Efficacy Of Neuromuscular Electrical Stimulation Research Articles

Efficacy of neuromuscular electrical stimulation and interrupted serial casting in children with spastic diplegia

ObjectivesThis research was aimed at comparing the effects of neuromuscular electrical stimulation (NMES) combined with interrupted serial casting (SC) versus SC alone on various aspects of lower limb function in children with diplegic cerebral palsy. SC is a clinical technique used to increase passive range of motion (ROM), decrease hypertonicity, and improve walking in children with cerebral palsy (CP). MethodsThis randomized comparative trial involved 33 children with diplegic CP, who were randomly assigned to group A or group B at recruitment. Group A received SC along with a customized physical therapy program, whereas group B received the same interventions as group A along with NMES applied through cast windows during casting. Evaluations were based on ROM, the Modified Tardieu Scale, handheld dynamometer measurements, and the Observational Gait Scale. Assessments were conducted before and after 8 weeks of intervention. ResultsBoth groups exhibited significant improvements in dorsiflexion ROM, popliteal angle, gastrocnemius dynamic spasticity, and hamstring dynamic spasticity after the intervention (P = 0.0001 for all). However, significant differences (P < 0.05) in dorsiflexor strength, knee extensor strength, and observational gait scale score were observed between groups after the intervention, favoring group B. ConclusionsThe use of NMES during SC may help overcome the substantial decrease in strength resulting from casting, thus achieving less reduction of tone, improving ROM without significantly decreasing strength, and attaining greater improvements in gait function.

Efficacy of neuromuscular electrical stimulation for thoracic and abdominal surgery: A systematic review and meta-analysis.

This systematic review and meta-analysis examined the efficacy of neuromuscular electrical stimulation (NMES) on lower limb muscle strength and health-related quality of life (HR-QOL) after thoracic and abdominal surgery. We searched the Cochrane Central Register of Controlled Trials, MEDLINE via PubMed, Excerpta Medica Database via Elsevier, Physiotherapy Evidence Database, Cumulative Index to Nursing and Allied Health Literature, World Health Organization International Clinical Trials Registry Platform via their dedicated search portal, and ClinicalTrials.gov on November 2021 and updated in April 2023 to identify randomized controlled trials that examined the effects of NMES after thoracic and abdominal surgery. The primary outcomes were lower limb muscle strength, HR-QOL, and adverse events. We used the Cochrane Risk of Bias Tool and the Grading of Recommendations, Assessment, Development, and Evaluation approach to assess the certainty of evidence. A total of 18 randomized control trials involving 915 participants, including 10 on cardiovascular surgery, two on pulmonary surgery, five on digestive system surgery, and one on other surgery, were included. NMES slightly increased lower limb muscle strength and adverse events in cardiovascular surgery. Adverse events (hypotension, pain, and muscle discomfort) occurred in seven patients. HR-QOL was measured in two studies on cardiovascular surgery, but these were not pooled due to concept heterogeneity. Overall, NMES slightly increases lower limb muscle strength after cardiovascular surgery without serious adverse events. However, higher-quality randomized control trials in thoracic and abdominal surgeries are needed.

Efficacy of neuromuscular electrical stimulation with combined low and high frequencies on body composition, peripheral muscle function and exercise tolerance in patients with chronic kidney disease undergoing haemodialysis: a protocol for a randomised, double-blind clinical trial

IntroductionNeuromuscular electrical stimulation (NMES) as an adjunctive strategy to increase isolated muscular strength or endurance has been widely investigated in patients with chronic kidney disease (CKD) undergoing haemodialysis (HD). However,...

Neuromuscular Electrical Stimulator as a Protective Treatment against Intensive Care Unit Muscle Wasting in Sepsis/Septic Shock Patients.

