Home Electric Stimulation Research Articles

The Effects of Chronic Electrical Stimulation Evaluation Functional and Electrical Properties of Muscle in a Small Group of Patients with Congenital Muscle Disorders

BackgroundIn the case of Congenital Muscle Disorders like Myotonic Dystrophy type 1 (DM1) the rehabilitative interventions have always been aimed at muscle strengthening, increasing of fatigue resistance and improving of aerobic metabolism efficiency whereas the electrical membrane fault has always been addressed pharmacologically. Neuromuscular electrical stimulation (NMES) is a useful therapeutic tool in sport medicine and in the rehabilitation of many clinical conditions characterized by motor impairment such as stroke, cerebral palsy and spinal cord injury.The aim of our pilot study was to evaluate the effects of chronic electrical stimulation both on functional and electrical properties of muscle in a small group of patients with condenital muscle disorders.Materials and methodsfive DM1 patients and one patient with Congenital Myotonia (CM) performed a home electrical stimulation of the tibialis anterior muscle lasting 15 days with a frequency of two daily sessions of 60 minutes each. Muscle strength was assessed according to the MRC scale (Medical Research Council) and functional tests (10 Meter Walking Test, 6 Minutes Walking Test – MWT and Timed Up and Go Test – TUG test) were performed. We analyzed the average rectified value of sEMG signal amplitude (ARV) to characterize the sarcolemmal excitability.ResultsAfter the treatment an increase of muscle strength in those DM1 patients with a mild strength deficit was observed. In all subjects an improvement of 10 MWT was recorded. Five patients improved their performance in the 6 MWT. In TUG test 4 out of 6 patients showed a slight reduction in execution time. All patients reported a subjective improvement when walking. A complete recovery of the normal increasing ARV curve was observed in 4 out of 5 DM1 patients; the CM patient didn't show modification of the ARV pattern.ConclusionsNMES determined a clear‐cut improvement of both the muscular weakness and the sarcolemmal excitability alteration in our small group of DM1 patients. Therefore this rehabilitative approach, if confirmed by further extensive studies, could be considered early in the management of muscular impairment in these patients. An attractive hypothesis to explain our encouraging result could be represented by a functional inhibition of small conductance calcium‐activated potassium channels expressed 3 (SK3) in muscle of DM1 subjects.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Home electrical stimulation for women with fecal incontinence: a preliminary randomized controlled trial

Home electrical stimulation for women with fecal incontinence: a preliminary randomized controlled trial

Home electrical stimulation for women with fecal incontinence: a preliminary randomized controlled trial.

The purpose of this study is to compare the effectiveness and cost of home electrical stimulation and standardized biofeedback training in females with fecal incontinence Thirty-six females suffering from fecal incontinence were randomized into two groups, matched for mean age (67.45 ± 7.2 years), mean body mass index (kg/m2) (26.2 ± 3.9), mean disease duration (4.1 ± 0.8 years), mean number of births (2.7 ± 1.3), and reports of obstetric trauma (25%). Questionnaires were used to evaluate their demographics, medical, and childbearing history. Subjects were randomized to home electrical stimulation or standardized biofeedback training for a period of 6 weeks. Subjective outcome measures included the frequency of fecal, urine, and gas incontinence by visual analog scale, Vaizey incontinence score, and subjects' levels of fecal incontinence related anxiety. Objective outcome measures included pelvic floor muscle strength assessed by surface electromyography. We also compared the cost of each treatment modality. Only females who received home electrical stimulation (HES) reported a significant improvement in Vaizey incontinence score (p = 0.001), anxiety (p = 0.046), and in frequency of leaked solid stool (p = 0.013). A significant improvement in pelvic floor muscle strength was achieved by both groups. HES was much cheaper compared to the cost of standardized biofeedback training (SBT) (US $100 vs. US $220, respectively). Our study comprised a small female population, and the study endpoints did not include objective measures of anorectal function test, such as anorectal manometry, before and after treatment. Home electrical stimulation may offer an alternative to standardized biofeedback training as it is effective and generally well-tolerated therapy for females with fecal incontinence.

