Electrical Stimulation Research Articles

Non-invasive neurostimulation: an emerging therapeutic modality in veterinary neurology

Non-invasive neurostimulation involves techniques that stimulate the nervous system without penetrating the skin. These techniques, which range from electrical and magnetic to other types of stimulation, are designed to alter the activity of nerve cells and the broader networks they form. Although these methods have proven effective and safe for treating certain neurological conditions in humans, their success varies significantly from one individual to another. This variability can be because of the lack of standardised stimulation protocols, biological differences among individuals and the particular state of the neural areas being targeted. Various non-invasive neurostimulation techniques have been investigated, particularly in human medicine, including transcutaneous vagal nerve stimulation, transcutaneous electrical nerve stimulation on various nerves, repetitive transcranial magnetic stimulation and transcranial direct current stimulation. Of these, repetitive transcranial magnetic stimulation has emerged as the leading technique in research for human and veterinary medicine because of its potential in treating a wide range of neurological disorders. In the field of veterinary medicine, the use of non-invasive neurostimulation as a treatment approach is still in its early phases, with only a few reports documenting its application in managing seizures and behavioural issues in animals.

Current Practice Patterns in the Management of Bell's Palsy Among Physiotherapists of Sargodha, Pakistan

Objectives: We intend to find out current practice patterns in managing Bell’s palsy among the physiotherapists of Sargodha, Pakistan. Methods: A cross-sectional study was conducted from May to August 2022. Data were obtained from 50 physiotherapists working in various clinical settings of Sargodha with more than 2 years of clinical experience. They were selected using convenient sampling. A self-designed questionnaire was used to gather all necessary information regarding the physical therapy practice patterns of Bell’s palsy. The obtained data were analyzed by using SPSS software, version 20. Results: Proprioceptive neuromuscular facilitation (PNF) was the preferred (42%) neurodevelopmental technique used in current practice patterns to manage Bell’s palsy. The most used therapeutic exercises by the physiotherapists were facial expression coordination exercises (66%). Also, 44% of physiotherapists used electrical muscle stimulation as the preferred electrotherapeutic modality in their current practice. Soft tissue release (54%) was the most preferred manual therapy technique in Bell’s palsy patients. The combination of electrical muscle stimulation, facial exercises, and biofeedback was the most used (54%) among physiotherapists. Discussion: Current practice for Bell’s palsy treatment includes PNF techniques, facial expression coordination exercises, soft tissue release, and electrical muscle stimulation by most physiotherapists in Sargodha. The most preferred combination was facial exercises, electrical stimulation, and biofeedback.

Effectiveness of low-intensity electrical current in accelerating the en-masse retraction of the upper anterior teeth following first-premolar extraction in young adult patients with Class II division 1 malocclusion: A randomized controlled clinical trial

Many efforts have been made to shorten fixed appliance orthodontic treatment time by accelerating the rate of tooth movement. Low-intensity electrical stimulation (LIES) is one of the proposed physical methods that has not yet been well studied in the medical literature. This study aimed to evaluate the effectiveness of LIES in accelerating orthodontic tooth movement in cases of en-mass retraction of the upper anterior teeth. Patients who attended the Department of Orthodontics at the Faculty of Dentistry, University of Damascus, between September 2019 and February 2021, for treatment were carefully checked. All patients who met the eligibility criteria were invited to participate in this RCT. Young adult patients having class II division I malocclusion were equally and randomly assigned into the low-intensity electrical stimulation group (LIES), and traditional en-masse retraction group (TRAD). The mini-implants assisted en-masse retraction technique was used to close the extracted upper first premolar spaces in both groups. NiTi closed coil springs (250g/side) were used. Electrical stimulation of 15-20μA for each tooth was applied on the upper anterior teeth using a recently developed intraorally removable device in the LIES group. The primary outcome was the en-masse retraction rate, the secondary outcomes were changes in the first molar position, intermolar width, and intercanine width. These outcomes were measured on the digital photographs of the maxilla cast using the Image J program. Two-sample t-test with Bonferroni's correction was utilized to explore any significant differences between the two groups in all studied variables. Of the 168 patients examined by the researcher, 38 patients with Class II division I malocclusion (30 females and 8 males; mean age: 21.1±2.31 years) were finally recruited in this RCT. The overall en-masse retraction rate was significantly greater in the LIES group compared to the TRAD group (1.02±0.08, 0.73±0.04mm/month respectively; P<0.001). In addition, the monthly rate of space closure was significantly greater in this group at all evaluation times (P<0.001). A small increase was noted in the intercanine width (1.60±0.27, and 1.65±0.33mm respectively). Negligible changes were noted in the first molar positions and intermolar width, with insignificant differences between the two groups. LIES according to the protocol applied in this trial accelerated the upper anterior teeth en-masse retraction rate by approximately 28% compared to the traditional en-masse retraction method. While this acceleration was statistically significant, may not have substantial clinical implications. This trial protocol was registered in the Clinical Trials database (ClinicalTrials.gov NCT05350280).

