Electrotherapy Research Articles

Adjunctive Use of Bone Growth Stimulation Increases Cervical Spine Fusion Rates in Patients at Risk for Pseudarthrosis.

A prospective multicenter clinical trial (NCT03177473) was conducted with a retrospective cohort used as a control arm. The purpose of this study was to evaluate cervical spine fusion rates in subjects with risk factors for pseudarthrosis who received pulsed electromagnetic field (PEMF) treatment. Certain risk factors predispose patients to pseudarthrosis, which is associated with prolonged pain, reduced function, and decreased quality of life. Subjects in the PEMF group were treated with PEMF for 6 months postoperatively. The primary outcome measure was fusion status at the 12-month follow-up period. Fusion status was determined using anterior/posterior, lateral, and flexion/extension radiographs and computed tomography (without contrast). A total of 213 patients were evaluated (PEMF, n=160; Control, n=53). At baseline, the PEMF group had a higher percentage of subjects who used nicotine ( P =0.01), had osteoporosis ( P <0.05), multi-level disease ( P <0.0001), and were >65 years of age ( P =0.01). The PEMF group showed over two-fold higher percentage of subjects that had ≥3 risk factors (n=92/160, 57.5%) compared with the control group (n=14/53, 26.4%). At the 12-month follow-up, the PEMF group demonstrated significantly higher fusion rates compared with the control (90.0% vs. 60.4%, P <0.05). A statistically significant improvement in fusion rate was observed in PEMF subjects with multi-level surgery ( P <0.0001) and high BMI (>30kg/m 2 ; P =0.0021) when compared with the control group. No significant safety concerns were observed. Adjunctive use of PEMF stimulation provides significant improvements in cervical spine fusion rates in subjects having risk factors for pseudarthrosis. When compared with control subjects that did not use PEMF stimulation, treated subjects showed improved fusion outcomes despite being older, having more risk factors for pseudarthrosis, and undergoing more complex surgeries.

A prospective observational study comparing outcomes application of low-frequency pulse electrical combined with target-oriented rehabilitation therapy in postoperative nerve function rehabilitation of patients with distal humeral fracture and radial nerve injury.

The aim of the present study was to compare the effect of low-frequency pulse electrical stimulation combined with target-oriented rehabilitation therapy and single low-frequency pulse electrical stimulation therapy on postoperative neurological improvement in patients with radial nerve injury and humeral condylar fracture. A total of 88 patients with humeral condyle fracture and radial nerve injury admitted to our hospital from April 2019 to January 2022 were randomly divided into a combined group and a control group, with 44 patients in each group. The patients in the combined group received low-frequency pulse electrical stimulation combined with target-oriented rehabilitation therapy, while those in the control group received low-frequency pulse electrical stimulation therapy. The recovery rate of radial nerve function, the recovery of finger extensor and wrist extensor muscle strength, and the occurrence of postoperative complications were evaluated in all patients. After treatment, the recovery rate in the combined group (77.27%) was higher than that in the control group (50.00%) (p < 0.05). There was no significant difference in finger extensor and wrist extensor muscle strength before treatment between the two groups (p > 0.05). After treatment, both groups showed improvement compared to before treatment (p < 0.05), and the recovery in the combined group was better than that in the control group (p < 0.05). There was no significant difference in MCV and amplitude before treatment between the two groups (p > 0.05). After treatment, both groups showed improvement compared to before treatment (p < 0.05), and the recovery in the combined group was better than that in the control group (p < 0.05). The fracture healing time in the combined group was shorter than that in the control group (p < 0.05). During the treatment period, there was one case of infection and one case of joint pain in the combined group, with a complication rate of 4.55%. In the control group, there was one case of infection and two cases of joint pain, with a complication rate of 6.82%. There was no significant difference in the complication rate between the two groups (p > 0.05). The DHI score in the combined group was better than that in the control group (p < 0.05). The ESCA score in the combined group was better than that in the control group (p < 0.05). Low-frequency pulse electrical stimulation combined with target-oriented rehabilitation therapy can promote muscle strength and functional recovery after radial nerve injury, accelerate fracture healing time, and no additional risk of complications. https://www.researchregistry.com/, researchregistry9461.