To investigate the efficacy of neuromuscular electrical stimulation (NMES) application in preventing muscle wasting in intensive care unit (ICU) patients diagnosed with sepsis/septic shock. A single-centre, unblinded, parallel-group, prospective, randomised clinical study. Ondokuz Mayıs University, Faculty of Medicine Hospital, Level 3 ICU, between October 28th 2018, and October 1st, 2020. Eighty patients from a single centre who were diagnosed with sepsis/septic shock, followed up at level 3 ICU, and met the criteria were included. The patients were evaluated in 2 groups: One who received physiotherapy alone (n=40) and the other who received physiotherapy + NMES (n=40). The development of intensive care unit-muscle wasting was evaluated in patients of both groups. Muscle wasting was identified by anthropometric and ultrasonographic measurements. The day the patients were diagnosed with sepsis was determined as the first day and the bilateral anthropometric and ultrasonographic measurements of the biceps brachii and rectus femoris muscles were obtained on days 3, 7, 14, 21, and 28. There was no significant difference between the groups in the ultrasonographic and anthropometric measurements on days 1, 3, and 7 (p>0.005). However, the ultrasonographic measurements of the group that received physiotherapy + NMES demonstrated a significantly lower loss in the upper extremities on days 14 and 21 compared to the group that received physiotherapy alone (p=0.003 and p=0.028, respectively). No significant difference was found in the anthropometric measurements. The NMES, which have been increasingly used as new treatment protocols in the prevention of ICU-AW, yield favourable results in patients with sepsis/septic shock. Intensive care unit, Acquired weakness, Neuromuscular electrical stimulation, Muscle wasting, Sepsis.

O101 Increased contractile activity through electrical stimulation attenuates postoperative loss of muscle mass and function, even in the presence of inadequate nutrition

Abstract Introduction Significant muscle atrophy occurs after major abdominal surgery. Lack of physical activity and protein intake may play a significant role. This study assesses the efficacy of neuromuscular electrical stimulation (NMES) in attenuating loss of muscle mass and function following open colorectal resection. Methods Fifteen patients were recruited, and their lower limbs randomised to control (CON) or NMES (STIM). Vastus Lateralis (VL) cross sectional area (CSA), muscle thickness (MT) and knee extensor strength (KES) were measured preoperatively and repeated on postoperative day (POD) 5. Dietary intake was recorded, and nutritional intake calculated. Fifteen minutes of NMES was applied to the quadriceps of the STIM leg twice a day on POD 1–4. All outcomes were analysed using linear mixed model approaches. The study was approved by the NHS REC (ref 20/EM/069). Results NMES significantly reduced the loss of CSA (mean difference (MD) 1.18, 95%CI: 0.75–1.61, p&amp;lt;0.001), MT (MD 0.12, 95%CI: 0.04–0.2, p=0.001) and KES (MD 4.48, 95%CI: 0.00–8.97, p=0.03). Total energy and protein intakes over POD1 - 4 were 42.6% (± 19.7) and 21.1% (± 11.4) of the ESPEN recommended daily amount for perioperative patients. No adverse events occurred, and patients reported that NMES caused minimal or no discomfort. Conclusion NMES has been demonstrated to reduce loss of muscle mass and function following major abdominal surgery and may be an important tool in aiding recovery to normal functional state. Further studies should establish the efficacy of bilateral whole-leg NMES for improving patient centred outcomes. Take-home message Loss of muscle mass and function after major abdominal surgery causes significant morbidity. Neuromuscular electrical stimulation reduces this muscle loss and should be investigated further as a potential therapy.

Efficacy of neuromuscular electrical stimulation of calf muscles on nocturnal symptoms and quality of life in asthmatic children.

