Form Of Electric Therapy Research Articles

Noninvasive Interactive Neurostimulation Therapy for the Treatment of Low-Grade Lateral Ankle Sprain in the Professional Contact Sport Athlete Improves the Short-Term Recovery and Return to Sport: A Randomized Controlled Trial

Ankle injuries are very common between professional athletes and recreational sports. Lateral stable ligaments injury can be treated conservatively. Noninvasive interactive neurostimulation (NIN) is a form of electric therapy that works by locating areas of lower skin impedance. The objective of this prospective, double-blinded, randomized controlled trial was to compare the results in terms of improvement of a foot functional score, lower level of reported pain, and return to sports in 2 groups of contact sport athlete affected by a grade I or II lateral ankle sprain. Patients were randomized using random blocks to the NIN program (group I) or a sham device (group II). The outcome measurements were the use of a self-reported Inability Walking Scale, patient-reported subjective assessment of the level of pain using a standard visual analogue scale, and daily intake of nonsteroidal antiinflammatory drugs (etoricoxib 60 mg). Patients were also reached by telephone at 2 and 4 months of follow-up to register their return to sport activity. Beyond baseline evaluation, follow-ups were done after 5 (1 week) and 10 sessions (2 weeks) of treatment, and then at 30 days after the end of therapy. Of the 70 athletes admitted to the study, 61 eligible patients were randomized using random blocks to group I (n = 32) and group II (n = 29). Group I patients showed better improvement in terms of functional impairment (Inability Walking Scale), reported pain (visual analogue scale), and daily intake of etoricoxib 60 mg. Athletes of group I registered a faster resuming of sport activities. This prospective, randomized trial showed NIN can improve short-term outcomes in athletes with acute grade I or II ankle sprain and that it can hasten resuming of sport activities.

Treatment of Chronic Plantar Fasciitis with Noninvasive Interactive Neurostimulation: A Prospective Randomized Controlled Study

The initial treatment of plantar fasciitis should be conservative, with most cases responding to standard physiotherapy, nonsteroidal anti-inflammatory drugs (NSAIDs), heel pads, and stretching. In cases of chronic refractory symptoms, more invasive treatment could be necessary. Noninvasive interactive neurostimulation (NIN) is a form of electric therapy that works by locating areas of lower skin impedance. The objective of the present prospective randomized controlled study was to evaluate whether the use of NIN for chronic plantar fasciitis could result in greater improvement in a foot functional score, lower levels of reported pain, reduced patient consumption of NSAIDs, and greater patient satisfaction compared with electric shockwave therapy in patients without a response to standard conservative treatment. The patients were randomized using random blocks to the NIN program (group 1) or electric shockwave therapy (group 2). The outcome measurements were the pain subscale of the validated Foot Function Index (PS-FFI), patient-reported subjective assessment of the level of pain using a standard visual analog scale, and daily intake of NSAID tablets (etoricoxib 60 mg). The study group was evaluated at baseline (time 0), week 4 (time 1), and week 12 (final follow-up point). Group 1 (55 patients) experienced significantly better results compared with group 2 (49 patients) in term of the PS-FFI score, visual analog scale score, and daily intake of etoricoxib 60 mg. NIN was an effective treatment of chronic resistant plantar fasciitis, with full patient satisfaction in >90% of cases. The present prospective randomized controlled study showed superior results for noninvasive neurostimulation compared with electric shockwave therapy, in terms of the functional score, pain improvement, and use of NSAIDs.

Long-term outcome of cardiac contractility modulation in patients with severe congestive heart failure