Difference in Cyclic Versus Non-cyclic Symptom Patterns in Patients with the Symptoms of Gastroparesis Undergoing Bioelectric Therapy.

Patients with gastroparesis (Gp) have symptoms with or without a cyclic pattern. This retrospective study evaluates differences in cyclic vs. non-cyclic symptoms of Gp by analyzing mucosal electrogastrogram (mEG), familial dysautonomias, and response to gastric stimulation. 37 patients with drug refractory Gp, 7 male and 30 female, with a mean age of 41.4years, were studied. 18 had diabetes mellitus, 25 had cyclic (Cyc), and 12 had a non-cyclic (NoCyc) pattern of symptoms. Patients underwent temporary mucosal gastric stimulator (tGES) placement, which was done as a trial before permanent stimulator (GES) placement. Electrogastrogram (EGG) by mucosal (mEG) measures, including frequency, amplitude, and frequency-amplitude ratio (FAR), were pre- and post-tGES. Patients' history of personal and familial dysautonomias, quality of life, and symptom scores were recorded. Baseline vs. follow-ups were compared by paired t tests and McNemar's tests. T tests contrasted symptom scores, gastric emptying tests (GET), and mEG measures, while chi-squared tests deciphered comorbidity differences between two groups and univariate and multivariate analyses. There were significantly more patients with diabetes in the Cyc group vs. the NoCyc group. Using a 1 point in symptom outcome, 18 patients did not improve and 19 did improve with tGES. Using univariable analysis, with the cyclic pattern as a predictor, patients exhibiting a cyclic pattern had an odds ratio of 0.22 (95% CI 0.05-0.81, p = 0.054) for achieving an improvement of at least one unit in vomiting at follow-up from baseline. The mucosal electrogastrogram frequency to amplitude ratio (FAR) for the "not Improved" group was 19.6 [3.5, 33.6], whereas, for the "Improved" group, it was 54.3 [25.6, 72.5] with a p-value of 0.049. For multivariate logistic regression, accounting for sex and age squared, patients exhibiting a cyclic pattern had an adjusted odds ratio (OR) of 0.16 (95% CI 0.03-0.81, p = 0.027) for achieving an improvement of at least one unit in vomiting at follow-up from baseline. The two groups had no significant differences in the personal or inherited history of investigated familial patterns. This study shows differences in Gp patients with Cyc vs. NoCyc symptoms in several areas. Larger studies are needed to elicit further differences between the two groups about cycles of symptoms, EGG, findings, familial patterns, and response to mucosal GES.

Bone union-promoting effect of romosozumab in an ovariectomized rat posterolateral lumbar fusion model.

Spinal fixation surgery has been increasingly performed in patients with osteoporosis. Romosozumab, a drug that was introduced in Japan recently, is known to possibly promote bone healing. However, few studies have reported the therapeutic effects of romosozumab in clinical practice in Japan. Therefore, here, we investigated the effects of romosozumab dosage on bone fusion promotion using an ovariectomized rat spinal fusion model. Eight-week-old female Sprague-Dawley rats were matched by body weight and divided into three groups: 1.0 romosozumab (R) group (Evenity®, 25 mg/kg), 1/10R group (Evenity®, 2.5 mg/kg), and control (C) group (saline). Subcutaneous injections were administered twice a week for 8 weeks postoperatively. Computed tomography scans were performed every 2 weeks from the time of surgery till 8 weeks postoperatively. The mean fusion rates in terms of volume were significantly higher in the R groups [1/10R, 1.0R] than in the C group from 4 weeks postoperatively. The rate of increase was significantly higher in the 1.0R group from 4 weeks postoperatively and in the 1/10R group from 6 weeks postoperatively, than in the C group. The proportion of trabecular bone area was approximately 1.5 times higher in the R groups than in the C group. No significant differences were observed between the R groups. Our results suggest that romosozumab stimulates bone growth at the graft site, and similar effects were achieved at 1/10 of the standard dosage.

