Electrotherapy Research Articles

Vaginal Electrical Stimulation for Postpartum Neuromuscular Recovery: A Randomized Clinical Trial.

The aim of this study was to compare 3-month postpartum anal incontinence symptoms in women who sustain obstetric anal sphincter injuries and begin immediate vaginal electrical stimulation versus sham therapy. In this double-blind randomized controlled trial, women who sustained obstetric anal sphincter injuries were randomized to receive self-administered vaginal electrical stimulation using a commercial device or sham therapy with an identical device. Anal incontinence symptom severity was assessed at 1 week (baseline) and again at 13 weeks postpartum using the Fecal Incontinence Severity Index. The primary outcome was anal incontinence symptom severity measured by the total Fecal Incontinence Severity Index score at 13 weeks postpartum. Between February 2016 and September 2018, 48 women completed a 13-week follow-up. At 13 weeks postpartum, median Fecal Incontinence Severity Index scores were higher (more severe) in the vaginal electrical stimulation group (12; interquartile range, 0-23) than in the sham group (4; interquartile range, 0-10) (P = 0.04). Unlike the vaginal electrical stimulation group, the improvement in Fecal Incontinence Severity Index scores in the sham group (vaginal electrical stimulation: 12 [interquartile range, 8-22] to 12 [interquartile range, 0-23] [P = 0.12] vs sham: 12 [interquartile range, 6-18] to 4.0 [interquartile range, 0-11] [P < 0.001]) met the threshold for clinical significance based on the minimum important difference of the Fecal Incontinence Severity Index. At 13 weeks postpartum, women who underwent postpartum vaginal electrical stimulation reported more anal incontinence symptoms compared with those receiving sham therapy. Vaginal electrical stimulation after obstetric anal sphincter injury was not beneficial in reducing anal incontinence symptoms and may impede recovery.

Transcutaneous electrical nerve stimulation in speech therapy rehabilitation of voice and swallowing function in adults-a systematic review.

IntroductionIn recent years, a number of clinical trials have been published comparing transcutaneous electrical nerve stimulation (TENS) and traditional speech therapy treatment of voice and swallowing functions, but results have been conflicting.ObjectiveAssess the methodological quality of studies and determine whether TENS is an efficient therapeutic strategy for speech therapy treatment of healthy adults or those with dysphonia and/or dysphagia.MethodsThe databases used were Medical Literature Analysis and Retrieval System Online (MedLine), Biblioteca Virtual em Saúde (BVS), Cochrane Library and Web of Science (ISI Web of Knowledge). The study was conducted between May 2018 and January 2019, in line with Cochrane Handbook guidelines, and included studies on the use of TENS in healthy adults or those with compromised voice and/or swallowing function.ResultsAfter the search and extraction of studies, the following were identified: TENS + VOICE: 7 articles; TENS + SWALLOWING: 5 articles. The studies exhibited medium quality and are heterogeneous, making it difficult to determine their effectiveness and the parameters to be used in future research. There were no statistically significant differences between the use of TENS alone or associated with another therapeutic technique for voice. For swallowing function, one study proved better results in cases of associated techniques – TENS + traditional therapy.DiscussionSpeech therapy should increase the number of studies published and improve their methodological quality, reassessing methodological criteria. Current clinical practice is not grounded in evidence‐based science.Clinical Message the studies analyzed exhibited medium methodological quality;there are variations in the time, number and periodicity of the therapeutic sessions for TENS;there were no statistically significant differences between the use of TENS alone or associated with another therapeutic technique in voice;there were statistically significant differences between the use of TENS associated with traditional therapeutic in swallowing function.

