Electro Stimulation Research Articles

Importance of modern treatment procedures for infected and colonized wounds in dermatology

In the coming years increasing numbers of patients with chronic ulcers and tumor wounds are to be expected, both of which are typically multifaceted diseases requiring complex and increasingly long-term ambulatory therapy. Therefore, in recent years special medical emphasis has been placed on efficacious therapies with good tolerability and also suitability regarding feasibility for outpatient treatment. Some of these methods, such as cold plasma therapy, extracorporeal shock wave therapy (ESWT), water-filtered infrared therapy (wIRA), electrostimulation (ES) and low level laser therapy (LLLT) have a good chance of success when applied as an adjuvant method in the multimodal treatment concept for patients with recalcitrant wounds. All of these methods have at least indirect antimicrobial properties which can be advantageous in cases of microbial infiltration of wounds. As for all other methods for treating recalcitrant wounds, the promising application of the aforementioned methods requires great expertise in wound healing together with a broad and continuous interdisciplinary diagnostics and therapy (wound center).

Awareness and timing of pelvic floor muscle contraction, pelvic exercises and rehabilitation of pelvic floor in lifelong premature ejaculation: 5 years experience

To assess the cure rate of patients with premature ejaculation who underwent a treatment involving: 1) awareness of the pelvic floor muscles 2) learning the timing of execution and maintenance of contraction of the pelvic floor muscles during the sensation of the pre-orgasmic phase 3) pelvic floor rehabilitation (bio feed back, pelvic exercises and electrostimulation). We recruited 78 patients with lifelong premature ejaculation who completed the training. The patients were informed of the role of the pelvic floor. They were taught to carry out the execution and maintenance of contraction of the pelvic floor muscles during the sensation of the pre-orgasmic phase to control the ejaculatory reflex. In order to improve the awareness, the tone and the endurance of the pelvic floor muscles, patients were treated with the rehabilitation of pelvic floor (RPF) consisting mainly in biofeedback, pelvic exercises and in some cases also in electro-stimulation (ES). The training was carried out for a period of about 2-6 months with an average of 2-5 visits per cycle. 54% of patients who completed the training were cured of premature ejaculation and learned over time to be able to postpone the ejaculation reflex. In a subgroup of 26 patients was also measured the IELT which on the average increased from < 2 minutes to >10 minutes. The best results occurred mainly in patients aged less than 35 where the cure rate was 65%. There were no side effects. In this study, approximately half of patients with premature ejaculation were cured after applying the above treatment.This therapy, necessitates a fairly long period of time (2-6 months) and a great commitment on the part of the patient, nevertheless it can be a valid and effective treatment for patients with premature ejaculation. This treatment makes the patient independent in that he is not bound to specific times for taking medication. Furthermore there are no side effects and this therapy is particularly effective in young males.

The analgesic effect of electrostimulation (WoundEL®) in the treatment of leg ulcers

This study aims to demonstrate the analgesic efficacy of electrostimulation (ES), a recognised treatment for leg ulcers. Patients treated by ES for leg ulcers between 2011 and 2013 were included in the study. The pain score obtained with the numerical rating scale (NRS) was reported before the start of the ES (D0), after 3 days (D3) and 1 week following treatment initialisation. The analgesic treatments (AT) were reported at each assessment. Seventy-three patients were included (mean age 75·19 years): 31 venous leg ulcers, 21 mixed venous leg ulcers, 2 arterial ulcers, 17 hypertensive ischaemic ulcers, 1 Hydrea(®)-induced ulcer and an amputation stump ulcer. The NRS at D0 was on average 5·3 (median = 6) while it was 2·2 at D7 (median = 2), that is P < 0·001. The results were also significant between D0 and D3 (P < 0·001). A decrease in the number of AT used was observed between D0 (2·0 AT per patient on average) and D7 (1·7 AT on average) (P < 0·001). We also observed a decrease in the consumption of grade 3 analgesics on D0 and D7 (P = 0·03). This study demonstrates the rapid analgesic efficacy of ES in leg ulcers, with a clear impact on the NRS score and especially on the decrease in analgesic consumption.