To determine whether neuromuscular electrical stimulation of calf muscles could improve nocturnal symptoms and quality of life in asthmatic children. Sixty children (8-12 years) with moderate asthma were randomly allocated to three groups (A, B, and C). The three groups completed 12 weeks of supervised breathing exercises for 30 min. In addition, group A completed neuromuscular electrical stimulation of the calf muscles and group B completed aerobic exercise in the same period. The intervention was conducted five days a week for 12 consecutive weeks. Pre-and post-treatment evaluations involved pulmonary function tests, the Children's Asthma Control Questionnaire, calf muscle isometric muscle force, six-minute walk test, and Pediatric Asthma Quality of Life Questionnaire. A significant increase in all measured variables was recorded in all groups in favor of group A (p < 0.001). However, calf muscle isometric muscle strength, and nocturnal symptoms were non-significant in group C (p > 0.05). There was a significant difference between groups A and C in all measured variables (p < 0.001) in favor of group A. Significant differences between groups B and C in all measured variables (p < 0.001) in favor of group B were also noted. No significant differences were seen between groups A and B (p > 0.05). Neuromuscular electrical stimulation of calf muscles is an excellent adjunct to breathing exercise programs in improving nocturnal symptoms and quality of life in asthmatic children. Moreover, it can serve as a considerable alternative to traditional physical training in periods of disease exacerbation.

Effect of neuromuscular electrical stimulation associated with swallowing-related muscle training for post-stroke dysphagia: A protocol for systematic review and meta-analysis.

Background:Swallowing dysfunction is a common dysfunction after stroke, and its incidence exceeds 50%. Aspiration pneumonia and malnutrition induced by dysphagia not only cause psychological shock to patients after stroke, but also burden the medical payment. Neuromuscular electrical stimulation, which stimulates the cortex and cortical bulb pathways to improve swallowing function, has been one of the emerging treatments for the post-stroke deglutition disorder. These therapy operators require the proficiency in professional knowledge, limiting clinical large sample studies, so there is an absence of evidence-based medicine. The research is to evaluate the effectiveness of neuromuscular electrical stimulations combined with swallowing-related muscle training to treat swallowing dysfunction after stroke.Methods:Computer retrieval performed in the 9 databases, including PubMed, Embase, Web of science, Cochrane Library, ClinicalTrials, China Biomedical Literature Database (CBM), China Knowledge Network Database (CNKI), Wanfang Database (WanFang), and China VIP Database (VIP). Taking the published literature from the establishment of the database until December 20, 2020. Literature searching is related to neuromuscular electrical stimulation randomized controlled trials on the effect of swallowing in stroke. In addition, we will do the manual search in Baidu Academic and Google Academic database as a supplementary search. The correlative randomized controlled clinical studies retrieval time range from the establishment of the database to December 20, 2020. Two investigators will screen the literature according to the inclusion and exclusion criteria independently, during that period they will evaluate the quality of the included studies and extract data from studies. The extracted data are dichotomous data will be represented by relative risk, continuous data will be represented by mean difference or standard mean deviation. If there exists heterogeneity and the final data summary analysis select random effect model. On the contrary, the fixed effect model is selected. Then, RevMan5.3 software was used when analyzing included literature. Meanwhile, the analysis results were illustrated by drawing.Results:This review will summarize available trials aimed at providing a comprehensive estimation of effectiveness of neuromuscular electrical stimulation associated with swallowing muscle training for post-stroke dysphagia.Conclusion:This review based on a comprehensive analysis of currently published randomized controlled trials on post-stroke dysphagia, that provide reliable evidence-based medicine evidence for the efficacy of neuromuscular electrical stimulation associated with swallowing rehabilitation training.Registration number:INPLASY202110009.

&lt;p&gt;Effectiveness of Neuromuscular Electrical Stimulation on Post-Stroke Dysphagia: A Systematic Review of Randomized Controlled Trials&lt;/p&gt;

The purpose of this review was to summarize the latest best scientific evidence on the efficacy of neuromuscular electrical stimulation on swallowing function in dysphagic stroke patients. A comprehensive systematic search of literature published between November 2014 and May 2020 was performed using the following electronic databases: PubMed/Medline, CINAHL, PEDro, Science Direct, Google Scholar, EMBASE, and Scopus. Only randomized controlled trials (RCT) evaluating the effect of neuromuscular electrical stimulation on swallowing function in dysphagic stroke patients were included. Physiotherapy Evidence Database (PEDro) has been used to evaluate the risk of bias of included trials. This review was reported in accordance with PRISMA statement guideline. The methodological quality of the studies was determined using PEDro scale and GRADE approach. Evidence of overall quality was graded from moderate to high. Eleven RCTs involving 784 patients were analyzed. The primary outcome measures of this review were functional dysphagia scale (FDS) and standard swallowing assessment. This review found neuromuscular electrical stimulation (NMES) coupled with traditional swallowing therapy could be an optional intervention to improve swallowing function after stroke in rehabilitation department.