Effectiveness of suboccipital muscle inhibition combined with interferential current in patients with chronic tension-type headache: a randomised controlled clinical trial

IntroductionManual therapy has been shown to reduce self-reported symptoms in patients with chronic tension-type headache (CTTH). However, simultaneous application of suboccipital muscle inhibition and interferential current has not previously been investigated. This study evaluates the effectiveness of combined treatment with suboccipital muscle inhibition and interferential current compared to standard treatment for pain, disability, and headache impact in patients with CTTH. MethodsPatients were randomly allocated to receive either standard treatment (n = 13) or the experimental treatment (n = 12), consisting of 20 minutes of suboccipital muscle inhibition plus interferential current twice weekly for 4 weeks. The primary outcome was improvement in pain, and secondary outcomes included improvement in headache-related disability and reduction in headache impact, which were assessed at baseline and at 4 weeks by a blinded rater. ResultsStatistical analysis showed improvements in the experimental treatment group at 4 weeks for headache-related disability (Neck Disability Index: Hedges’ g = 1.01, P = .001; and Headache Disability Inventory: Hedges’ g = 0.48, P = .022) and headache impact (6-item Headache Impact Test: Hedges’ g = 0.15, P = .037) but not for self-reported pain (numerical rating scale: Hedges’ g = 1.13, P = .18). ConclusionsCombined treatment with suboccipital muscle inhibition and interferential current in patients with CTTH did not significantly improve self-reported pain but did reduce disability and the impact of headache on daily life at 4 weeks. These improvements exceed the minimum clinically important difference, demonstrating the clinical relevance of our findings.

Characterizing the stimulation interference in electroencephalographic signals during brain-computer interface-controlled functional electrical stimulation therapy.

The integration of brain-computer interface (BCI) and functional electrical stimulation (FES) has brought about a new rehabilitation strategy: BCI-controlled FES therapy or BCI-FEST. During BCI-FEST, the stimulation is triggered by the patient's brain activity, often monitored using electroencephalography (EEG). Several studies have demonstrated that BCI-FEST can improve voluntary arm and hand function after an injury, but few studies have investigated the FES interference in EEG signals during BCI-FEST. In this study, we evaluated the effectiveness of band-pass filters, used to extract the BCI-relevant EEG components, in simultaneously reducing stimulation interference. We used EEG data from eight participants recorded during BCI-FEST. Additionally, we separately recorded the FES signal generated by the stimulator to estimate the spectral components of the FES interference, and extract the noise in time domain. Finally, we calculated signal-to-noise ratio (SNR) values before and after band-pass filtering, for two types of movements practiced during BCI-FEST: reaching and grasping. The SNR values were greater after filtering across all participants for both movement types. For reaching movements, mean SNR values increased between 1.31 dB and 36.3 dB. Similarly, for grasping movements, mean SNR values increased between 2.82 dB and 40.16 dB, after filtering. Band-pass filters, used to isolate EEG frequency bands for BCI application, were also effective in reducing stimulation interference. In addition, we provide a general algorithm that can be used in future studies to estimate the frequencies of FES interference as a function of the selected stimulation pulse frequency, FSTIM , and the EEG sampling rate, FS .

Nonpharmacologic Treatment for Children with Functional Constipation: A Systematic Review and Meta-analysis

To evaluate the effectiveness and safety of nonpharmacologic interventions for the treatment of childhood functional constipation. Randomized controlled trials (RCTs) evaluating nonpharmacologic treatments in children with functional constipation which reported at least 1 outcome of the core outcome set for children with functional constipation. We included 52 RCTs with 4668 children, aged between 2weeks and 18years, of whom 47% were females. Studied interventions included gut microbiome-directed interventions, other dietary interventions, oral supplements, pelvic floor-directed interventions, electrical stimulation, dry cupping, and massage therapy. An overall high risk of bias was found across the majority of studies. Meta-analyses for treatment success and/or defecation frequency, including 20 RCTs, showed abdominal electrical stimulation (n=3), Cassia Fistula emulsion (n=2), and a cow's milk exclusion diet (n=2 in a subpopulation with constipation as a possible manifestation of cow's milk allergy) may be effective. Evidence from RCTs not included in the meta-analyses, indicated that some prebiotic and fiber mixtures, Chinese herbal medicine (Xiao'er Biantong granules), and abdominal massage are promising therapies. In contrast, studies showed no benefit for the use of probiotics, synbiotics, an increase in water intake, drycupping, or additional biofeedback or behavioral therapy. We found no RCTs on physical movement or acupuncture. More well-designed high quality RCTs concerning nonpharmacologic treatments for children with functional constipation are needed before changes in current guidelines are indicated.

Effect of electromyography-triggered peripheral magnetic stimulation on voluntary swallow in healthy humans.