USE OF THE TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) IN CONTROL OF NAUSEA AND VOMITING

Nausea and vomiting are symptoms that cause significant impact on the quality of life cancer patients undergoing chemotherapy. The aim of this study was to evaluate the influence of TENS in controlling nausea and vomiting after chemotherapy. Methods: We performed an exploratory quantitative study of experimental blind randomized clinical trial with 83 patients with antineoplastic drugs classified as medium and high emetogenic degree. Were divided into two groups: in one group, classified as intervention, electro stimulation was performed with TENS for 30 minutes with a frequency of 10 Hz to 500 mS pulse width with varying intensity, which was increased according to the tolerance of the patient from the point P6. In the other group, the control, patients suffered a simulation of electrical stimulation at zero frequency. Was performed electro stimulation during chemotherapy session. The symptoms and the amount of administered antiemetics at home were valued in the first two consecutive days of chemotherapy. The intensity of nausea was quantified by visual analog scale. The patient was instructed to write down the number of episodes of vomiting and antiemetic amount administered. Results: The average amount of nausea on the day of chemotherapy, vomiting on the day of chemotherapy and the next day following day and the amount of antiemetic taken at home in those first two days was significantly lower in the group of intervention. Conclusion: TENS showed a complementary effective in controlling nausea and vomiting.

Effects of a Dynamic Warm-Up, Static Stretching or Static Stretching with Tendon Vibration on Vertical Jump Performance and EMG Responses

The purpose of this study was to investigate the short-term effects of static stretching, with vibration given directly over Achilles tendon, on electro-myographic (EMG) responses and vertical jump (VJ) performances. Fifteen male, college athletes voluntarily participated in this study (n=15; age: 22±4 years old; body height: 181±10 cm; body mass: 74±11 kg). All stages were completed within 90 minutes for each participant. Tendon vibration bouts lasted 30 seconds at 50 Hz for each volunteer. EMG analysis for peripheral silent period, H-reflex, H-reflex threshold, T-reflex and H/M ratio were completed for each experimental phases. EMG data were obtained from the soleus muscle in response to electro stimulation on the popliteal post tibial nerve. As expected, the dynamic warm-up (DW) increased VJ performances (p=0.004). Increased VJ performances after the DW were not statistically substantiated by the EMG findings. In addition, EMG results did not indicate that either static stretching (SS) or tendon vibration combined with static stretching (TVSS) had any detrimental or facilitation effect on vertical jump performances. In conclusion, using TVSS does not seem to facilitate warm-up effects before explosive performance.

Morphometric Assessment of the Effectiveness of Post-Traumatic Regeneration of Peripheral Nerves Using Single and Repeated Courses of Electrostimulation

The effects of electrostimulation (ES) on peripheral nerve regeneration were studied in 41 dogs by transection and microsuturing of the sciatic nerve (SN). The control group consisted of 23 animals, while 18 underwent ES of the spinal cord and SN using a 50-Hz alternating current; 13 animals received one course of 18 sessions 1–2.5 months after surgery (subgroup ES1) and five animals received a first courses at the same times and a second at 6–7.5 months after surgery (subgroup ES2). The mean diameter of myelinated fibers (MF) in subgroup ES1 was significantly greater than in controls at 2.5, 4, 6, and 12 months after surgery, mainly because of increases in axon diameter. At 12 months, subgroup ES2 and to a lesser extent subgroup ES1 showed a marked tendency to recovery of the bimodal distribution of MF diameter. Thus, ES was found to produce effective increases in MF regeneration and differentiation, though it led to relative hypomyelinization of MF.

Different volumes of injectate using electrostimulator and blinded techniques for brachial plexus block in dogs

To compare different volumes of injectate using electrostimulator (ES)-guided and blind brachial plexus blockade (BPB) techniques in dogs. Prospective, randomised, blinded study. Fifty-eight healthy adult purpose-bred beagle dogs. Animals were...

Transcranial electro stimulation in the acute treatment of chronic migraine patients with lateral cerebral ventricles asymm/INS;etry

Background: Transcranial electro stimulation (TES) is an effective acute treatment for chronic migraine (CM), one of the possible mechanisms being the increase of β/INS;-endorphin level. Pharmacologic CM preventive treatment seemed to be less efficient if a “benign” lateral ventricles asymmetry (LVA) was associated. The aim of our study was to estimate the efficiency of TES in the acute treatment of CM with pronounced LVA.

Pelvic floor electrostimulation in women with urinary incontinence and/or overactive bladder syndrome: A systematic review

Abstract Context Electrostimulation (ES) is one of the techniques employed in conservative treatment of urinary incontinence (UI) and/or overactive bladder syndrome (OAB). Nevertheless, there is controversy in the scientific literature regarding its effectiveness as monotherapy. Objective To evaluate the scientific evidence on ES of the pelvic floor in women with UI and with/without OAB. Evidence acquisition A systematic review of clinical trials was carried out in the following databases: PubMed, Cochrane, PEDro, Elsevier (Doyma) and EnFisPo (1980–2011). Quality of study registries was evaluated and information was obtained from those that presented the inclusion criteria established in the review. Evidence synthesis The 27 clinical trials were included in the review: 13 randomized controlled trials, 11 randomized non-controlled trials and 3 non-randomized trials. Conclusion Most of the clinical trials conclude that ES is effective in the treatment of UI and OAB in women. However, better methodological quality studies are needed to obtain a higher level of scientific evidence and to know the optimal current modality, type and parameters for each type of UI and OAB.