Effects of Transcutaneous Neuromuscular Electrical Stimulation on Swallowing Disorders: A Systematic Review and Meta-Analysis.

The aim of the study was to evaluate the efficacy of transcutaneous neuromuscular electrical stimulation on swallowing disorders. MEDLINE/PubMed, Embase, CENTRAL, Web of science, and PEDro were searched from their earliest record to August 1, 2019. All randomized controlled trials and quasi-randomized controlled trial were identified, which compared the efficacy of neuromuscular electrical stimulation plus traditional therapy with traditional therapy in swallowing function. The Grading of Recommendations Assessment, Development and Evaluation approach was applied to evaluate the quality of evidence. Eight randomized controlled trials and three quasi-randomized controlled trials were included. These studies demonstrated a significant, moderate pooled effect size (standard mean difference = 0.62; 95% confidence interval = 0.06 to 1.17). Studies stimulating suprahyoid muscle groups revealed a negative standard mean difference of 0.17 (95% confidence interval = -0.42, 0.08), whereas large effect size was observed in studies stimulating the infrahyoid muscle groups (standard mean difference = 0.89; 95% confidence interval = 0.47 to 1.30) and stimulating the suprahyoid and infrahyoid muscle groups (standard mean difference = 1.4; 95% confidence interval = 1.07 to 1.74). Stimulation lasting 45 mins or less showed a large, significant pooled effect size (standard mean difference = 0.89; 95% confidence interval = 0.58 to 1.20). The quality of evidences was rated as low to very low. There is no firm evidence to conclude on the efficacy of neuromuscular electrical stimulation on swallowing disorders. Larger-scale and well-designed randomized controlled trials are needed to reach robust conclusions.

Does Neuromuscular Electrical Stimulation Benefit Patients With Head and Neck Cancer Treated With Radiation Therapy?

Purpose This article is a review of the evidence for using neuromuscular electrical stimulation (NMES) as a treatment for dysphagia when given to head and neck cancer patients with dysphagia secondary to radiation therapy. Method The rationale for using NMES for dysphagia in this population will be summarized. Recent studies will then be reviewed for evidence of efficacy of NMES when given to patients post–radiation therapy or during radiation therapy. Conclusion Evidence to date suggests no benefit from electrical stimulation when used therapeutically postradiotherapy. There are too few studies to date that have looked at NMES during radiotherapy to make any conclusions. Further studies are warranted.

Effects of quadriceps muscle neuromuscular electrical stimulation in living donor liver transplant recipients: phase-II single-blinded randomized controlled trial

Objective: To evaluate the efficacy of neuromuscular electrical stimulation on quadriceps muscle strength and thickness in liver transplantation patients. Design: Phase-II, randomized, parallel-group, allocation-concealed, assessor-blinded, single-center controlled trial. Setting: Inpatient rehabilitation sector. Subjects: Patients following living donor liver transplantation. Interventions: The quadriceps muscle stimulation and the control groups received bilateral muscle electrical stimulation on the quadriceps and tibialis anterior muscles, respectively. Neuromuscular electrical stimulation sessions in both groups were conducted for 30 minutes per session, once per day for five weekdays over four weeks by a physical therapist. Main measures: Quadriceps muscle strength and quadriceps muscle thickness. Results: Neuromuscular electrical stimulation was applied to the quadriceps muscles group (n = 23) or the tibialis anterior muscle in the control group (n = 22). The decrease in quadriceps muscle thickness differed significantly between both groups on postoperative day 30 (median −3 vs −8, P < 0.01). The changes in predicted quadriceps strength and 6 minutes walking distance were not significantly different between groups (quadriceps strength median −12% vs −5%, P = 0.40; 6 minutes walking distance median −18 vs −21 m, P = 0.74). Conclusion: Neuromuscular electrical stimulation of the quadriceps muscle for liver transplantation recipients was able to maintain the quadriceps muscle thickness after surgery. Future larger scale studies are needed to consider the effectiveness of neuromuscular electrical stimulation and how to incorporate this intervention in the overall strategy of the physical therapy program.