Electrical stimulation therapy is effective for patients with dysphagia. However, because of the pain, strong stimulation cannot be applied. Although magnetic stimulation induces less pain, there are no reports on magnetic stimulation being synchronised with a swallowing reflex. This study aimed to determine whether it is possible to induce magnetic stimulation during a voluntary swallowing using electromyography (EMG)-triggered peripheral magnetic stimulation and to evaluate its effect on healthy individuals. A total of 20 healthy adults in seated position were instructed to swallow saliva and 10ml of barium under videofluoroscopy. For concomitant use of magnetic stimulation, a magnetic stimulus for suprahyoid muscles at 30Hz frequency was applied for 2s when the EMG level in the sternohyoid muscle exceeded the threshold. During the voluntary swallowing, the movement of the hyoid bone and opening width of the upper oesophageal sphincter (UES) were measured. Furthermore, pressure topography was evaluated in 6 subjects using high-resolution manometry. The magnetic stimulation significantly extended the movement time of the hyoid bone (p<0.001). During liquid deglutition, significant increases were observed in the anterior maximum movement distance of the hyoid bone (p<0.05), opening width of the UES (p<0.001) and anterior movement distance of the hyoid bone at the maximum UES opening (p<0.01). In the pressure topography, the maximum pressure immediately after UES closure significantly decreased with magnetic stimulation (p<0.05). EMG-triggered peripheral magnetic stimulation made it possible to apply magnetic stimulation during a voluntary swallowing.

A Systematic Review and Meta-analysis Investigating the Pain-Relieving Effect of Interferential Current on Musculoskeletal Pain.

Interferential current is one of the most common electrotherapeutic modalities used in the treatment of painful conditions. Patients seeking medical help to reduce their musculoskeletal pain can be treated using interferential current. The current review aimed to analyze the recently available information regarding the efficacy of interferential current in alleviating the pain of musculoskeletal origin. This study used Scopus, CINAHL, Cochrane Library, Web of Science, MEDLINE, Embase, and EBSCOas as data sources. The initial selection of the studies, thorough assessment of the full articles, and extraction of the necessary study characteristics were carried out by two independent reviewers. Another two independent reviewers assessed the methodological quality of each included trial against 39 criteria. These criteria were integrated from several popular scales. Pain intensity-measured using the visual analog scale, numeric pain rating scale, or McGill Pain Questionnaire-was the outcome of interest. This review included 35 trials of variable methodological quality from which 19 trials were selected for the meta-analysis. In general, interferential current alone versus placebo demonstrated a significant pain-relieving effect. On the other hand, interferential current showed no significant difference when added to standard treatment compared with placebo plus standard treatment or standard treatment alone. Similarly, interferential current showed no significant difference when compared with other single interventions (laser, transcutaneous electrical nerve stimulation, cryotherapy). Interferential current alone is better than placebo at discharge. However, the low number of studies raises suspicions about this conclusion. Interferential current alone or added to other interventions is not more effective than comparative treatments in relieving musculoskeletal pain.

Effects of Electrotherapy on Delayed Onset Muscle Soreness (DOMS)

In this article, the reasons for the occurrence of Delayed Onset Muscle Soreness (DOMS) and the effect of electrotherapy on it were discussed. Electrotherapy is a non-invasive and easy method to treat DOMS and muscle fatigue. As a result of intense and abnormal exercise, the creatine phosphokinase enzyme in the muscle increases and DOMS occur. DOMS can be treated with electrotherapy techniques such as micro-current electrotherapy. Micro-currents devices reduce the severity of DOMS symptoms by maintaining intracellular calcium homeostasis. Devices such as Transcutaneous Electrical Nerve Stimulation (TENS) and Micro-Current Electrical Therapy (MET) belong to the category of micro-currents. The number of electrotherapy sessions after the occurrence of DOMS and the frequency of electrotherapy devices are two important factors in the treatment of DOMS. TENS conducts electrical current to the body through electrodes that attach to the skin, and helping to reduce pain by releasing endorphins, a natural painkiller, and blocking the passage of pain to the brain. MET uses resonant frequencies to aid in deeper and longer treatment, increase the body’s production of natural catalysts in the healing process, and is more useful in chronic pain than TENS. Research has shown that electrotherapy has been shown to improve DOMS symptoms.