173 Electrical Stimulation Used as an Adjunct to Cervical Spine Fusion in Patients at Risk for Pseudarthrosis

INTRODUCTION: Prior studies show that pulsed electromagnetic field (PEMF) stimulation promotes bone healing and can be a valuable tool to help overcome biological deficiencies in patients at risk. The current study further evaluates the adjunct effect of PEMF in subjects undergoing cervical spinal surgery presenting with risk factors for pseudarthrosis. METHODS: A prospective multicenter clinical trial (NCT 03177473) was conducted at eleven clinical sites. Subjects undergoing cervical spinal fusion surgery with one or more risk factors for pseudarthrosis were identified for enrollment. Risk factors for pseudarthrosis included multilevel fusion, prior failed cervical spine fusion, diabetes, osteoporosis, or smoking. Subjects undergoing cervical spinal fusion were required to wear the PEMF device for 4 hours/day for 6 months post-op. Fusion status was determined at the 12-month visit using anterior/posterior, lateral, and flexion/extension radiographs and computed tomography (without contrast). NDI, EQ-5D, SF-36, and VAS for neck and arm pain were collected as secondary outcome measures. RESULTS: Out of 160 subjects, 144 (90.0%) were graded as fused (all levels) at the 12-month visit. Fusion success was 91.7% (n = 55/60), 89.0% (n = 89/100), and 90.9% (n = 20/22) for subjects with 1, 2+, or 3+ risk factors, respectively. Significant improvements in NDI, SF-36, EQ-5D, VAS-arm and VAS-neck were observed compared to baseline (p &lt; 0.001). A device compliance rate of 85.0% was observed at 3-months and 78.3% at 6-months in subjects who had successful cervical fusion. CONCLUSIONS: The PEMF bone growth stimulator device is a valuable tool to aid in fusion healing, especially in challenging populations. Subjects in this study experienced favorable fusion rates of 90% and significant improvement in patient reported outcomes despite having elevated comorbidity and/or complex surgeries.

1085 Adjunctive Use of Bone Growth Stimulation in Cervical Spine Fusion in Patients at Risk for Nonunion

INTRODUCTION: Prior failed fusion, multi-level disease, diabetes, nicotine usage, and osteoporosis are factors associated with nonunion, leading to prolonged pain, reduced function, and overall decreased quality of life. Previous studies have shown that pulsed electromagnetic field (PEMF) stimulation can improve fusion rates, particularly in subjects at risk for nonunion. METHODS: Data from a multi-center prospective study of subjects that underwent cervical spine fusion and were treated with PEMF was compared to a “matched” retrospective cohort that had fusion but were not treated with PEMF. The prospective cohort was enrolled based on having 1 or more of the following risk factors for nonunion: prior failed cervical spine fusion, multilevel fusion, diabetes, osteoporosis, or nicotine use. Fusion was assessed at 12 months postop using x-rays and/or CT. A cohort of cervical spine fusion patients that were prescribed PEMF, but did not receive PEMF treatment (e.g., insurance denial) were compared to PEMF treated subjects. RESULTS: At baseline, subjects in the PEMF treated group had a significantly higher average number of risk factors for nonunion (1.8 for treated group vs. 1.1 for control, p &lt; 0.001), and significantly higher average number of surgical levels (2.8 for treated group vs. 2.0 for control, p &lt; 0.005). At 12 months post-op, subjects in the PEMF group (n = 161) had a 90.1% fusion rate, compared to a 65.4% for the control group (n = 26) (p &lt; 0.001). CONCLUSIONS: PEMF stimulation provides significant improvements in cervical spine fusion rates in subjects having risk factors for nonunion. Compared to control subjects, PEMF treated subjects had improved fusion outcomes despite being older, having more risk factors for pseudarthrosis, and undergoing more complex surgeries.

Determination of Optimal Conditions for Neuroprosthetic Functional Electrical Stimulation Therapy to Produce Wrist Dorsiflexion Movements Using the Versatility Index

Determination of Optimal Conditions for Neuroprosthetic Functional Electrical Stimulation Therapy to Produce Wrist Dorsiflexion Movements Using the Versatility Index

ZnO-doped β-TCP ceramic-based scaffold promotes osteogenic and antibacterial activity