Sa2043 The Impact of Lower Gastrointestinal Symptoms on Quality of Life in Women With Systemic Sclerosis

G A A b st ra ct s assessed by surface electromyography (EMG). Results: A total of 36 women with FI were randomized to HES or SBT (18 in each treatment group). Groups were matched by mean age: 65.5±13.5 years, mean BMI (kg/m2): 26.2±3.9, mean disease duration: 1.42±0.8 yrs, mean number of births: 2.7±1.3 and reports of obstetric trauma (25%). Only patients that received HES reported a significant improvement of FIGS (p=0.0015) and a significant drop in the number of leaked solid and liquid stool (p=0.012, p= 0.07, respectively). SF-36 scores were not affected significantly by treatment in both groups. A significant improvement of PEM contraction was achieved in 89 % of patients from both groups. Conclusions: Home electric stimulation only was found to be more efficient than standardized biofeedback training only if assessed by both subjective and objective measures.

Sa2045 25-G Is Better Than 50-G Lactose for Hydrogen Breath Test to Diagnose and Predict Symptom Resolution Following Milk Withdrawal in Adult Type Hypolactasia

G A A b st ra ct s assessed by surface electromyography (EMG). Results: A total of 36 women with FI were randomized to HES or SBT (18 in each treatment group). Groups were matched by mean age: 65.5±13.5 years, mean BMI (kg/m2): 26.2±3.9, mean disease duration: 1.42±0.8 yrs, mean number of births: 2.7±1.3 and reports of obstetric trauma (25%). Only patients that received HES reported a significant improvement of FIGS (p=0.0015) and a significant drop in the number of leaked solid and liquid stool (p=0.012, p= 0.07, respectively). SF-36 scores were not affected significantly by treatment in both groups. A significant improvement of PEM contraction was achieved in 89 % of patients from both groups. Conclusions: Home electric stimulation only was found to be more efficient than standardized biofeedback training only if assessed by both subjective and objective measures.

Sa2047 Effectiveness of a Therapeutic Algorithm for Functional Anorectal Pain: Experience in a Private Ambulatory Coloproctology Center in Buenos Aires, Argentina

G A A b st ra ct s assessed by surface electromyography (EMG). Results: A total of 36 women with FI were randomized to HES or SBT (18 in each treatment group). Groups were matched by mean age: 65.5±13.5 years, mean BMI (kg/m2): 26.2±3.9, mean disease duration: 1.42±0.8 yrs, mean number of births: 2.7±1.3 and reports of obstetric trauma (25%). Only patients that received HES reported a significant improvement of FIGS (p=0.0015) and a significant drop in the number of leaked solid and liquid stool (p=0.012, p= 0.07, respectively). SF-36 scores were not affected significantly by treatment in both groups. A significant improvement of PEM contraction was achieved in 89 % of patients from both groups. Conclusions: Home electric stimulation only was found to be more efficient than standardized biofeedback training only if assessed by both subjective and objective measures.

Sa2042 Home Electric Stimulation Is Better Than Standardized Biofeedback Training for Women With Fecal Incontinence

Sa2042 Home Electric Stimulation Is Better Than Standardized Biofeedback Training for Women With Fecal Incontinence

Chronic muscle stimulation improves muscle function and reverts the abnormal surface EMG pattern in Myotonic Dystrophy: a pilot study

BackgroundTo date, in Myotonic Dystrophy type 1 (DM1) the rehabilitative interventions have always been aimed at muscle strengthening, increasing of fatigue resistance and improving of aerobic metabolism efficiency whereas the electrical membrane fault has always been addressed pharmacologically. Neuromuscular electrical stimulation (NMES) is a useful therapeutic tool in sport medicine and in the rehabilitation of many clinical conditions characterized by motor impairment such as stroke, cerebral palsy and spinal cord injury.The aim of our pilot study was to evaluate the effects of chronic electrical stimulation both on functional and electrical properties of muscle in a small group of DM1 patients.MethodsFive DM1 patients and one patient with Congenital Myotonia (CM) performed a home electrical stimulation of the tibialis anterior muscle lasting 15 days with a frequency of two daily sessions of 60 minutes each. Muscle strength was assessed according to the MRC scale (Medical Research Council) and functional tests (10 Meter Walking Test, 6 Minutes Walking Test and Timed Up and Go Test) were performed. We analyzed the average rectified value of sEMG signal amplitude (ARV) to characterize the sarcolemmal excitability.ResultsAfter the treatment an increase of muscle strength in those DM1 patients with a mild strength deficit was observed. In all subjects an improvement of 10MWT was recorded. Five patients improved their performance in the 6MWT. In TUG test 4 out of 6 patients showed a slight reduction in execution time. All patients reported a subjective improvement when walking. A complete recovery of the normal increasing ARV curve was observed in 4 out of 5 DM1 patients; the CM patient didn’t show modification of the ARV pattern.ConclusionsNMES determined a clear-cut improvement of both the muscular weakness and the sarcolemmal excitability alteration in our small group of DM1 patients. Therefore this rehabilitative approach, if confirmed by further extensive studies, could be considered early in the management of muscular impairment in these patients. An attractive hypothesis to explain our encouraging result could be represented by a functional inhibition of SK3 channels expressed in muscle of DM1 subjects.