Physical Therapy Modalities in Children with Thalassemia and Sickle Cell Disease: Narrative Review

Abstract Background: Physical therapy is playing an important role in enhancing and promoting health related quality of life in children with thalassemia and sickle cell disease by de-creasing the associated disease symptoms as pain, anxiety, depression and fatigue and enhancing the cardiopulmonary system, bone mass index, ferritin and serum levels by using different physical therapy modalities as exercise training, Yoga, Massage therapy, transcutaneous electrical nerve stim-ulation (TENS), spirometer and vibration therapy. Aim of Study: To identify the effectiveness of using physical therapy modalities in children with thalassemia and sickle cell disease. Subjects and Methods: This review included Children with thalassemia and sickle cell disease aged between 6 to 18 years, receive different physical therapy modalities. Design: A search of electronic databases that included, PubMed, Physical therapy Evidence Database, Google scholar, Science Direct and Cochrane was searched since ever till December 2019 using the following keywords: 'Physical therapy modalities', 'thalassemia', 'exercise training', 'sickle cell disease', 'breathing exercise', 'health related quality of life', 'transcutaneous electrical nerve stimulation' and 'children'. Results: Twelve articles that were retrieved met the inclusion criteria. Conclusion: From clinical point of view using physical therapy modalities can promote quality of life in children suffering from thalassemia and from sickle cell disease but furthermore studies are needed to help the researchers and the patients.

The effect of skeletal muscle-derived cells implantation on stress urinary incontinence and functional urethral properties in female patients.

To evaluate improvement of stress urinary incontinence (SUI) and functional status of the urethra after autologous skeletal-muscle derived cell (aSMDC) implantation. Phase I-II, open, non-randomized, single-center study of ultrasound guided aSMDC implantation (dosed at 0.2×106 cells/2mL) into the external urethral sphincter to treat SUI. A total of 38 patients were treated and followed for 2years. SUI measured by Incontinence Episode Frequency score, short pad test, quality of life, patient's and clinician's perception significantly improved and remained improved after 2years. However, urodynamic urethral properties in general did not improve at 1-year after treatment. Subgroup analysis revealed that addition of an adjuvant functional electrical stimulation therapy discontinued 4weeks after injection in the compliant group, gave better urodynamic values and maintained the long-term SUI improvement at 2years. The aSMDC injection was safe and well-tolerated by patients. The status of SUI improved and with it the quality of life of patients, even if this was not necessarily reflected in the urodynamic urethral properties. Electrical stimulation, as an adjuvant therapy, could have an essential role in the success of the therapy. Clinical study was registered under Eudra-CT number: 2010-021867-34 at European Clinical Trial Database (EudraCT), accessible at: EudraCT (europa.eu).

Cortical Re-organization After Traumatic Brain Injury Elicited Using Functional Electrical Stimulation Therapy: A Case Report.

Functional electrical stimulation therapy (FEST) can improve motor function after neurological injuries. However, little is known about cortical changes after FEST and weather it can improve motor function after traumatic brain injury (TBI). Our study examined cortical changes and motor improvements in one male participant with chronic TBI suffering from mild motor impairment affecting the right upper-limb during 3-months of FEST and during 3-months follow-up. In total, 36 sessions of FEST were applied to enable upper-limb grasping and reaching movements. Short-term assessments carried out using transcranial magnetic stimulation (TMS) showed reduced cortical silent period (CSP), indicating cortical and/or subcortical inhibition after each intervention. At the same time, no changes in motor evoked potentials (MEPs) were observed. Long-term assessments showed increased MEP corticospinal excitability after 12-weeks of FEST, which seemed to remain during both follow-ups, while no changes in CSP were observed. Similarly, long-term assessments using TMS mapping showed larger hand MEP area in the primary motor cortex (M1) after 12-weeks of FEST as well as during both follow-ups. Corroborating TMS results, functional magnetic resonance imaging (fMRI) data showed M1 activations increased during hand grip and finger pinch tasks after 12-weeks of FEST, while gradual reduction of activity compared to after the intervention was seen during follow-ups. Widespread changes were seen not only in the M1, but also sensory, parietal rostroventral, supplementary motor, and premotor areas in both contralateral and ipsilateral hemispheres, especially during the finger pinch task. Drawing test performance showed improvements after the intervention and during follow-ups. Our findings suggest that task-specific and repetitive FEST can effectively increase cortical activations by integrating voluntary motor commands and sensorimotor network through functional electrical stimulation (FES). Overall, our results demonstrated cortical re-organization in an individual with chronic TBI after FEST.