β-Tricalcium phosphate (β-TCP) scaffolds, which are synthetic bone graft materials, have been explored as a potential solution in the healing of bone deformities due to their acceptable degradation rate and ability to support bone growth. However, these scaffolds have limitations such as poor mechanical properties, to stimulate bone growth, which increases the risk of infection after implantation. To overcome these issues, a new type of biomedical scaffold was developed that incorporated zinc oxide (ZnO) particles into β-TCP using wet chemical techniques. The scaffolds were created using sintering to produce porous β-TCP scaffolds with good connectivity. The addition of zinc oxide as a dopant significantly improved the biophysical properties of the scaffolds, with higher concentrations of zinc oxide, leading to better cell adhesion and proliferation. The scaffolds placed in simulated body fluid demonstrated exceptional ability to promote bone growth and regeneration by developing a bone-like apatite layer on their surfaces. The mechanical and physical properties of the scaffolds were effectively assessed using X-ray diffraction and scanning electron microscopy analyses. To validate the efficacy of the specimen in preventing microbial growth and promoting bone growth, a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test and gene expression investigation were conducted. Zinc oxide-doped β-TCP scaffolds are envisaged to show enormous potential for use in future bone-healing applications.

Comparative Efficacy of Non-Invasive Therapies in Temporomandibular Joint Dysfunction: A Systematic Review.

Temporomandibular disorder (TMD) is a multifaceted disorder impacting the temporomandibular joint (TMJ), causing substantial discomfort and functional limitations. This systematic review aims to comprehensively assess the effectiveness of non-invasive treatment modalities for TMJ dysfunction, prioritizing a definitive protocol to ensure patient safety and enhance quality of life. Employing the PRISMA guidelines, we meticulously analyzed 20 studies from a pool of 1,417 articles sourced from databases such as PubMed, Google Scholar, ScienceDirect, and Medline. These studies underscore the multifarious nature of TMD and the varied responses to treatments such as physical therapy, laser therapy, ultrasound and electrical stimulation, splint therapy, injections, and arthrocentesis. Notably, the review highlights the paramount importance of precise diagnosis, often through surface electromyography, followed by a tailored treatment approach integrating manual therapy, counseling, and splint therapy. The systematic analysis revealed that while certain treatments such as transcutaneous electrical nerve stimulation and low-level laser therapy showed limited efficacy, combination therapies, especially those involving manual therapy, counseling, and splint therapy, demonstrated substantial improvement in reducing pain, depression, and anxiety. The findings advocate for a non-invasive, patient-centric approach, emphasizing education and symptom management before considering more invasive procedures such as injections and arthrocentesis. The review identifies the need for more comprehensive, longitudinal studies to establish a standardized, evidence-based treatment protocol for TMJ dysfunction, aiming to improve patient outcomes holistically.

Peran Fisioterapi Pada Individu Dengan Hemiparesis Sinistra Post Stroke : A Case Study

Introduction: Stroke occurs when the blood supply to the brain is blocked and blood vessels in the brain burst. The brain can't get the blood and oxygen it needs, so brain cells die. In this case, the patient complained of a feeling of weakness and heaviness in the left side of the body, which made it difficult for him to carry out everyday activities. Objective: To determine the role of physical therapy in individuals with left hemiparesis after stroke on muscle strength, spasticity, and functional ability using infrared intervention, electrical stimulation, and exercise therapy. Method: Subjective and objective examinations were carried out, followed by physiotherapeutic intervention in 3 weeks. Results: After physiotherapeutic intervention, the results showed an increase muscle strength using manual muscle testing (MMT) of the hip muscle group T1=2 to T3=2+, the knee muscle group T1=2 to T3=-3. Reduced muscle tone according to the Asworth scale in the shoulder area T1=1+ to T3=1, as well as functional ability according to the Barthel index with results from T1=65 to T3=70. Conclusion: Physiotherapeutic interventions using infrared, electrical stimulation, and exercise therapy can increase muscle strength, reduce spasticity, and improve functional ability in individuals with left-sided hemiparesis after stroke

A Study to Assess the Effectiveness of Acupressure with that of Electro Therapy in Relieving pain among patients with Osteo Arthrits at selected Hospital, Kanyakumari District

The experience of pain is complex, involving emotional and cognitive components. Pain is subjective and highly individualised. There are so many invasive and non invasive modalities to decrease pain intensity and has adverse effect. Study was conducted to identify the effect of two non pharmacological interventions in reduction of pain among clients with osteo arthritis. A quasi experimental design with two group consisting 60 patients with osteoarthritis were selected to determine the effectiveness acupressure and electrotherapy in relieving pain in selected hospitals in Kanyakumari district. For the clients in experimental group with osteoarthritis acupressure was given with the help of thumb and index finger on knee joint of the body to alleviate pain for 20 minutes and electrotherapy was applied in the knee joint for the control group for 20 minutes. Pre assessment was done on day 1 before the intervention for both the groups and post assessment was done on day 3 and day 5 using simple descriptive pain intensity scale prepared by the researcher. The result showed that clients in Experimental group receiving acupressure had significant reduction of pain than clients in control group receiving electrotherapy.

