether lowering the hyolaryngeal complex by surface electrical stimulation interfered with swallowing in healthy adults. Ten bipolar surface electrode placements overlying the submental and laryngeal regions were tested. Maximum tolerated stimulation levels were applied at rest while participants held their mouths closed. Videofluoroscopic recordings were used to measure hyoid bone and subglottic air column (laryngeal) movements from resting position and while swallowing 5 ml of liquid barium, with and without stimulation. Videofluoroscopic recordings of swallows were rated blind to condition using the National Institutes of Health-Swallowing Safety Scale. Significant (P < 0.0001) laryngeal and hyoid descent occurred with stimulation at rest. During swallowing, significant (P <or= 0.01) reductions in both the larynx and hyoid bone peak elevation occurred during stimulated swallows. The stimulated swallows were also judged less safe than nonstimulated swallows using the National Institutes of Health-Swallowing Safety Scale (P = 0.0275). Because surface electrical stimulation reduced hyolaryngeal elevation during swallowing in normal volunteers, our findings suggest that surface electrical stimulation will reduce elevation during swallowing therapy for dysphagia.

Effects of Surface Electrical Stimulation Both at Rest and During Swallowing in Chronic Pharyngeal Dysphagia

We tested two hypotheses using surface electrical stimulation in chronic pharyngeal dysphagia: that stimulation (1) lowered the hyoid bone and/or larynx when applied at rest, and (2) increased aspiration, penetration, or pharyngeal pooling during swallowing. Bipolar surface electrodes were placed on the skin overlying the submandibular and laryngeal regions. Maximum tolerated levels of stimulation were applied while patients held their mouth closed at rest. Videofluoroscopic recordings were used to measure hyoid movements in the superior-inferior and anterior-posterior dimensions and the subglottic air column position while stimulation was on or off. Patients swallowed 5 ml liquid when stimulation was off, at low sensory stimulation levels, and at maximum tolerated levels (motor). Speech pathologists, blinded to condition, tallied the frequency of aspiration, penetration, pooling, and esophageal entry from videofluorographic recordings of swallows. Only significant (p = 0.0175) hyoid depression occurred during stimulation at rest. Aspiration and pooling were significantly reduced only with low sensory threshold levels of stimulation (p = 0.025) and not during maximum levels of surface electrical stimulation. Those patients who had reduced aspiration and penetration during swallowing with stimulation had greater hyoid depression during stimulation at rest (p = 0.006). Stimulation may have acted to resist patients' hyoid elevation during swallowing.

Effects of surface electrical stimulation on the muscle–tendon junction of spastic gastrocnemius in stroke patients

Purpose: The purpose of this study was to explore the effects of spasticity suppression by surface electrical stimulation (ES) on the muscle–tendon junction of spastic gastrocnemius muscles in stroke.Methods: Twenty-four neurologically stable stroke patients (aged 41 – 69 years, 12 – 35 months post-stroke), with spasticity graded 2 or 3 on the modified Ashworth scale, were recruited and divided into two groups. In the ES group, each patient received 20 min of surface ES once daily, 6 days per week for 1 month. In the control group, ES was used with stimulation intensity kept at zero. To evaluate the therapeutic effect, the modified Ashworth scale, Fmax/Mmax ratio, H-reflex latency, H-reflex recovery curve, and the 10-m walking time were tested before and after the 1-month treatment.Results: In the ES group, the modified Ashworth Scale showed a trend toward reduced spasticity after 1 month of treatment. The Fmax/Mmax ratio decreased from 8.10% ± 4.84% to 4.00% ± 1.36%; the H-reflex latency increased from 28.87 ± 2.45 ms to 29.40 ± 2.57 ms; the H-reflex recovery curves indicated a downward shift; and the 10-metre walking time significantly decreased after ES. In the control group, none of the measures showed a statistically significant change.Conclusions: In the study, we demonstrated a way to suppress spasticity at a metameric site and to increase walking speed effectively by applying surface ES on the muscle–tendon junction of spastic gastrocnemius muscles.

State of the art of functional electrical stimulation in France.

After summarizing the various physiological and functional effects of surface electrical stimulation, the authors review its main applications, including chronic-use or training orthoses, neuromuscular facilitation and automatic cyclical stimulation. Each of the therapeutic principles is illustrated by discussion of an example, with particular emphasis being placed on the practical methods of application that determine the success of the programme.