Electric field stimulation on electronic, electro-optical and non-linear optical properties of some fluoro-isothiocyanate and fluorinated alkyl terphenyl liquid crystals: A comparative DFT approach

Employing density functional theory, electronic, electro-optical, and NLO properties of some fluorinated NCS terphenyl and fluorinated terphenyl liquid crystals have been investigated in the presence of static electric field. Two DFT functionals, in this study, includes M06-2X and ωB97XD combined with 6–311 + G(d,p) basis set have been used. All the computations have been performed on Gaussian 16 W program and visualized on GaussView6.0. A comparative analysis of computational outcomes has been done in order to forecast mesogens’ improved electronic characteristics, global descriptors, NLO and UV–vis spectra. All of the chosen LC molecules exhibit properties that make them suitable materials for NLO applications.

Silicone-based AC102-loaded cochlear implant coatings protect residual hearing in an animal model of cochlear implantation

Cochlear implant users with residual hearing benefit synergistically from combined electrical stimulation via the cochlear implant and preserved residual hearing after surgery. However, direct mechanical trauma and subsequent inflammation may deteriorate hearing function. AC102, a novel otoprotective pyridoindole with anti-apoptotic and anti-oxidative properties significantly improved hearing recovery following cochlear implantation when administered intratympanically prior to surgery. Additionally, AC102 exerts neurotrophic effects, possibly aiding in the preservation of auditory nerve fibers and spiral ganglion neurons. Rapid clearance of the drug, however, might be a limiting factor to further attenuate the inflammatory response and maintain neuronal health. The aim of the current study was to design an AC102-loaded electrode array for sustained drug delivery and investigate its effects in hearing preservation cochlear implantation.First, the release-kinetics of AC102 were investigated in vitro and modelled by the Higuchi equation of drug release. An electrode array coated with 10% AC102 was manufactured, its release kinetics evaluated, and subsequently tested in vivo. 20 normal hearing Mongolian gerbils were unilaterally implanted with an AC102-loaded or an unloaded control electrode. Compound action potentials were measured prior to cochlear implantation and serially over 28 days. Hair cells, inner hair cell synapses, and auditory nerve fibers were quantified in cochlear whole-mounts by immunofluorescence staining.AC102 release from silicone coating could be predictably modelled by the Higuchi equation of drug release. The electrode array with an AC102-silicone depot enabled non-linear sustained drug release with initially higher release concentrations. In vivo, the AC102-loaded electrode array significantly recovered auditory threshold shifts near the maximum insertion depth over 28 days. In the apical region, a significant recovery was noticed only until day 14, after which threshold shifts aligned between groups. Histologically, AC102-loaded electrodes significantly preserved outer hair cells apical of the maximum insertion depth and inner hair cells and neuronal structures at the tip of the inserted electrode.In conclusion, the drug-loaded electrode arrays could predictably release AC102 over a period of 28 days. AC102 enabled the restoration of auditory thresholds near the area of maximum insertion, which is the desired region to be preserved in cochlear implant recipients with residual hearing.