Tu2017 Home Electric Stimulation for Women With Fecal Incontinence: Effectiveness and Predictors of Outcome

Tu2017 Home Electric Stimulation for Women With Fecal Incontinence: Effectiveness and Predictors of Outcome

Randomized, Controlled Trial of Anal Electrical Stimulation for Fecal Incontinence

Anal electric stimulation has been described as effective for fecal incontinence in several case series, but no study has addressed possible mechanism of benefit. We wished to examine whether anal electric stimulation, using an anal probe electrode, used on a daily basis at home for eight weeks, in the absence of any adjunctive exercises or advice, would improve symptoms of fecal incontinence and anal sphincter pressures when compared with "sham" electric stimulation. Ninety patients (9 males, 81 females), with median age of 55 (range, 30-77) years were randomized, 47 to active anal stimulation at 35 Hz and 43 to "sham" stimulation at 1 Hz. Outcome measures included a one-week bowel diary, symptom questionnaire, manometry, and patients' evaluation of outcome. Seventy patients completed the study. On an intention-to-treat analysis, there was no difference between the two groups on any of the outcome measures after eight weeks. Of those who completed stimulation, 44 (63 percent) felt the stimulation had improved their continence. Those with intact anal sphincters were not likely to rate their change more positively than those with sphincter disruption (P=0.71). Median patient rating of bowel control increased from 3 of 10 before stimulation to 5 of 10 after stimulation (P=0.001). Eight weeks of anal electric stimulation was rated by patients as having improved their bowel control to a modest extent. There was no statistically significant difference detected between the groups, suggesting that 1 Hz was as effective as 35 Hz. This raises the possibility that the main effect is not sphincter contraction but sensitization of the patient to the anal area, or simply the effect of intervening per se. Home electric stimulation is a relatively cheap and generally well-tolerated therapy in the conservative treatment of fecal incontinence.

Home electrical stimulation for urinary incontinence: a study of the diffusion ofa new technology

The objective of this study was to investigate the extent to which physicians requested home electrical stimulation (ES) treatment for patients with urinary incontinence (UI). Home ES was requested by 429 general practitioners (GPs) and 147 gynecologists within 2 years (1992 to 1994) after the Norwegian National Insurance Service offered reimbursement for the procedure. For first-time requesters, cumulative plots of time to request were compared for GPs versus gynecologists. Characteristics of requesting GPs were compared with those of a randomly selected control sample of nonrequesting GPs, collected by postal questionnaire. A greater proportion of gynecologists than GPs prescribed home ES during the 2-year study period (42% vs 14%, P <0.001). Median time to request for ES was 5.8 months for gynecologists versus 8.6 months for GPs ( P <0.01). A greater proportion of female GPs than male GPs requested the treatment (17% vs 13%, P <0.01). Sufficient information about and/or knowledge of treatment indications were claimed by 71% of requesting GPs versus 21% of controls ( P <0.001). Altogether, 91% of requesters versus 62% of controls judged that home ES was effective or a good treatment alternative ( P <0.001). Requesters (versus controls) prescribed more bladder training and estrogen for urge UI, more pelvic floor exercises and estrogen to treat stress UI, and more ES to treat both types of UI (all P <0.05). Gynecologists prescribed ES more often and earlier than GPs. Prescribers of ES were more proactive in treating UI in their practices than those who were not prescribers.