THE EFFECTIVENESS OF AN INTENSIVE EXERCISE PROGRAMME IN THE FUNCTIONAL RECOVERY OF A SEVERE DEGENERATIVE ACHILLES TENDINOPATHY. IS IT ENOUGH BY ITSELF? A CASE REPORT

IntroductionAchilles tendinopathy (AT) is classically known to be very resistant to treatment. Although other diagnoses such as bursitis and insertional problems have been described, the most common pathology is mid-portion...

EFFECTIVENESS OF ULTRASOUND-GUIDED PERCUTANEOUS ELECTROLYSIS INTRATENDON (EPI) IN THE TREATMENT OF INSERTIONAL PATELLAR TENDINOPATHY IN SOCCER PLAYERS

IntroductionPatellar tendinopathy or ‘jumper's knee’ is considered more of a degenerative (tendinosis) than a non-inflammatory process (tendinitis). Recent histopathological studies have shown the absence of inflammatory cells in this type...

Electro Stimulation of Paretic Muscles and Chinese Acupuncture Are for the Rehabilitation in Patients with Stroke (P01.177)

Objective: To evaluate the efficacy and safety of Chinese Acupuncture (CA) and Electro stimulation of paretic muscles (ESPM) for rehabilitation in stroke outcomes patients. Background CA is a well known and completely developed system of ancient China. It works according points are on the acupuncture channels of human body. ESPM is a method for releasing paresis. Design/Methods: The author observed two groups with equal number of 36 patients in each other for 110 days. The first group of patients was treated only by ESPM therapy and another one was treated by both methods of using CA and ESPM in the same shortage of time. The results of treatment were evaluated by lowering pyramidal pathologic, increasing the strength and volume of movement in paralytic extremities and were estimated using scale of stroke outcomes. As a scale were using Canadian Neurological Scale (CNS) and American Heart Association (AHA) Stroke Outcome Classification Score. Also, the improving of outcomes was evaluated by the tools monitoring included EMG and dopplering of brain blood circulation. Results: In ESPM group of scientific investigation the improvement was in summary 17,9 % according the scale of stroke outcomes and the blood circulation has increased on 7,2 %. The group that had been treating by both: ESPM and CA, responded by 28,4 % of the increasing of the strength and volume of movement in paralytic extremities those were estimated by the scale of stroke outcomes and the improvement of blood circulation was 9,6%. EMG was approximately of the same pattern. ESPM and CA were well tolerated and they were without any complications. Conclusions: This trial demonstrates that ESPM and CA are of high efficacious and well tolerated when administered as ways for rehabilitation in patients suffering of stroke outcomes. Disclosure: Dr. Aslanyan has nothing to disclose.

Development of Bioartificial Myocardium by Electrostimulation of 3D Collagen Scaffolds Seeded with Stem Cells

Electrostimulation (ES) can be defined as a safe physical method to induce stem cell differentiation. The aim of this study is to evaluate the effectiveness of ES on bone marrow mesenchymal stem cells (BMSCs) seeded in collagen scaffolds in terms of proliferation and differentiation into cardiomyocytes. BMSCs were isolated from Wistar rats and seeded into 3D collagen type 1 templates measuring 25 × 25 × 6 mm. Bipolar in vitro ES was performed during 21 days. Electrical impedance and cell proliferation were measured. Expression of cardiac markers was assessed by immunocytochemistry. Viscoelasticity of collagen matrix was evaluated. Electrical impedance assessments showed a low resistance of 234±41 Ohms which indicates good electrical conductivity of collagen matrix. Cell proliferation at 570 nm as significantly increased in ES groups after seven day (ES 0.129±0.03 vs non-stimulated control matrix 0.06±0.01, P=0.002) and after 21 days, (ES 0.22±0.04 vs control 0.13±0.01, P=0.01). Immunocytoche mistry of BMSCs after 21 days ES showed positive staining of cardiac markers, troponin I, connexin 43, sarcomeric alpha-actinin, slow myosin, fast myosin and desmin. Staining for BMSCs marker CD29 after 21 days was negative. Electrostimulation of cell-seeded collagen matrix changed stem cell morphology and biochemical characteristics, increasing the expression of cardiac markers. Thus, MSC-derived differentiated cells by electrostimulation grafted in biological scaffolds might result in a convenient tissue engineering source for myocardial diseases.