The impact of electrical stimulation on NaCl diffusion in tenderloin and the quality of dry-cured loin during the marination process

The impact of electrical stimulation on NaCl diffusion in tenderloin and the quality of dry-cured loin during the marination process

Early Hearing Outcomes and Audiological Experiences With a Novel Fully Implanted Cochlear Implant.

To review audiological experiences and early hearing outcomes from the early feasibility study of a fully implanted cochlear implant. Prospective cohort. Tertiary academic medical center. Three adults (two-male, one female) with bilateral sensorineural hearing loss. Implantation with a fully implanted cochlear implant as part of an early feasibility study. Postoperative unaided and aided pure-tone audiometry, tympanometry, mapping parameters, speech perception, battery life, and quality-of-life assessment. All patients in the early feasibility study of this fully implanted cochlear implant now use their devices regularly. Preoperative and postoperative audiometric measurements showed that their residual hearing in the implanted ear decreased slightly after surgery but was preserved. All patients had type A tympanograms after their transient middle ear effusion resolved. Electrical stimulation levels were comparable to those routinely used in traditional cochlear implants. Two of the three patients use a hearing aid in the implanted ear for additional gain and show significant improvement in speech perception since implantation. Average battery life before recharging is 4 days. All patients are regular users with two showing improvement in quality-of-life metrics after receiving the fully implanted cochlear implant. The patient experience and hearing outcomes from the early feasibility study of a novel fully implanted cochlear implant are detailed in this study and demonstrate ease of operation and daily use by all participants. All patients obtained hearing, but two of three use a hearing aid with their device to overcome unanticipated implant circuitry noise and achieve improved speech perception scores. Current work is focused on reducing this system noise to allow for the device to be used as intended, without a hearing aid.

Meta-analysis of electrical stimulation promoting recovery of gastrointestinal function after gynecological abdominal surgery

BACKGROUND The effects of electrical stimulation on gastrointestinal function recovery after gynecological abdominal surgery was not clear. AIM To systematically evaluate the effects of electrical stimulation on gastrointestinal function recovery after gynecological abdominal surgery. METHODS The Cochrane Library, Web of Science, PubMed, ProQuest, and the Chinese biomedical literature databases Wanfang, Weipu, and CNKI were used to search for relevant studies on controlled trials of electrical stimulation in gynecological abdominal surgery patients from self-established databases to May 2024. The RevMan software (version 5.3) was used to analyze the included literature and explore the heterogeneity of each study. RESULTS Seven controlled trials, involving 520 patients, were included. The results of meta-analysis showed that electrical stimulation could shorten the recovery time of intestinal sound after gynecological abdominal surgery [odds ratio (OR): -5.11, 95%CI: -5.84 to -4.38, P &lt; 0.00001] and improve the time of first anal exhaust (OR: -1.19, 95%CI: -1.38 to -0.99, P &lt; 0.00001), improved the time of first anal defecation (OR: -0.98, 95%CI: -1.19 to -0.78, P &lt; 0.00001), The difference is significant. According to the funnel plot, if the scatter is symmetrical, it indicates that the funnel plot is unbiased. CONCLUSION Electrical stimulation can shorten this reduces the length of time it takes for the patient to recover from bowel sounds and also affects the time to first anal voiding and defecation to some extent, thereby promoting gastrointestinal function recovery after gynecological abdominal surgery. The quality of the studies included in this review was poor, which may have affected the final results. It is necessary to conduct a randomized controlled study with higher quality and more samples to further confirm the promoting effect of electrical stimulation on gastrointestinal function recovery to guide clinical treatment.

