High Voltage Electrical Stimulation Research Articles

Effects of High-Voltage Electrical Stimulation in Improving the Viability of Musculocutaneous Flaps in Rats

The musculocutaneous flap of the transverse rectus abdominis muscle is a technique used for breast reconstruction, and one of the complications of this procedure is tissue necrosis. The objective of the study is to determine the effect of high-voltage electrical stimulation (HVES) in the transverse rectus abdominis muscle flap in rats. Fourteen rats underwent surgery for obtaining the flap. The rats were distributed into 2 homogeneous groups: group 1 underwent both surgery and the use of HVES, whereas group 2 underwent just the surgery (control). Electrical stimulation was applied immediately after surgery and for 2 consecutive days. The percentage of necrotic area was analyzed using the Image J software, and blood flow was assessed by infrared thermography in different regions of the flap, divided into 4 zones according to the proximity of the pedicle of the inferior epigastric artery. The results were analyzed using a Student t test, where group 1 experienced a necrotic area of 26.2%, and group 2 had an area of 54.5%. Regarding the temperature, the 2 groups showed increase in the minimum and maximum temperature on the fourth postoperative day. The HVES appeared to have a positive influence on the viability of the flap.

Normative Values for Intertrial Variability of Motor Responses to Nerve Root and Transcranial Stimulation: A Condition for Follow-Up Studies in Individual Subjects.

ObjectiveIntertrial variability (ITV) of motor responses to peripheral (CMAP) and transcranial (MEP) stimulation prevents their use in follow-up studies. Our purpose was to develop strategies to reduce and measure CMAP and MEP ITV to guide long-term monitoring of conduction slowing and conduction failure of peripheral and central motor pathway in the individual patient.MethodsMaximal compound muscle action potentials to High Voltage Electrical Stimulation (HVES) of lumbo-sacral nerve roots (r-CMAP) and activated, averaged motor evoked potentials (MEPs) to Transcranial Magnetic Stimulation (TMS) using double cone coil were recorded from 10 proximal and distal muscle districts of lower limbs. The procedure was repeated twice, 1–2 days apart, in 30 subjects, including healthy volunteers and clinically stable multiple sclerosis patients, using constant stimulating and recording sites and adopting a standardized procedure of voluntary activation. ITV for latency and area indexes and for the ratio between MEP and r-CMAP areas (a-Ratio) was expressed as Relative Intertrial Variation (RIV, 5th-95th percentile). As an inverse correlation between the size of area and ITV was found, raw ITV values were normalized as a function of area to make them comparable with one another.ResultsAll RIV values for latencies were significantly below the optimum threshold of ± 10%, with the exception of r-CMAP latencies recorded from Vastus Lateralis muscle. RIVs for a-Ratio, the most important index of central conduction failure, ranged from a maximum of -25.3% to +32.2% (Vastus Medialis) to a minimum of -15.0% to + 17.4% (Flexor Hallucis Brevis).ConclusionsThe described procedure represents an effort to lower as much as possible variability of motor responses in serial recording; the reported ITV normative values are the necessary premise to detect significant changes of motor conduction slowing and failure in the individual patient in follow-up studies.

Effects of electrical stimulation on meat quality of bison striploin steaks and ground patties

As bison is characteristically dark in colour, this study was conducted to determine if high-voltage electrical stimulation (HVES) could improve the colour and other quality characteristics in bison, similar to positive effects of HVES previously observed in beef. Forty bison bull carcasses were split and HVES (400 V peak, 5 ms pulses at 15 pulses s−1 for 30 s) was applied to the right sides and subsequently evaluated for grade characteristics, metabolic activity, and quality characteristics. The bison carcasses used in this study had a wide range of lean and fat, with minimal marbling. In the present study, HVES had no effect on bison quality traits, sensory attributes, retail display characteristics, nor the glycolytic metabolites (P > 0.05) except lactate. Inherent differences in muscle fibre type or physical carcass differences may have influenced the response to the electrical parameters used in the present study and merits further investigation.

Computational modeling of neurons: intensity-duration relationship of extracellular electrical stimulation for changes in intracellular calcium.