Effects of Mime Therapy With Sensory Exercises on Facial Symmetry, Strength, Functional Abilities, and the Recovery Rate in Bell's Palsy Patients

Background and Objectives: Bell palsy is the sudden lower motor neuron paralysis of the facial nerve, characterized by acute unilateral peripheral facial muscle weakness. Physiotherapy has been proven to be beneficial in the rehabilitation of patients with Bell palsy and is important to prevent permanent contractures of the paralyzed facial muscles. A physiotherapy technique includes electrical stimulation and mime therapy to help in restoring lost muscle functions. Also, sensory exercises include varied normality solutions administered. This study aimed to find the effects of mime therapy with sensory exercises on facial symmetry and functional abilities among Bell palsy patients. Methods: A total number of 30 participants were recruited for an interventional study and conveniently assigned into three groups (n=10), where group A received electrical stimulation with facial exercises, group B received electrical stimulation with mime therapy, and group C received a combination of electrical stimulation, mime therapy, and sensory exercises. Each group received 18 sessions; each session was for 60 minutes per day, six days per week, for three weeks. Then, all the participants were assessed using the Sunnybrook facial grading system and the facial disability index. Results: Intragroup analysis showed a significant difference within all three groups (P&lt;0.05). Besides, the intergroup comparison showed maximum recovery in group C followed by groups B and A. Conclusion: A combination of mime therapy and electrical stimulation along with sensory exercises provides the most beneficial intervention to improve facial function and reduce facial synkinesis in Bell palsy individuals. Hence, sensory exercises are recommended as an adjunct to electrical stimulation and mime therapy for the line of treatment for individuals with Bell palsy.

Neuromuscular Electrical Stimulation Therapy Effects on the Functional and Motor Recovery of the Upper Extremity in Patients after Stroke: A Randomized Controlled Trial

Neuromuscular Electrical Stimulation Therapy Effects on the Functional and Motor Recovery of the Upper Extremity in Patients after Stroke: A Randomized Controlled Trial

Preliminary Study on Effect of Motor Imagery Combined With Low-Frequency Pulsed Electrical Stimulation Therapy on Upper Limb Function of Young Stroke Patients

Background: To observe and explore the clinical effect of motor imagery therapy (MIT) combined with low-frequency pulsed electrical stimulation therapy (LFPEST) on improving upper limb function in young stroke patients. Methods: Eighty-one young stroke patients with hemiplegia were divided into MIT group, LFPEST group and combined treatment group. Fugl-Meyer assessment (FMA), functional test hemiplegic upper extremity (FTHUE) and modified Barthel Index (MBI) were used to evaluate the upper limb function and activities of daily living before and 6 weeks after treatment. Results: After treatment, the FMA score, FTHUE grading and MBI score of the combined treatment group and the MIT group were significantly higher than those of the LFPEST group (P &lt; 0.05), and the curative effect of the combined treatment group was significantly higher than that of the MIT group (P &lt; 0.05). Conclusions: MIT combined with LFPEST has more obvious curative effect than LFPEST and MIT, which can significantly improve the upper limb function, hand function and daily living ability of young stroke patients with hemiplegia. J Neurol Res. 2021;11(3-4):54-59 doi: https://doi.org/10.14740/jnr661

In vivo investigation of 3D printed polycaprolactone/graphene electro-active bone scaffolds

Additive manufactured scaffolds are widely used as 3D support structures for tissue engineering. This paper investigates the mechanisms behind bone regeneration due to the combined use of 3D printed poly (ϵ-caprolactone)/graphene (PCL/G) electro-active scaffolds and electrical stimulation. A comprehensive in vivo study was conducted to assess the proposed approach, using a rat model. Results show that the combined use of electro-active scaffolds and electrical stimulation therapy accelerates the bone regeneration process and the formation of more organized new bone, through fast angiogenesis, and a rapid transition to the mineralization and bone remodelling phase. The mechanism is investigated and explained.