Emerging role of extracellular vesicles and exogenous stimuli in molecular mechanisms of peripheral nerve regeneration.

Peripheral nerve injuries lead to significant morbidity and adversely affect quality of life. The peripheral nervous system harbors the unique trait of autonomous regeneration; however, achieving successful regeneration remains uncertain. Research continues to augment and expedite successful peripheral nerve recovery, offering promising strategies for promoting peripheral nerve regeneration (PNR). These include leveraging extracellular vesicle (EV) communication and harnessing cellular activation through electrical and mechanical stimulation. Small extracellular vesicles (sEVs), 30-150 nm in diameter, play a pivotal role in regulating intercellular communication within the regenerative cascade, specifically among nerve cells, Schwann cells, macrophages, and fibroblasts. Furthermore, the utilization of exogenous stimuli, including electrical stimulation (ES), ultrasound stimulation (US), and extracorporeal shock wave therapy (ESWT), offers remarkable advantages in accelerating and augmenting PNR. Moreover, the application of mechanical and electrical stimuli can potentially affect the biogenesis and secretion of sEVs, consequently leading to potential improvements in PNR. In this review article, we comprehensively delve into the intricacies of cell-to-cell communication facilitated by sEVs and the key regulatory signaling pathways governing PNR. Additionally, we investigated the broad-ranging impacts of ES, US, and ESWT on PNR.

A comparison of interferential current efficacy in elderly intervertebral disc degeneration patients with or without sarcopenia: a retrospective study

BackgroundIntervertebral disc degeneration and sarcopenia are both age-related diseases without effective treatments. Their comorbidities may worsen the prognosis, and further studies on interaction and therapy are needed. The purpose of the study was to investigate the prevalence of sarcopenia in intervertebral disc degeneration, and to compare the characteristics of intervertebral disc degeneration with and without sarcopenia and effects of interferential current.MethodsOne hundred twenty disc degeneration patients were included from 2021 to 2022 in a single institute. Medical records, examination results and radiological reports were reviewed. Patients with sarcopenia were screened and grouped according to Asian Working Group for Sarcopenia 2019. VAS, ODI, SARC-F, SMI, gait speed (GS), grip strength, disc Pfirrmann grading, standard cross-sectional area (SCSA), degree of fatty infiltration (DFF), and nerve conduction velocity (NCV) were assessed before and after treatment.ResultsThe prevalence of sarcopenia in intervertebral disc degeneration was 28.3%. The difference of VAS, ODI, disc Pfirrmann grading, SCSA, DFF and NCV between two groups were significant before intervention (P < 0.05), SCSA and DFF were related to the degree of disc degeneration. The improvement of SMI, GS, grip strength, VAS, SARC-F and ODI in intervertebral disc degeneration with sarcopenia group was significant after intervention, as well as SMI, GS, grip strength, VAS and ODI in those without sarcopenia (P < 0.05). The improvement of grip strength, GS, ODI and SARC-F in intervertebral disc degeneration with sarcopenia group were greater than the one without sarcopenia (P < 0.05), whereas there was no significance in improvement degree of other indicators between the two groups (P > 0.05).ConclusionThe prevalence of sarcopenia was high in intervertebral disc degeneration, and paravertebral muscles degeneration correlated with the degree of disc degeneration. Compared to those without sarcopenia, intervertebral disc degeneration patients with sarcopenia have more severe pain, poorer mobility and neurological function. Interferential current is effective in intervertebral disc degeneration patients and sarcopenia patients.

Advancements in autologous peripheral nerve transplantation care: a review of strategies and practices to facilitate recovery.