Acute inhibitory effect of neuromuscular electro stimulation on muscle sympathetic activity in chronic heart failure

Acute inhibitory effect of neuromuscular electro stimulation on muscle sympathetic activity in chronic heart failure

Femoral and obturator nerves palsy caused by pelvic cement extrusion after hip arthroplasty.

Cement extrusion into the pelvis with subsequent palsy of the obturator and femoral nerves is a rare entity after hip replacement surgery. Cemented fixation of the acetabular cup has been considered as a safe and reliable standard procedure with very good long term results. We present a case of fifty year old female patient after hip arthroplasty procedure which suffered an obturator and femoral nerve palsy caused by extrusion of bone cement into the pelvis. Postoperative X-rays and CT-scan of the pelvis demonstrated a huge mass consisted of bone cement in close proximity of femoral and obturator nerves. The surgery charts reported shallow and weak bony substance in postero-superior aspect of the acetabulum. This weak bony acetabular substance may have caused extrusion of bone cement during press-fitting of the polyethylene cup into the acetabulum, and the following damage of the both nerves produced by polymerization of bone cement. The bone cement fragment has been surgically removed 3 weeks after arthroplasty. The female patient underwent intensive postoperative physical therapy and electro stimulation which resulted in full recovery of the patient to daily routine and almost normal electromyography results.

Operative treatment of primary brain tumors localized in motor zone with direct corticalis electrostimulation: Series of 62 patients

In spite of the progress made in diagnostic procedures and development of the operating rooms technology, considerable neurological deficit after operation of tumors localised in the brain motor zone commits one to direct intraoperative identification of the motor zone. By introducing direct electrocortical stimulation into the routine intraoperative application the primary goal has been achieved -reaching the maximum degree of radicalness of surgical resection while preserving motor centres in the cerebral cortex. We are hereby demonstrating a series of 60 patients operated for primary brain tumors localised in the area in the front and around the central sulcus. All operations have been performed under the general anesthetics. During the operations the method of direct electrostimulation (ES) was used for the purpose of identifying motor centres. Intraoperatively a level of subtotal resection was achieved in 22 cases, while radical resection was possible in 38 cases. Significantly higher level of radicalness of surgical resection of the low grade glioma tumor was confirmed statistically in relation to the group of patients with glioblastoma multiforme by applying the ES cortex (p < 0.05). Patients with slow developing brain glioma have statistically considerably higher KI value in relation to the KI values in the group of patients with glioblastoma multiforme (p 0 < 0.01). Difference in the measured values of distance from the coronal suture based on the results of MRI measuring and finding obtained by ES, has shown a statistically considerably higher difference with a glioblastoma multiforme 8.26 +/- 4.288 mm when compared to slowly developing astrocitoma 5.88 +/- 3,080 (p < 0.05). Electrostimulation of the brain cortex is a safe, simple and precise method for identification of the brain motor zone which enables prevention of additional postoperative deficit and higher level of surgical radicalness.

Effects of 3-methylhistamine and phenylethylamine on histamine action on isolated guinea-pig trachea rings

It is well known that histamine produces constriction via H1 receptors and decreases tracheal smooth muscle tone via H2 and H3 receptors. In addition, it has already been reported that 3-methylhistamine and phenylethylamine are competitive antagonists of histamine N-methyl-transferase (HMT), the enzyme responsible for rapid inactivation of histamine. Our results suggest the possibility that 3- methyl-histamine and phenylethylamine as competitive antagonists of histamine N-methyl-transferase lead to potentiation of histamine induced constriction of isiolated guinea-pig trachea, probably due to the decrease of histamine methylation and consequent inactivation. In as much, 3-methyl-histamine and phenylethylamine had no effect on the basal tone of isolated trachea smooth muscle, as well as on other mechanisms leading to increased responsiveness of guinea-pig tracheal smooth muscle (acetylcholine, KCl, electro stimulation).