In many instances of extensive nerve damage, the injured nerve never adequately heals, leaving lack of nerve function. Electrical stimulation (ES) has been shown to increase the rate and orient the direction of neurite growth, and is a promising therapy. However, the mechanism in which ES affects neuronal growth is not understood, making it difficult to compare existing ES protocols or to design and optimize new protocols. We hypothesize that ES acts by elevating intracellular calcium concentration ([Ca(2+)]i) via opening voltage-dependent Ca(2+) channels (VDCCs). In this work, we have created a computer model to estimate the ES Ca(2+) relationship. Using COMSOL Multiphysics, we modeled a small dorsal root ganglion (DRG) neuron that includes one Na(+) channel, two K(+) channels, and three VDCCs to estimate [Ca(2+)]i in the soma and growth cone. As expected, the results show that an ES that generates action potentials (APs) can efficiently raise the [Ca(2+)]i of neurons. More interestingly, our simulation results show that sub-AP ES can efficiently raise neuronal [Ca(2+)]i and that specific high-voltage ES can preferentially raise [Ca(2+)]i in the growth cone. The intensities and durations of ES on modeled growth cone calcium rise are consistent with directionality and orientation of growth cones experimentally shown by others. Finally, this model provides a basis to design experimental ES pulse parameters, including duration, intensity, pulse-train frequency, and pulse-train duration to efficiently raise [Ca(2+)]i in neuronal somas or growth cones.

Physiotherapy Management of People Diagnosed with de Quervain's Disease: A Case Series

Purpose : To report the outcomes of a physiotherapy management approach for de Quervain's disease (DQD), a common hand disorder for which evidence for physiotherapy management is lacking, in 4 consecutive patients with DQD. Methods : Participants underwent a median of eight treatment sessions, consisting of mobilizations with movement, eccentric muscle training, and high-voltage electrical stimulation. Outcomes were assessed with an 11-point numeric pain rating scale (NPRS; range 1-10) and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH; range 0%-100%). Result s: Median NPRS and DASH scores decreased from a baseline of 5 and 48, respectively, to 2.8 and 19 after treatment; at 6-month follow-up, all participants reported minimal pain and disability, but one participant required a corticosteroid injection shortly after discharge from physiotherapy. Conclusions : Overall outcome was considered successful for three of four patients, comparable to the success rate previously reported for corticosteroid injections. A randomized clinical trial evaluating the efficacy of this intervention seems warranted.

Hearing Loss After Activation of Hearing Preservation Cochlear Implants Might Be Related to Afferent Cochlear Innervation Injury.

Characterize hearing loss (HL) after hearing preservation cochlear implantation and determine the association between high charge electrical stimulation (ES) and late loss of acoustic hearing. A retrospective cohort analysis of all hearing preservation implantees at our center (n = 42) assayed HL as a function of maximum charge. We analyzed serial audiometry from 85 patients enrolled in the multicenter Hybrid S8 trial to detail the hearing loss greater than 1 month after implantation. Cochleotypic explant cultures were used to assess susceptibility to high levels of ES. Early HL after implantation tends to be mild and averages 12.2 dB. After activation of the Hybrid S8 device, 17 (20%) of 85 patients experienced acceleration of HL. Compared with the majority of patients who did not lose significant hearing after activation, these patients experienced more severe HL at 1 year. Five patients implanted at our center experienced acceleration of HL after high charge exposure. In patients implanted at our center, high charge was associated with late HL (Pearson 0.366, p = 0.016). In rat cochleotypic explants, high voltage ES damaged afferent nerve fibers, reflected by blebbing and a 50% reduction in the number of fibers innervating the organ of Corti. In contrast, hair cells displayed only minor differences in cell number and morphology. Based on clinical and in vitro data, we theorize that the combination of acoustic amplification and ES in the setting of intact hair cells and neural architecture may contribute, in part, to cochlear toxicity, perhaps by damaging the afferent innervation.

Physical methods in the treatment of leg ulcers

Abstract The most common complication of the chronic venous leg are ulcers and their frequency increases with age. Taking into consideration time and cost of treatment the ulcers are a serious medical and socioeconomic problem. Causal treatment concerns vein surgery, however, the recurrence risk up to 50% is observed. In the case of contraindications the conservative treatment is practiced. Topical treatment of ulcers is one of the methods of the conservative therapy. Methods of conservative treatment include general and local pharmacotherapy and compression therapy. Shall apply surgical skin grafting. Nowadays the standard therapy is more often completed by physical methods. Physical methods are not only the complement of the conventional treatment, but also a relevant factor referring to the effective treatment, especially as far as the minimum of contraindications is concerned. Electrotherapy, magnetic therapy, sonotherapy, etc. belong to this kind of methods. The purpose of the paper is to present some methods of physical therapy in the treatment of leg ulcers. Based on the presented in the literature regiments, summarizes efficiency of magnetic therapy, high-voltage electrical stimulation and sonotherapy in the treatment of ulcers. The paper is a review of the current knowledge on the effects of therapeutic action of the above-mentioned methods. The results of the review indicate that magnetic therapy, electrostimulation of high-voltage and sonotherapy have the influence on the process of accelerating the healing of leg ulcers. It has been proved that treatment with low-frequency magnetic field indicates analgesic and anti-inflammatory, purifies wounds, accelerates the skin formation and finally leads to a complete epithelialization. After applying high voltage electrostimulation, can be observed a reduction in the amount of purulend secretions. High voltage electrostimulation (HVS) accelerates the skin formation and granulation process. After applying sonotherapy the uclers surface decreased. Therapy accelerated the process of clearing the wound of pus and the formation of granulation tissue.