Activation thresholds for electrical phrenic nerve stimulation at the neck: evaluation of stimulation pulse parameters in a simulation study

Abstract Objective. Phrenic nerve stimulation reduces ventilator-induced-diaphragmatic-dysfunction, which is a potential complication of mechanical ventilation. Electromagnetic simulations provide valuable information about the effects of the stimulation and are used to determine appropriate stimulation parameters and evaluate possible co-activation. Approach. Using a multiscale approach, we built a novel detailed anatomical model of the neck and the phrenic nerve. The model consisted of a macroscale volume conduction model of the neck with 13 tissues, a mesoscale volume conduction model of the phrenic nerve with three tissues, and a microscale biophysiological model of axons with diameters ranging from 5 to 14 µm based on the McIntyre–Richardson–Grill-model for myelinated axons. This multiscale model was used to quantify activation thresholds of phrenic nerve fibers using different stimulation pulse parameters (pulse width, interphase delay, asymmetry of biphasic pulses, pulse polarity, and rise time) during non-invasive electrical stimulation. Electric field strength was used to evaluate co-activation of the other nerves in the neck. Main results. For monophasic pulses with a pulse width of 150 µs, the activation threshold depended on the fiber diameter and ranged from 20 to 156 mA, with highest activation threshold for the smallest fiber diameter. The relationship was approximated using a power fit function x −3. Biphasic (symmetric) pulses increased the activation threshold by 25 to 30 %. The use of asymmetric biphasic pulses or an interphase delay lowered the threshold close to the monophasic threshold. Possible co-activated nerves were the more superficial nerves and included the transverse cervical nerve, the supraclavicular nerve, the great auricular nerve, the cervical plexus, the brachial plexus, and the long thoracic nerve. Significance. Our multiscale model and electromagnetic simulations provided insight into phrenic nerve activation and possible co-activation by non-invasive electrical stimulation and provided guidance on the use of stimulation pulse types with minimal activation threshold.

Laser therapy for Bell's palsy: a systematic review and meta-analysis of randomized trials.

This meta-analysis investigated therapeautic effects of laser therapies in patients with Bell's palsy (BP). The authors performed the literature search in the PubMed, Embase, and Cochrane Library databases using the following search terms: (facial paralysis OR Bell's palsy OR facial palsy OR idiopathic facial paralysis) AND (laser OR low-level laser OR photobiomodulation OR phototherapy). Relevant studies published before October 29th 2024 were identified. Randomized trials comparing the outcomes of laser therapies with other interventions, including electrical stimulation and control or usual care in patients with BP were included. The mean difference (MD) was determined as the effect size for continuous outcomes, and outcome accuracy was determined using 95% confidence intervals (CIs). Twelve studies were included, with a total of 597 patients. Nine studies were further included in the quantitative analysis. Our meta-analysis revealed that laser therapy significantly improved disease severity (House-Brackmann facial paralysis scale) (MD = -1.51, 95% CI = -2.43 to -0.59), facial asymmetry (Sunnybrook facial grading system) (MD = 20.63, 95% CI = 10.33 to 30.94), and facial function and disability (Facial disability index) (MD = 17.91, 95% CI = 5.60 to 30.22) when compared with control care in adult patients. Moreover, laser therapy significantly improved facial severity (MD = 21.05, 95% CI = 16.77 to 25.33) when compared with electrical stimulation. In addition, no adverse effects of laser therapy were reported. Laser therapy has favorable effects on disease severity, facial asymmetry, and facial function and disability for patients with BP.

Efficacy of electrical stimulation of the zygomaticus muscle in complete facial paralysis: evidence from facial grading and automated image analysis

Surface Functional Electrical Stimulation (FES) is a well-studied intervention for multiple muscular disorders. However, it is still controversially discussed as a complementary therapy for complete facial paralysis. The aim of this intervention is to test a daily home-based ES concept as a pilot study regarding safety, feasibility, and effects on facial functionality and symmetry. In a prospective single-centre pilot study, 10 patients (median 61 years, denervation 130 d) with complete peripheral facial paralysis performed home-based FES of the affected lateral mouth region Stimulation parameters, facial paralysis scores and standardised photographs were assessed in monthly follow-ups. No serious adverse events appeared. Stimulation parameters could be constantly increased indicating effective muscle training while subjectively perceived functionality of the face improved. Thus, smile angle of the paralysed side improved as well. FES is a safe therapy model for application in facial nerve paralysis patients. A feasible stimulation protocol could be applied, which improved the functionality and symmetry of the stimulated facial region. A future controlled, randomised and double-blind follow-up study is needed to investigate these initial results in a further evolved replicable setting.