Effectiveness of physiotherapy for lower urinary tract symptoms in postpartum women: systematic review and meta-analysis.

The efficacy of physiotherapy for postpartum lower urinary tract symptoms (LUTS) has attracted considerable research interest. In the current study we evaluated the efficacy and safety of pelvic floor muscle training (PFMT) combined with biofeedback (BF), electrical stimulation (ES) therapy, or both for postpartum LUTS. PUBMED, EMBASE, Web of Science, Cochrane Library, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Chinese Science and Technique Journals Database, and Wanfang databases were searched from inception to December 2020. Eligible randomized controlled trials on postpartum LUTS comparing PFMT plus BF, ES, or both with PFMT alone were included. The Cochrane handbook was used to evaluate the quality of the studies. Seventeen studies were included. The results of the meta-analysis showed that PFMT plus ES with or without BF was more effective than PFMT alone. Patients receiving PFMT plus ES and BF achieved greater improvement than controls receiving PFMT alone in incontinence quality of life scores (mean difference: 15.33, 95% confidence interval [CI]: 11.70-18.97, P < 0.00001), pelvic floor muscle strength (risk ratio: 2.29, 95% CI: 1.53-3.43, P < 0.0001), and urodynamic parameters (maximum urethral closure pressure, abdominal leak point pressure, and maximum urinary flow rate), and 1-h urine leakage (standardized mean difference: -0.70, 95% CI: -1.23 to -0.17, P = 0.010) also decreased. PFMT plus ES with or without BF exhibited better efficacy and safety for early postpartum LUTS than PFMT alone.

EFFECT OF SHOCKWAVE THERAPY VERSUS LOW-INTENSITY PULSED ULTRASOUND ON BONE HEALING OF MANDIBULAR FRACTURES; (A RANDOMIZED CLINICAL TRIAL)

INTRODUCTION: Low- intensity Pulsed Ultra Sound (LIPUS) and Extra Corporeal Shock Wave Therapy (ESWT), are the different forms of acoustic mechanical waves that might promote bone healing by stimulating bone growth in long or other bones. OBJECTIVES: To evaluate the effect of adjuvant therapy with LIPUS and ESWT in healing fresh mandibular fractures patients. MATERIAL AND METHODS: Twenty one patients (12 males, 9 females) , aged from 20 to 40 years , had fresh mandibular fractures to be treated with closed reduction and maxillary mandibular fixation (MMF), prospectively. Patients enrolled into this study with ethical approval and informed consent. Those patients were randomly assigned in three treatment groups. Group I received a single treatment with 4000 impulses of focused ESWT, group II received 18 sessions of LIPUS for 20 Min each ; while group III , received neither of those treatments, represented the control group -- Clinical assessment together with radiographic follow-up using Cone Beam Computed Tomography (CBCT) at 1.5 and 3 months were done for all patients postoperatively. RESULTS: There was statistically significant difference in bone density between three groups in different times after six weeks and after three months as bone density higher in group I than in groups II, III. CONCLUSIONS: Focused ESWT appeared to be more effective than LIPUS or nothing as an adjuvant treatment of adults with fresh mandibular fractures.

Interferential Electrical Stimulation Efficacy in the Management of Lower Urinary Tract Dysfunction in Children: A Review of the Literature.

Lower urinary tract dysfunction (LUTD) is the most common problem of the referral children to the pediatric urology clinics. If this condition does not treat early in life, it will be a lifelong problem. During recent decades, electrical stimulation therapy has been expanded and extensively used for the treatment of LUTD in both adults and children. The aim of this review is to suggest clinicians an updated understanding of effects of interferential (IF) electrical stimulation therapy in management of LUTD in children. The search was performed in databases of Medline, PubMed, Google Scholar, ,and Scopus for information about IF electrical stimulation and its application using search words such as " IF electrical stimulation", "transcutaneous IF electrical stimulation" , "IF therapy " , " electrical stimulation", "voiding dysfunction" , " LUTD", " urinary incontinence" and " children". As this review focuses on the answer of this question "Does transcutaneous IF electrical stimulation has effect on management of LUTD in children?" we included the reference list of articles identified by this search strategy and selected those we judged relevant according to our keywords. Clinical trial studies that publishing in English were included. Categorical data were reported as frequencies and percentages. Eleven studies were included in this review. The success rate of IF therapy in these studies has been reported from 61% to 90% of children with LUTD and urinary incontinence. IF electrical stimulation is an effective, safe and reproducible option to manage LUTD and urinary incontinence in children.