Effectiveness of Electromyographic Biofeedback, Mirror Therapy, and Tactile Stimulation in Decreasing Chronic Residual Limb Pain and Phantom Limb Pain for a Patient with a Shoulder Disarticulation

Background and Purpose: There are 1.3 million people in the United States living with limb loss, and most of these patients experience some form of residual limb pain and phantom limb pain (PLP). The purpose of this case study was to determine the effectiveness of mirror therapy, biofeedback, and tactile stimulation on decreasing chronic residual limb pain and PLP in a patient with an upper-limb traumatic amputation. Case Description: The patient is a 48-year-old male who is employed as a construction worker. The patient was working on a conveyer belt transporting stones when the conveyer belt caught his arm resulting in a shoulder disarticulation. According to the International Classification of Functioning, Disability, and Health (ICF), the patient’s activity limitations included difficulty in sleeping, inability to write, or inability to perform heavy household chores, yard work, cook, or manage his own transportation needs. The patient’s participation limitations included decreased recreational activities with his 15-year-old son, maximum difficulty with sexual activities with his wife, and decreased confidence interfering with his normal social activities. Intervention: Interventions include electromyographic (EMG) biofeedback training to infraspinatus and pectoralis major muscle in short/quick, sustained, and gradual contraction with decreasing sensitivity of electrodes. Treatment strategies also included mirror therapy, scapular proprioceptive neuromuscular facilitation (PNF), high-voltage electrical stimulation, retrograde massage, scar mobilizations, tactile cuing, and soft tissue mobilization. Outcomes: The patient demonstrated a 30% decrease in Disability of the Arm, Shoulder, and Hand (DASH) score, decreased pain with Numeric Pain Rating (NPR) from 9/10 to 3/10, increased amplitude of contraction of infraspinatus and pectoral muscles, decreased sensitivity of myoelectric electrodes, and decreased edema. The patient also reported increased confidence in social interactions with friends and personal interactions with his wife. The patient was also able to participate in recreational activities with his teenage son. Discussion: This case is clinically relevant to the field of physical therapy in terms of decreasing chronic residual limb pain, PLP, and improving muscular control with use of mirror therapy, biofeedback, and tactile stimulation.

Immediate Effects of Electrical Stimulation, Diathermy, and Physical Exercise on Lower Limb Arterial Blood Flow in Diabetic Women With Peripheral Arterial Disease: A Randomized Crossover Trial

ObjectiveThe purpose of this study was to assess the effects of high-voltage electrical stimulation (HVES), continuous short wave diathermy, and physical exercise on arterial blood flow in the lower limbs of diabetic women with peripheral arterial disease. MethodsA crossover study was carried out involving 15 diabetic women (mean age of 77.87 ± 6.20 years) with a diagnosis of peripheral arterial disease. One session of each therapeutic resource was held, with a 7-day washout period between protocols. Blood flow velocity was evaluated before each session and 0, 20, 40 and 60 minutes after the administration of each protocol. Two-way repeated-measures analysis of variance with Bonferroni post hoc test was used for the intragroup and intergroup comparisons. ResultsIn the intragroup analysis, a significant reduction (P < .05) was found in blood flow velocity in the femoral and popliteal arteries over time with HVES and physical exercise and in the posterior tibial artery with the physical exercise protocol. However, no significant differences were found in the intergroup analysis (P > .05). ConclusionProximal blood circulation in the lower limb of diabetic women with peripheral arterial disease was increased by a single session of HVES and physical exercise, whereas distal circulation was only increased with physical exercise.

Effect of high-voltage electrical stimulation on the albumin and histamine serum concentrations, edema, and pain in acute joint inflammation of rats.