Efficacy of neuromuscular electrical stimulation on Wilson's disease patients with dysphagia.

[Purpose] Dysphagia is a neurological symptom that is observed in more than half of patients with Wilson’s disease. It is often associated with aspiration pneumonia, dehydration, and malnutrition, resulting in drastic reduction of the quality of life. Neuromuscular electrical stimulation could be an adjunct therapy for dysphagia treatment. However, there is limited data about the application of NMES for dysphagia in Wilson’s disease. Thus, we explored the potential application of NMES for dysphagia treatment in Wilson’s disease. [Participants and Methods] Sixty Wilson’s disease patients who suffered from dysphagia were randomized into two groups. Swallowing function training was taught to the control group (n=30) while Neuromuscular electrical stimulation therapy was given to treatment group (n=30). Eight weeks post treatment, using the water swallow test and the Standardized Swallowing Assessment, the swallowing function was determined. [Results] None of the patients experienced discomfort before, during or after the intervention. After 8 weeks of therapy, when compared to the control, an increased improvement in swallowing function was noted for the treatment group. [Conclusion] Neuromuscular electrical stimulation treatment can improve swallowing function in Wilson’s disease patients afflicted with dysphagia. Therefore, it has the potential to be a form of therapy in clinical practice.

A Top-Down versus Bottom-Up Approach to Lower-Extremity Motor Recovery and Balance Following Acute Stroke: A Pilot Randomized Clinical Trial

Abstract: Neuromuscular electrical stimulation (NMES) uses electric current to produce contractions of paralyzed or paretic muscles. Mirror therapy (MT) is a cognitively induced intervention that introduces visual illusion of the paretic limb through movements of the healthy limb with external feedback that is communicated with a mirror. Both NMES and MT have been found to be effective adjuvant treatments for motor and functional recovery in stroke rehabilitation. The present study compares the efficacy of NMES and MT for lower-extremity (LE) motor recovery and balance among stroke survivors. We studied 30 stroke patients who were referred for rehabilitation (onset < 3 wk) and used Brunnstrom LE recovery stages 3 and higher. Subjects were randomized into two groups, and each received an eclectic approach for 30 min/d for 6 d to remediate LE recovery. In addition, group A (n = 15) received 30 min of surface NMES training for six major LE paretic muscle groups, and group B (n = 15) received 30 min of MT sessions. NMES had greater change scores compared to those of the MT group, as follows: LE subscale of the Fugl-Meyer Assessment (FMA-LE), 25.12 ± 3.01 vs. 23.31 ± 2.38; Berg Balance Scale (BBS), 35.12 ± 4.61 vs. 34.68 ± 5.42; and Barthel Index (BI), 40.00 ± 10.32 vs. 37.18 ± 7.73. Among groups, no significance was found for FMA-LE (p = 0.09), BBS (p = 0.80), or BI (p = 0.39). We conclude that an eclectic approach is an effective adjunct treatment in very early phases of poststroke rehabilitation, regardless of NMES or MT use

Comparison of the Efficacy of Neuromuscular Electrostimulation and Interval Exercise Training in Early Rehabilitation of Patients Hospitalized with Decompensation of Chronic Heart Failure