Cardiac contractility modulation (CCM) is a new form of electrical therapy in patients with congestive heart failure. Recently published clinical studies provide evidence of safety and improvements of exercise tolerance and quality of life. In this study, we investigated the impact of CCM on cardiac and all-cause mortality. Fifty-four consecutive patients (age 63 ± 10 years, 91% male, left ventricular ejection fraction 23 ± 6%, baseline peak oxygen consumption 10.0 ± 4.8 mL/min/kg, N-terminal pro-B-type natriuretic peptide 5194 pg/mL, New York Heart Association III/IV) who underwent implantation of an Optimizer system (IMPULSE Dynamics, Orangeburg, NY, USA) at our centre between June 2003 and June 2010 were analysed retrospectively. Patients were followed every 3 months at our outpatient clinic. This study determined long-term outcomes of patients receiving CCM therapy. Twenty-four (44%) patients died during the follow-up period, which included 19 cardiac deaths (3 sudden cardiac deaths and 16 terminal cardiac pump failure deaths). The Kaplan-Meier analysis calculated a median survival time of 992 days (33.1 months) and a mean death rate of 18.4% per year. All-cause mortality for these patients was precisely predicted by the Seattle Heart Failure Model. Cardiac contractility modulation appears to be a safe therapeutic option for advanced heart failure patients who have no other therapeutic options. Symptomatic improvement by CCM has been shown in earlier studies but our observational study suggests, for the first time, that there is no adverse effect of CCM on long-term survival.

Anaesthesia and cardiac contractility modulation

Chronic heart failure is known to be an important risk factor for adverse perioperative outcome in patients undergoing non-cardiac surgery. A promising new form of electric therapy is currently being used in a phase III trial in patients with severe chronic heart failure (cardiac contractility modulation). Cardiac contractility modulation is a non-pharmacological approach to improve Ca2+ effect on cardiac myofilaments using electric currents. The cardiac contractility modulation system used at present (OPTIMIZER III, Impulse Dynamics, Orangeburg, NY, USA) consists of a subcutaneously implanted pulse generator and three electrodes. As far as we know, cardiac contractility modulation therapy is a safe and feasible way of improving the systolic function of the heart in congestive heart failure patients. No pro-arrhythmic effects of this new therapy have been reported. The technique shows promise as an additive treatment for severe chronic heart failure. The perioperative and intraoperative management of patients should follow current cardiac pacemaker/implantable cardioverter defibrillator guidelines.

Prevention and management of chronic heart failure with electrical therapy

Sudden cardiac death is responsible for >40% of patients with heart failure losing their lives. Thus, the prevention of life-threatening cardiac arrhythmias is a major goal in the management of heart failure. In several randomized clinical trials, electrical therapy with the implantable cardioverter defibrillator (ICD) has proved superior to medical antiarrhythmic therapy in both the secondary and primary prevention of sudden cardiac death in patients with reduced left ventricular function. In addition to the severity of left ventricular dysfunction, the etiology of the cardiomyopathy appears to be a determinant in the benefit derived from this form of electrical therapy. Whereas patients with ischemic cardiomyopathy clearly show improved survival with ICD therapy, outcome data in patients with nonischemic cardiomyopathy are less convincing. The major challenge lies in the risk stratification of patients with heart failure for arrhythmic death. Catheter ablation is another form of electrical therapy that can help in the treatment of patients with heart failure. In patients with a tachycardia-mediated cardiomyopathy because of drug-refractory atrial fibrillation with rapid ventricular response, catheter ablation of the atrioventricular node and pacemaker implantation can effectively restore a physiologic heart rate, often with dramatic regression of left ventricular dysfunction. In patients with frequent ICD therapies because of frequent recurrences of ventricular tachyarrhythmias, catheter ablation of ventricular tachycardia can be an effective adjunctive therapy. New catheter ablation techniques and new atrial pacing algorithms can also significantly reduce the atrial fibrillation burden in patients with heart failure who are particularly susceptive to decompensation because of atrial fibrillation. Pacing for hemodynamic benefit in heart failure has evolved from dual-chamber pacing modes with optimized atrioventricular delay to biventricular pacing resulting in cardiac resynchronization. This new treatment modality for advanced heart failure has been shown to result in significant symptomatic and hemodynamic improvement.

Benjamin Franklin and Static Electricity. Considerations of Past, Present, and Future

ABSTRACT.There was great interest in static electricity during the early years of discovery. Following the demonstration of flowing electricity, however, interest and application of static electricity waned as new uses for flowing electricity were found. At present, single capacitor discharges are used only in cardiac defibrillation. Might this form of electrical therapy be an improvement on present electrocon-vulsive therapy?