Comparison of the Efficiency of High-Intensity Laser Therapy and Transcutaneous Electrical Nerve Stimulation Therapy in Patients With Symptomatic Temporomandibular Joint Disc Displacement With Reduction

Many different treatment modalities have been tried in the treatment of temporomandibular joint (TMJ) disorders and different results have been reported. The aim of the study was to investigate and compare the effects of high-intensity laser therapy (HILT) and transcutaneous electrical nerve stimulation (TENS) therapy on the treatment of patients with TMJ disc displacement with reduction(DDWR). Researchers conducted a prospective, single-blind, controlled clinical trial on patients with TMJ disc disease at a university's oral and maxillofacial surgery clinic. One hundred two patients were randomized into 3 groups (HILT, TENS and control group). The patients were evaluated in terms of maximum mouth opening (MMO), assisted MMO, Visual Analog Scale (VAS) (pain), and VAS (function). In addition, the disability status of the patients with the Jaw Functional Limitation Scale-20 (JFLS-20) and the quality-of-life with the Oral Health Impact Profile (OHIP-14) was evaluated. At the start of the trial, in terms of socio-demographic characteristics, no significant differences existed between the groups. Significant improvements were seen in pain (VAS), MMO, total JFLS-20 and total OHIP-14 scores in the HILT and TENS groups compared to the control group. At week 4, the VAS pain score decreased significantly in the HILT group compared to the TENS group (48 and 25%, respectively), while the MMO was significantly increased (24 and 10%, respectively). In addition, there was a significant improvement in both the total JFLS-20 score and the total OHIP-14 score at weeks 4 and 12 in the HILT group compared to the TENS group (P < .05). It was observed that the healing effect of pulsed Nd: YAG laser therapy was significantly higher than TENS in patients with DDWR. Therefore, HILT should be a priority option over TENS therapy in patients with disc displacement.

Liquiritigenin promotes osteogenic differentiation and prevents bone loss via inducing auto-lysosomal degradation and inhibiting apoptosis

Osteoporosis (OP) is a debilitating skeletal abnormality involving bone remodeling and bone cell homeostasis characterized by decreased bone strength and high fracture risk. A novel therapeutic intervention for OP by manipulating cellular autophagy–apoptosis processes to promote skeletal homeostasis is presented. Protective effects of the naturally occurring plant extract Liquiritigenin (LG) were demonstrated in an ovariectomy (OVX)-OP mouse model and preosteoblast MC3T3-E1 cells. Micro-CT and histological staining assessments of skeletal phenotype were applied alongside detection of autophagy activity in osteocytes and MC3T3-E1 cells by transmission electron microscopy (TEM). The effects of LG on chloroquine (CQ)- and the apoptosis-inducing TS-treated osteogenic differentiations and status of lysosomes within MC3T3-E1 cells were analyzed by Neutral red, Alizarin red S and alkaline phosphatase (ALP) staining and Western blot assays. Treatment with LG prevented bone loss, increased osteogenic differentiation in vivo and in vitro, and inhibited osteoclast formation to some extent. TEM analyses revealed that LG can improve auto-lysosomal degradation within osteocytes from OVX mice and MC3T3-E1 cells. The abnormal status of lysosomes associated with CQ and TS treatments was notably alleviated by LG which also reduced levels of apoptosis-induced inhibition of osteogenic differentiation and averted abnormal osteogenic differentiation as a consequence of a blockage in autolysosome degradation. Overall, LG stimulates bone growth in OVX mice through increased osteogenic differentiation and regulation of autophagy-apoptosis mechanisms, presenting an auspicious natural therapy for OP.