FORTALECENDO O CONTROLE PÉLVICO PARA UMA VIDA SEM LIMITAÇÕES: UMA REVISÃO DE LITERATURA SOBRE A EFICÁCIA DA FISIOTERAPIA COM EXERCÍCIO DE KEGEL NO TRATAMENTO DA INCONTINÊNCIA URINÁRIA

The pelvic floor muscles support organs such as the bladder and uterus, and can weaken due to pregnancy and aging, which results in problems such as urinary incontinence or prolapse. The latter affects millions of women, being associated with factors such as age and number of births. Evaluation, especially through ultrasound, is crucial. Treatments include Kegel exercises, behavioral therapy, and mechanical devices. Innovative strategies, such as the gamification of Kegel exercises, have shown promise for improving adherence and treatment outcomes. The importance of pelvic floor muscles and their dysfunctions, such as urinary incontinence, was addressed, highlighting the need for effective and innovative approaches to improve patients' quality of life. An analysis of the efficacy of Kegel exercise on urinary incontinence in women was conducted, reviewing studies, synthesizing results, and offering recommendations for future research. A systematic review of the literature, conducted between February and May 2024, was adopted to analyze studies on Kegel exercise in urinary incontinence in women, searching for articles in databases such as VHL, PubMed, ScienceDirect, and JSTOR, with strict inclusion criteria. Studies on treatments for pelvic floor dysfunctions, such as prolapse and urinary incontinence, have revealed several approaches. Some have shown effectiveness in personalized training of the muscles, while others have compared methods such as electrical stimulation and active training. In addition, innovative techniques such as position detection during Kegel exercises and mechanotherapy were explored. The efficacy of simple interventions, such as Kegel exercises combined with behavioral therapy, was highlighted. These studies highlighted the complexity of pelvic floor dysfunctions and the importance of multifaceted and individualized approaches to treatment, highlighting the challenges faced and the need for more effective interventions to improve patients' health and quality of life. Authors have emphasized the importance of pelvic muscles and treatments such as training and behavioral therapy, while innovative strategies such as gamification have shown promise for promoting better physical, emotional, and social well-being and outcomes.

Whole-body vibration elicits 40Hz cortical gamma oscillations and ameliorates age-related cognitive impairment through hippocampal astrocyte synapses in male rats.

Age-related cognitive impairment is a prevalent issue in developed societies. Gamma oscil2lations at 40Hz have been identified as a potential therapeutic approach for age-related cognitive decline and can be induced through various modalities, including auditory, visual, electrical, and magnetic stimulation. In this study, we investigated a novel modality of stimulation: whole-body vibration at 40Hz. We examined the effects of 40Hz vibration on cognitive performance and associated neuronal activity in the brains of aged male rats. Our findings revealed that only vibration at 40Hz, rather than 20Hz or 80Hz, elicited cortical gamma oscillations in aged male rats. Additionally, following 8weeks of prolonged treatment, the implementation of 40Hz whole-body vibration significantly augmented the cognitive function of aged male rats as evidenced by behavioral assessments. Mechanistic studies demonstrated that these beneficial effects were attributed to the reduction of neuronal apoptosis in hippocampal CA1 through regulation of synaptic connections between astrocytes and neurons via 40Hz gamma oscillations. Collectively, this suggests a promising intervention for age-related cognitive decline and identifies neuron-astrocyte synapses as potential therapeutic targets.

Time-series transcriptomics reveals distinctive mRNA expression dynamics associated with gene ontology specificity and protein expression in skeletal muscle after electrical stimulation-induced resistance exercise.