Neuromuscular electrical stimulation (NMES) of large muscle groups in patients with stable chronic heart failure (CHF) increases physical work capacity and muscle strength. The safety and efficacy of short courses of NMES in patients with decompensated CHF has not been studied. The aim of the study was to compare the impact of leg NMES, interval bicycle training, and conventional treatment on the functional capacity and quality of life in patients hospitalized with decompensation of CHF. A total of 51 patients (84.3% of men; mean age, 62.5 ± 3.3 years) hospitalized with decompensated CHF were divided into three groups: optimal pharmacological therapy (OPT) + three weeks of NMES of thigh and shin muscles starting within the first three days after admission (n = 10), OPT + three weeks of bicycle exercise training (BET) starting on the fifth to seventh day (n = 20), and the control group of OPT only (n = 21). At baseline and after the three-week symptom-limited cardiopulmonary exercise test, 6-min walk test, Duke Activity Status Index (DASI) and quality of life assessment by the Minnesota Living with Heart Failure Questionnaire (MLHFQ) were performed. Patients in the NMES and BET groups presented with similar increases in the 6-min walk distance, plus 65.0 (50.0; 112.5) and 53.0 (51.0; 78; 0) m; DASI, plus 8.6 (5.5; 11.8) and 8.0 (4.5; 9.0) points; and VO2peak, plus 1.9 (0.3; 3.2) and 2.2 (0.7; 3.2) mL/(min kg), respectively. In the control group, only the 6-min walk distance increased significantly (+21 m). The improvement in the MLHFQ score was observed in all the three groups: maximal in the BET group and minimal in the NMES group. Three weeks of leg muscle electrical stimulation and bicycle training provide similar improvement in physical capacity, daily activity, and the quality of life in patients hospitalized for severe CHF. The efficacy of NMES is comparable with low to moderate intensity interval bicycle training and well tolerated by patients.

Efficiency of Neuromuscular Electrical Stimulation and Transcutaneous Nerve Stimulation on Hemiplegic Shoulder Pain: A Randomized Controlled Trial

ObjectiveTo compare the efficacy of neuromuscular electrical stimulation (NMES) and transcutaneous nerve stimulation (TENS) on hemiplegic shoulder pain (HSP). DesignThis is a prospective randomized controlled trial. SettingA rehabilitation hospital. ParticipantsParticipants (N=90) were randomized into NMES (n=36), TENS (n=36), or control groups (n=18). InterventionsNMES (15Hz, pulse width 200μs) was applied to supraspinatus and deltoids (medial and posterior parts), whereas TENS (100Hz, pulse width 100μs) was used on the same areas. The surface electrodes were placed near the motor points of the supraspinatus and medial or posterior bundle of deltoids. The 4-week treatment consisted of 20 sessions, each session composed of 1 hour of stimulation per day. Routine rehabilitation program without any stimulation was administered to the control and the NMES/TENS groups. Numerical rating scale (NRS), active/passive range of motion (AROM/PROM) of shoulder, upper extremity Fugl-Meyer Assessment (FMA), modified Ashworth scale (MAS), Barthel Index (BI), and stroke-specific quality of life scale (SSQOLS) were assessed in a blinded manner at baseline, 2, 4, and 8 weeks after treatment, respectively. Main Outcome MeasuresThe primary endpoint was the improvement from baseline in NRS for HSP at 4 weeks. ResultsNRS scores in NMES, TENS, and control groups had decreased by 2.03, 1.44, and 0.61 points, respectively after 4 weeks of treatment, with statistically significant differences among the 3 groups (P<.001). The efficacy of the NMES group was significantly better than that of the TENS group (P=.043). Moreover, the efficacy of NMES and TENS groups was superior to that of the control group (P<.001, P=.044, respectively). The differences in the therapeutic efficacy on shoulder AROM/PROM, FMA, MAS, BI, and SSQOLS scores were not significant among the 3 groups. ConclusionsTENS and NMES can effectively improve HSP, the efficacy of NMES being distinctly superior to that of TENS in maintaining long-term analgesia. However, NMES was not more efficacious than the TENS or control group in improving the shoulder joint mobility, upper limb function, spasticity, the ability of daily life activity, and stroke-specific quality of life in HSP patients.