Nuclear Remodeling in Bovine Somatic Cell Nuclear Transfer Embryos Using MG132-Treated Recipient Oocytes

The early events in the nuclear reprogramming process during somatic cell nuclear transfer (SCNT) consist of morphological remodeling of the donor nucleus including premature chromosome condensation (PCC). In the present study, the objective was to increase oocyte M-Phase Promoting Factor (MPF) kinase activity and to examine the fate of the donor nucleus and the development of SCNT embryos thereafter. Indeed, in controls, recipient oocytes activated upon nuclear transfer, undergo a decrease in MPF activity, responsible for the inability to promote PCC in 77.8% of reconstituted embryos. Here we showed that exposure of the recipient oocyte to the proteasome inhibitor MG132 prior to fusion inhibited the degradation of cyclin B, which normally occurred immediately after activation by electro stimulation, and therefore sustained a high level of MPF. Treatment with MG132 also significantly increased the percentage of SCNT embryos with PCC when compared to the nontreated SCNT control embryos (94.1 vs. 22.2%, respectively, p < 0.01). The frequency of development to the blastocyst stage did not differ between MG132-treated or untreated recipient oocytes. However, we observed a significant increase of the total cells number in embryos produced after MG132 treatment. Investigation of the global nuclear organization by immunodetection of heterochromatin protein 1 (CBX1) showed that SCNT embryos derived from MG132-treated recipient oocytes displayed organization patterns similar to the ones observed in IVF embryos in contrast to the nontreated SCNT controls. Taken together, these results suggest that the PCC induced by MG132 treatment allows reorganization of the chromatin at an appropriate time potentially, leading to better reprogramming.

Electro-acupuncture reduces the need for additional anesthetics in experimental studies

To evaluate the possible beneficial effects of electro-acupuncture in rats subjected to ketamine/xylazine (KX) intra-peritoneal (i.p.) anesthesia. Forty-eight male Wistar rats were distributed in four equal groups. All rats received i.p. injections of ketamine (90 mg/kg) +xylazine (10 mg/kg) anesthesia. Basal values group (control) rats (BV) received no additional treatment. The equivalent of the human right ST36 (Zusanli) and CV-12(Zhongwan) acupoints were chosen for needling and electrical stimulation. AC rats were needled with sterilized disposable stainless steel needles at right ST36 and CV12 acupoints; needles were retained for 30 minutes. EAC10 rats, after needle insertion as described, had electrodes connected to both needles and to an electro stimulator model NKL EL-608; pulsed square waves, 10 Hz, 10 mA, was applied for 30 minutes. EAC100 rats were submitted to EA as described. However, a greater frequency (100 Hz) was used. Thirty-seven rats remained under adequate anesthetic level during the experiment. However, maintenance anesthesia was required by 11 rats. Need for additional anesthesia decreased to 9.1% in EAC100 rats compared to BV (36.3%). Both the AC and the EAC10/100 prolong the anesthetic effect of the combination Ketamine-xylazine in rats, allowing longer duration of anesthesia with a lower dose of anesthetic, thereby reducing the occurrence of complications.

Acupuncture for dysphagia after chemoradiation therapy in head and neck cancer: An ongoing pilot, randomized, sham-controlled trial.

TPS270 Background: Dysphagia is a common side effect following chemoradiation therapy (CRT) in patients with head and neck cancer (HNC). Dysphagia and other treatment-related conditions such as aspiration, xerostomia, and fibrosis can significantly impact quality of life (QOL) in HNC patients. Acupuncture could potentially impact dysphagia by improving salivary production, restoring swallowing reflex, and inhibiting the fibrosis process. Preliminary clinical studies suggest that acupuncture may improve radiation–induced xerostomia in HNC patients. However, acupuncture has not been rigorously tested for dysphagia in HNC patients in a randomized controlled trial. The purpose of the ongoing pilot, randomized, sham-controlled trial is to assess the feasibility of recruiting and retaining HNC patients, and to collect preliminary data on the efficacy and safety of acupuncture on dysphagia and health-related quality of life (QOL). Methods: Eligible participants are patients diagnosed with squamous cell carcinoma of the head and neck at stage II, III and IV, without evidence of distant metastasis, receiving chemoradiation. They are randomized to 12 sessions of either active acupuncture (n=18) or sham acupuncture (n=18). All study personnel and study participants, except the treating acupuncturist, are blinded to the treatment assignment. The active acupuncture consists of manual and electro stimulation at extremities, while sham acupuncture needles are placed at adjacent sites with a mock stimulation device. The primary endpoint of the study is to assess the feasibility of recruiting and retaining HNC patients into a randomized controlled trial of acupuncture. The study will be considered feasible for further study if at least 75% of intervention participants are compliant and at least 80% of participants in each group complete all study evaluations. Secondary end points include: The M. D. Anderson Dysphagia Inventory and other QOL questionnaires are measured periodically during the treatment and a 6 months following up period. The planned study recruitment period is from January 2008 to December 2010. Seven patients have been enrolled into the study as of January 2010. No significant financial relationships to disclose.