Resistance exercise upregulates and downregulates the expression of a wide range of genes in skeletal muscle. However, detailed analysis of mRNA dynamics such as response rates and temporal patterns of the transcriptome after resistance exercise has not been performed. We aimed to clarify the dynamics of time-series transcriptomics after resistance exercise. We used electrical stimulation-induced muscle contraction as a resistance exercise model (5 sets × 10 times of 3 s of 100-Hz electrical stimulation) on the tibialis anterior muscle of rats and measured the transcriptome in the muscle before and at 0, 1, 3, 6, and 12 h after muscle contractions by RNA sequencing. We also examined the relationship between the parameters of mRNA dynamics and the increase in protein expression at 12 h after muscle contractions. We found that the function of the upregulated genes differed after muscle contractions depending on their response rate. Genes related to muscle differentiation and response to mechanical stimulus were enriched in the sustainedly upregulated genes. Furthermore, there was a positive correlation between the magnitude of upregulated mRNA expression and the corresponding protein expression level at 12 h after muscle contractions. Although it has been theoretically suggested, this study experimentally demonstrated that the magnitude of the mRNA response after electrical stimulation-induced resistance exercise contributes to skeletal muscle adaptation via increases in protein expression. These findings suggest that mRNA expression dynamics such as response rate, a sustained upregulated expression pattern, and the magnitude of the response contribute to mechanisms underlying adaptation to resistance exercise.

Enhancing cell motility via non-contact capacitively coupled electrostatic field.

Cellular motility is essential for making and maintaining multicellular organisms throughout their lifespan. Migrating cells can move either individually or collectively by a crawling movement that links the cytoskeletal activity to the adhesion surface. In vitro stimulation by electric fields can be achieved by direct, capacitive or inductive coupled setups. We tested the effects of electrical stimulation provided by capacitive coupling on glioma cells, using a capacitive-coupled system powered by a potential difference of 35V between two electrodes placed outside the culture dish. Numerical dosimetry identified two different fields: (i) in the order of 103 V/m at the level of the dielectric substrates, with almost uniform distribution; (ii) in the order of 10-1 V/m at the level of the culture medium, with spatial and material-dependent distribution. The scratch assay and the tracking of single-cell movement showed a boosted motility when crawling occurs on polystyrene surfaces, demonstrating the feasibility of this peculiar exposure system to generate forces capable of influencing cell behavior.

Enhancing Regeneration and Functionality of Excitable Tissues via Integrating Bioelectronics and Bioengineered Constructs

Abstract The inherent complexities of excitable cardiac, nervous, and skeletal muscle tissues pose great challenges in constructing artificial counterparts with bioelectrical, structural, and mechanical properties that closely resemble their natural states. Recent advances have increasingly revealed the beneficial impact of bioelectrical microenvironments on cellular behaviors, functional tissue regeneration, and improved therapeutic outcomes for these excitable tissues. This review aims to unveil the mechanisms by which electrical microenvironments enhance the regeneration and functionality of excitable cells and tissues, considering both endogenous electrical cues from electroactive biomaterials and exogenous electrical stimuli from external electronic systems. We explore the synergistic effects of these electrical microenvironments, combined with structural and mechanical guidance, on the regeneration of excitable tissues using tissue engineering scaffolds. Additionally, the emergence of micro/nanoscale bioelectronics has significantly expanded the scope of this field, enabling intimate interactions between implantable bioelectronics and excitable tissues at the cellular, tissue, and organ levels. These interactions allow for precise data extraction and localized modulation of cell and tissue functionalities through intricately designed electronic components according to physiological needs. The integration of tissue engineering and bioelectronics holds the potential to achieve optimal outcomes, highlighting a growing trend in engineering living tissue construct-bioelectronic hybrids for restoring and monitoring damaged excitable tissues. Furthermore, we envision critical challenges in engineering the next generation of these hybrids, focusing on integrated fabrication strategies, the development of ionic conductive biomaterials, and their convergence with biosensors.

Insulin mitigates acute ischemia induced atrial fibrillation and sinoatrial node dysfunction ex vivo.