BACKGROUND: The mechanism by which high-voltage electrical stimulation (HVPC) acts on edema reduction is unknown. OBJECTIVE: To assess the effect of HVPC with negative polarity (-) applied to the ankle of rats with acute joint inflammation. METHOD: Sixty-four rats were divided into four groups (n=16): inflamed+HVPC(-), 0.03 mL application of ι-carrageenan (3%) to the tibiotarsal joint plus HVPC(-); inflamed+HVPC placebo, carrageenan application and HVPC placebo; normal+HVPC(-), HVPC application(-); and normal control, no intervention. The HVPC(-) 100 Hz at a submotor level was applied daily for 45 min on three consecutive days. The variables were pain, hind-foot volume, and serum histamine and albumin assessed before and during the 48 hours following inflammation. The variables were compared using the t test, one-way ANOVA, nested ANOVA for repeated measures, and the post hoc Bonferroni test. Analysis of covariance was applied to adjust the effects of HVPC(-) by measurements of pain, inflammation, albumin, and histamine at 24 h, and the final weight was compared to the other groups. The significance level was set at p<0.05. RESULTS: There were no differences between the inflamed+HVPC(-) and inflamed+HVPC placebo groups in terms of pain or edema (p>0.05). Albumin was reduced in the groups that received the intervention, but there was no differences between them. There was only a 24 hour increase in histamine with the normal+HVPC(-) (p=0.0001) and inflamed+HVPC placebo groups (p=0.01) compared to the normal control group. CONCLUSIONS: The results of the present study suggest that HVPC(-) with the parameters employed did not reduce pain or edema and did not change serum albumin or histamine levels,, which indicates the inability of this resource to have a positive effect when treating treat acute joint inflammation.

P504: Non-invasive nerve root high voltage electrical stimulation in lumbosacral surgery: a methodological and clinical update

P504: Non-invasive nerve root high voltage electrical stimulation in lumbosacral surgery: a methodological and clinical update

P992: Approaching the mechanisms underlying analgesia induced by high voltage electrical stimulation of lumbosacral nerve roots

P992: Approaching the mechanisms underlying analgesia induced by high voltage electrical stimulation of lumbosacral nerve roots

Approaching The Mechanisms Underlying Analgesia Induced By High Voltage Electrical Stimulation Of Lumbosacral Nerve Roots (P7.315)

Approaching The Mechanisms Underlying Analgesia Induced By High Voltage Electrical Stimulation Of Lumbosacral Nerve Roots (P7.315)

Effect of Electrical Stimulation on Fruit Body Formation in Cultivating Mushrooms.

The effect of high-voltage electrical stimulation on fruit body formation in cultivating mushrooms was evaluated using a compact pulsed power generator designed and based on an inductive energy storage system. An output voltage from 50 to 130 kV with a 100 ns pulse width was used as the electrical stimulation to determine the optimum amplitude. The pulsed high voltage was applied to a sawdust-based substrate of Lyophyllum decastes and natural logs hosting Lentinula edodes, Pholiota nameko, and Naematoloma sublateritium. The experimental results showed that the fruit body formation of mushrooms increased 1.3–2.0 times in terms of the total weight. The accumulated yield of Lentinula edodes for four cultivation seasons was improved from 160 to 320 g by applying voltages of 50 or 100 kV. However, the yield was decreased from 320 to 240 g upon increasing the applied voltage from 100 to 130 kV. The yield of the other types of mushrooms showed tendencies similar to those of Lentinula edodes when voltage was applied. An optimal voltage was confirmed for efficient fruit body induction. The hypha activity was evaluated by the amount of hydrophobin release, which was mainly observed before the fruit body formation. The hydrophobin release decreased for three hours after stimulation. However, the hydrophobin release from the vegetative hyphae increased 2.3 times one day after the stimulation.

Effects of high voltage electrical stimulation on the rate of pH decline, meat quality and colour stability in chilled beef carcasses

Fifty beef carcasses were used to determine the effects of High Voltage Electrical Stimulation (HVES, 800 Volts) on pH and meat quality. Meat from M. longissimus dorsi was examined for pH and temperature at 1, 2, 5, 10 and 24 hours, while tenderness and colour were examined seven days after slaughter. HVES decreased the pH of the meat and accelerated rigor mortis (P&lt;0.05). HVES improved tenderness and colour compared with the control group across the ageing period at 4oC. It is suggested that HVES had positive effects on tenderness and colour. DOI: http://dx.doi.org/10.3329/bvet.v30i1.16283 Bangl. vet. 2013. Vol. 30, No. 1, 33-38

Effects of high voltage electrical stimulation on the rate of pH decline, meat quality and color stability in chilled beef carcasses

ObjectiveTo determine the effects of high voltage electrical stimulation (HVES, 800 Voltage) on rapid decreases in pH values and improvements in meat quality. MethodsA total of 50 beef carcasses were applied, divided into two groups, one as a control and another for HVES. Meat quality was evaluated based on M. longissimus dorsi by examining pH and temperature levels at 1, 2, 5, 10 and 24 h, while color stability was examined seven days after slaughter. ResultsHVES decreased the pH values of the meat and accelerated rigor mortis (P<0.05). HVES caused differences in instrumental color values compared with the control groups across the ageing period at 4 °C. Conclusionthe HVES had positive effects on meat quality and color stability, in contrast to undesirable consumer preferences.