Efficacy of neuromuscular electrical stimulation in improving the negative psychological state in patients with cerebral infarction and dysphagia

Objective To observe the improvement of negative affect disorders in patients with cerebral infarction and dysphagia by neuromuscular electrical stimulation.Methods One hundred and twelve patients with cerebral infarction and dysphagia were selected and randomized into treatment (n = 59) and control (n = 53) groups. Similar swallowing function was found in both groups before treatment: (1) Water-drinking test in the treatment group proved swallowing function Level III in 24 cases, Level IV in 22 cases and Level V in 13 cases; (2) in the control group, swallowing function was Level III in 21 cases, Level IV in 20 cases and Level V in 12 cases. Both groups received conventional drug therapy and swallowing training. The treatment group additionally received neuromuscular electrical stimulation. Both groups underwent water-drinking test evaluation, Hamilton Anxiety Scale test, and Hamilton Depression Scale test before and after treatment.Results After two courses of treatment, the rate of improvement in swallowing function was 88.1% in the treatment group while 69.8% in the control group. Somatic anxiety, psychogenic anxiety and total scores in the Hamilton Anxiety Scale in the treatment group were improved to varying degrees compared to the control group (P < 0.01). Anxiety, cognitive disorder, psychomotor retardation and total scores in the Hamilton Depression Scale in the treatment group were improved to varying degrees compared to the control group (P < 0.05).Conclusion Patients with cerebral infarction and dysphagia have varying degrees of anxiety, depression, and other negative affect disorders, which could be minimized by neuromuscular electrical stimulation in conjunction with conventional therapy.

Therapeutic efficacy of neuromuscular electrical stimulation and electromyographic biofeedback on Alzheimer's disease patients with dysphagia.

To study the therapeutic effect of neuromuscular electrical stimulation and electromyographic biofeedback (EMG-biofeedback) therapy in improving swallowing function of Alzheimer's disease patients with dysphagia.A series of 103 Alzheimer's disease patients with dysphagia were divided into 2 groups, among which the control group (n = 50) received swallowing function training and the treatment group (n = 53) received neuromuscular electrical stimulation plus EMG-biofeedback therapy. The mini-mental state scale score was performed in all patients along the treatment period. Twelve weeks after the treatment, the swallowing function was assessed by the water swallow test. The nutritional status was evaluated by Mini Nutritional Assessment (MNA) as well as the levels of hemoglobin and serum albumin. The frequency and course of aspiration pneumonia were also recorded.No significant difference on mini-mental state scale score was noted between 2 groups. More improvement of swallowing function, better nutritional status, and less frequency and shorter course of aspiration pneumonia were presented in treatment group when compared with the control group.Neuromuscular electrical stimulation and EMG-biofeedback treatment can improve swallowing function in patients with Alzheimer's disease and significantly reduce the incidence of adverse outcomes. Thus, they should be promoted in clinical practice.

Neuromuscular electrical stimulation promotes rehabilitation in obstructive pulmonary disease

Objective To explore the efficacy of neuromuscular electrical stimulation (NMES) in treating severe and chronic obstructive pulmonary disease (COPD). Methods Seventy-eight COPD patients were randomly divided into an NMES group of 38 and an exercise therapy group of 32. In addition to the routine drug therapy and basic rehabilitation training, the NMES group received 8 weeks of NMES of the lower limbs while the exercise group was provided with strength and endurance training of the lower limbs, also for 8 weeks. Before and after the 8 weeks of treatment, pulmonary function was tested along with isokinetic quadriceps strength, cardiopulmonary capacity, and lung capacity using Saint George′s respiratory questionnaire (SGRQ). Results The two groups showed no significant difference in any of the measurements before the treatment. After the treatment, forced expiratory volume in 1 second of (FEV1), FEV1/forced vital capacity (FVC), FEV1 in percentage of the predicted value, medical research council dyspnea scale (MRC) score and the 6-minute walk distance (6MWD) improved in both groups. However, the average body mass index and 6 minute walk distance differed significantly between the groups after the treatment. The quadriceps′ peak torque increased after the treatment in both groups, but the average in the exercise group was significantly higher than that in the NMES group. VO2max and Wmax also increased significantly in both groups, and the average time to exhaustion increased significantly in the exercise group. Significant improvement was observed in the BODE assessment after the intervention for both groups. Conclusion Neuromuscular electrical stimulation is as effective as therapeutic exercise in promoting the rehabilitation of severe COPD patients. However, lower limbs exercise is still the first choice in managing such patients. Key words: Chronic obstructive pulmonary disease; Endurance training; Strength training; Neuromuscular electrical stimulation