Acute atrial ischemia is a well-known cause of postoperative atrial fibrillation (POAF). However, mechanisms through which ischemia contributes to the development of POAF are not well understood. In this study, ex vivo Langendorff perfusion was used to induce acute ischemia and reperfusion in the heart in order to mimic POAF. Inducibility of atrial fibrillation (AF) was evaluated using programmed electrical stimulation and confirmed with open-atrium optical mapping. Compared to the control group without ischemia, 25 minutes of ischemia substantially increased the incidence of AF. The right atrium was more susceptible to AF than the left atrium. Administering insulin for 30 minutes before ischemia and during reperfusion with 25 minutes of ischemia greatly reduced the vulnerability to AF. However, insulin treatment during reperfusion only did not show substantial benefits against AF. Optical mapping studies showed that insulin mitigates ischemia-induced abnormal electrophysiology, including shortened action potential duration and effective refractory period, slowed conduction velocity, increased conduction heterogeneity, and altered calcium transients. In conclusion, insulin reduced the risk of acute ischemia/reperfusion-induced AF via improving the electrophysiology and calcium handling of atrial cardiomyocytes, which provides a potential therapy for POAF.

Full textile-based body-coupled electrical stimulation for wireless, battery-free, and wearable bioelectronics

Full textile-based body-coupled electrical stimulation for wireless, battery-free, and wearable bioelectronics

Effect of experimental knee pain location on gait kinematics.

In this study, we investigated whether experimental knee pain alters lower limb kinematics and knee arthrokinematics during gait, and if this motor adaptation depends on the spatial characteristics of the painful stimulus. Twenty-one participants walked on a treadmill for 60-s trials, either without stimulation or while experiencing painful electrical stimulation in the medial, lateral or anterior region of the knee. Perceived pain location was analyzed using pain drawing. Gait spatiotemporal parameters, lower limb kinematics, and dispersion of the knee helical axes on the sagittal plane were quantified for each trial and compared between conditions using ANOVAs with repeated measures or Friedman tests. Pain perception was localized in the area the stimulation was applied to. Compared to walking without pain, participants demonstrated reduced knee extension (1.5 ± 1.5 degrees, p = 0.002) and reduced hip extension (0.8 ± 1.1 degrees, p = 0.037) when pain was induced in the anterior region, but not medially or laterally. Anterior knee pain increased the mean distance of the helical axes during late stance (0.7 [0.3, 1.4], p = 0.010), while medial pain increased both mean distance (0.3 [0.1, 0.5], p = 0.037) and mean angle (1.2 ± 1.4, p = 0.010) during early swing. Acute, experimental knee pain alters gait kinematics and increases the dispersion of the helical axis. These adaptations depend on the spatial characteristics of the painful stimulus. These adaptations may reflect an attempt of the central nervous system to protect the painful tissue while searching for a less painful movement strategy.

Self-powered chitosan/graphene oxide hydrogel band-aids with bioadhesion for promoting infected wounds healing.

Typical anti-infection strategies, such as antibiotics and other antibacterial nanomaterials, are effective in preventing bacterial infections during the wound healing process. Additionally, electrical stimulation (ES) can also inhibit bacterial growth and facilitate skin wound repair. However, self-powered and therapeutic wearable devices combining antibacterial materials with ES are still lacking. In this research, a bio-adhesive band-aid with antibacterial activity and piezoelectric properties made up of a chitosan/graphene oxide (CSGO) hydrogel matrix and a piezoelectric nanogenerator (PENG) patch based on electrospun polyvinylidene difluoride (PVDF) nanofibers is developed for infected wound healing. Specifically, self-adhesive CSGO hydrogels help the band-aid closely adhere to the wound site, and PVDF nanofibers convert biokinetic energy into electricity to provide real-time ES. The in vitro antibacterial test demonstrates that >99 % of S. aureus and E. coli are killed by the treatment of CSGO hydrogel and ES. Remarkably, in the rat model of infected wounds, the assembled band-aid consisting of a PENG of 2.25 cm2 can promote angiogenesis, collagen deposition, and re-epithelialization, greatly accelerating infected wounds healing in 21 days. This study offers a simple and practicable method for the design of wearable bioelectronics, indicating a promising future in personalized healthcare and clinical treatment.