A new neurophysiological approach to assess central motor conduction damage to proximal and distal muscles of lower limbs

ObjectiveTo develop a neurophysiological method to explore central motor pathways to proximal and distal muscles of lower limbs. MethodsMEPs to transcranial magnetic stimulation using the double cone coil were bilaterally and simultaneously recorded from vastus medialis, tibialis anterior and flexor hallucis brevis. Voluntary facilitation was controlled using a predefined sequence of movements of constant amplitude. Compound motor action potentials elicited by maximal high voltage electrical stimulation of lumbosacral roots (root-CMAPs) were recorded from the same muscles to obtain the corresponding peripheral conduction times. We studied 28 healthy subjects and 28 multiple sclerosis (MS) patients with no or mild motor impairment. ResultsThe described facilitation procedure and the averaging of 5 MEPs reduced area variability to about 10%. In MS patients conduction slowing and/or MEP area reduction in at least one muscle was found in 91.7% of cases, with significant correlation with individual motor impairment. ConclusionsCombined use of stable MEPs and maximal root-CMAPs was able to detect both conduction slowing and conduction failure in central motor pathways to proximal and distal districts of lower limbs in MS patients. SignificanceThe proposed method provides an extensive electrophysiological mapping of central motor impairment of lower limbs in clinical application.

Single-cell juxtacellular transfection and recording technique

Genetic modifications and pharmacological studies enable the analysis of protein function in living cells. While many of these studies investigate the effect of proteins by bulk administration or withdrawal of the protein in complex cellular networks, understanding the more subtle mechanisms of protein function requires fine-tuned changes on a single-cell level without affecting the balance of the system. In order to analyse the consequences of protein modification at the single-cell level, we have developed a single-cell transfection method in the loose patch configuration, which allows juxtacellular recordings of neuronal cells prior to juxtacellular transfection. CA1 pyramidal neurons were selected based on morphological and electrophysiological criteria. Using a patch clamp amplifier which allows sensitive recordings of action currents in the loose seal mode as well as electroporation with high-voltage electrical stimulation the identified neurons were transfected with a combination of specific nucleotides, e.g. siRNA and a plasmid coding for GFP for later cell retrieval. Two days after transfection, whole-cell patch clamp recordings of transfected cells were performed to analyse electrophysiological properties. Action potential firing and synaptic transmission of single electroporated CA1 pyramidal cells were comparable to untransfected cells. Our study presents a method which enables identification of neurons by juxtacellular recording prior to single-cell juxtacellular transfection, allowing subsequent analysis of morphological and electrophysiological parameters several days after the genetic modification.

Wireless Electrical Stimulation

High-voltage electrical stimulation has been long proposed as a method of accelerating the wound healing process. Its beneficial effect has been successfully evaluated in the treatment of a number of chronic ulcers and burns. We present here the implementation of a new wireless electrical stimulation technique for the treatment of a complicated chronic ulcer of the lower limb. The device is transferring charges to the wound, without any contact with it, creating a microcurrent that is able to generate the current of injury. The results suggest that this easy-to-use method is an effective therapeutic option for chronic ulcers.

Changing the sensory threshold of elderly people through low-frequency, high-voltage acupoint electrical stimulation

It is widely known that acupoint of electrotherapy decreases the threshold of pain and release of catecholamine by mechanical and chemical stimulation. However, there have been no studies to find the change in the sensory threshold and time-dependent stimulus generated by acupoint electrical stimulation (AES) on the different body regions. The present study was conducted to examine the differences in sensory threshold between elderly and youthful subjects, as well as the sensory threshold by electrical stimulation in the lower back, shoulder, and knee joint regions in the elderly. The sensory threshold was increased in subjects over age 60 compared with 20 year olds. In relation to age, the sensory threshold was increased in the 60 s, 70 s, and 80 s, respectively, compared with during the 20 s. The sensory threshold was significantly increased in the lower back region compared with the shoulder and knee joint regions. The result of the analysis of the sensory threshold in response to the application of electrical stimulation revealed a time-dependent response, with the sensory threshold little changed. However, the change in the sensory threshold was significantly associated with time, increasing after AES from 10 and 15 min compared with 0 min for all ages. It was most pronounced in both the shoulder and knee joint region. Therefore, these results at least partially suggest that the change in sensory threshold is associated with age, and suggest the need to develop specialized physiotherapy to enable seniors to lead healthy lives.