Efficacy of Neuromuscular Electrical Stimulation on Vastus Medialis Obliqus in Patellofemoral Pain Syndrome: A Double Blinded Randomized Controlled Trail

Background: Neuromuscular Electrical Stimulation (NEMS) had found to be an effective treatment intervention for improving functional abilities in many neurological conditions. But, there is lack of literature about the role of NMES in Patellofemoral Pain Syndrome (PFPS) and existing studies show contradictory results. Objectives: To evaluate the effects of NEMS on early Vastus Medialis Obliqus (VMO) activation in PFPS. Methods: Total 30 subjects with PFPS were randomized into Group-A with NEMS and supervised exercise program and Group- B with supervised exercise program only. NMES used in this study was a single channel pre-programmed portable stimulator, which supplies biphasic symmetric rectangular pulses with pulse duration 20-1000 μsec, frequency 30-75 pulses per sec, time on: off 10:50 sec for 30 minutes. Outcome measures were - Visual Analogue Scale (VAS) for pain intensity during activities, Kujala Score for functional disability, Maximum Voluntary Isometric Contraction (MVIC) for muscle strength and Electromyography (EMG) for level of VMO: VL muscle activation. These parameters were measured at zero week (baseline data), 4th week (post-treatment) and 5th week (follow up). RESULTS: Group- A (NMES) showed more improvement than Group-B in VAS, Kujala Score, VMO: VL ratio and MVIC at post treatment and follow up with significance value p< 0.05. CONCLUSION: NEMS was found to be effective by decreasing pain and functional disability and improving muscle strength and activation of VMO in subjects with PFPS.

Efficacy of neuromuscular electrical stimulation in patients with COPD followed in intensive care unit.

Serious problems on muscle strength and functional status can be seen in bedridden-patients with chronic obstructive pulmonary diseases (COPD) receiving mechanical ventilation. We aimed to investigate the impact of active extremity mobilization and neuromuscular electrical stimulation (NMES) on weaning processes, discharge from hospital and inflammatory mediators in COPD patients receiving mechanical ventilation. Thirty conscious COPD patients (F/M:15/15) hospitalized in the intensive care unit (ICU) with diagnosis of respiratory failure were enrolled to this study. Patients were randomized into three groups, including 10 patients for each. Active extremity-exercise training and NMES were applied to Group-1, only NMES was applied to Group-2 and active extremity exercise training was applied to Group-3. Muscle strengths, mobilization duration and weaning situation were evaluated. Serum cytokine levels were evaluated. Lower extremity muscle-strength was significantly improved in Group-1 (from 3.00 to 5.00, P = 0.014) and 2 (from 4.00 to 5.00, P = 0.046). Upper extremity muscle strength was also significantly improved in all three groups (from 4.00 to 5.00 for all groups, P = 0.038, P = 0.046 and P = 0.034, respectively). Duration of mobilization and discharge from the ICU were similar among groups. There was a significant decrease in serum interleukin (IL)-6 level in Group-1 and in serum IL-8 level in Group-1 and Group-2 after rehabilitation. This study indicates that pulmonary rehabilitation can prevent loss of muscle strength in ICU. Nevertheless, we consider that further studies with larger populations are needed to examine the impact of NMES and/or active and passive muscle training in bedridden ICU patients who are mechanically ventilated.