Autologous peripheral nerve transplantation, a pioneering technique in nerve injury treatment, has demonstrated remarkable progress. We examine recent nursing strategies and methodologies tailored to various anatomical sites, highlighting their role in postoperative recovery enhancement. Encompassing brachial plexus, upper limb, and lower limb nerve transplantation care, this discussion underscores the importance of personalized rehabilitation plans, interdisciplinary collaboration, and innovative approaches like nerve electrical stimulation and nerve growth factor therapy. Moreover, the exploration extends to effective complication management and prevention strategies, encompassing infection control and pain management. Ultimately, the review concludes by emphasizing the advances achieved in autologous peripheral nerve transplantation care, showcasing the potential to optimize postoperative recovery through tailored and advanced practices.

Physiotherapy Management of Total Knee Replacement Et Causa Osteoarthritis Genu with Transcutaneous Electrical Nerve Stimulation Modalities and Exercise Therapy in Banten Provincial Hospital

Osteoarthritis is a chronic disease that most often occurs in elderly people aged over65 years. The age-standardized incidence of knee OA is 3.8% worldwide and 80% ofpatients over 75 years of age have radiologically proven OA. Knee osteoarthritissufferers usually complain of pain, swelling, limited joint mobility, and stiffness due toinflammation of the synovial joints. OA of the knee can also cause disruption offunctional activity and interference with patient work (Thacoor &amp; Sandiford, 2019).This research aims to find out more about the benefits of using TENS in reducing painand the benefits of exercise therapy in increasing the range of motion of joints andincreasing lower leg muscle strength as a result of total knee replacement. This type ofresearch is descriptive and action research with the subject Ny. I with medical recordsPost total knee replacement dextra surgery. Results of the physiotherapy managementprocess for Total knee replacement et causa osteroarthritis knee dextra withTranscutaneus Nerve Stimulation and exercise therapy in Ny. 1, aged 53 years, came tothe Banten Provincial Regional Hospital in November with the problem of pain in theright knee, limited range of motion of the joint, decreased muscle strength, anddecreased functional activities such as squatting and going up and down stairs. Afterundergoing physiotherapy six times from November 16, 2022 to December 19, 2022using Transcutaneal Electrical Nerve Stimulation (TENS) and Exercise Therapy, theresults showed that the level of pain had decreased, the range of motion of the jointshad increased, muscle strength had increased, and the patient's functional activity hadimproved. has increased, although not completely. It is hoped that education andhome programs, independent exercises given by therapists to patients must always beimplemented with family support to get maximum results and remind patients aboutwhat is recommended by the physiotherapist for the patient's recovery and recovery.

Efficacy of Core Muscle Exercise Combined with Interferential Therapy in Alleviating Chronic Low Back Pain in High-Performance Fighter Pilots: A Randomized Controlled Trial

BackgroundChronic low back pain (LBP) related to flight is a prevalent health issue in military aviation, impacting pilots. The objective of this investigation was to ascertain if the application of core muscle training in conjunction with interferential current (IFC) therapy results in a reduction in pain severity and associated disability, consequently enhancing core muscle functionality in Chinese Air Force high-performance fighter pilots experiencing chronic LBP.MethodsFifty-three fighter pilots with chronic LBP were randomized into 3 groups: a core muscle exercise combined with IFC group (CG, n = 19), a core muscle exercise group (EG, n = 19), and an IFC group (IG, n = 15). The three groups underwent therapeutic intervention 5 times a week for 12 weeks. The primary outcomes were pain intensity, Oswestry Disability Index (ODI) score and SF-12 health-related quality of life (PCS and MCS) score. Secondary outcomes included evaluations of trunk muscle strength, endurance, and range of motion (ROM) during medial/lateral rotation to assess muscle functionality. Measurements were obtained both before and after the implementation of the intervention therapy.ResultsAfter 12 weeks of intervention therapy, all the health condition parameters significantly improved among the three groups. However, the CG had a significant improvement in pain intensity compared to the EG (MD = − 0.84 scores; 95% CI = − 1.54 to − 0.15; p = 0.013) and the IG (MD = − 1.22 scores; 95% CI = − 1.96 to − 0.48; p = 0.000). Additionally, the CG led to greater conservation of ODI and improved SF-12 PCS scores than did the IG (p < 0.05). Finally, compared with those at baseline, the core muscle function parameters in the CG and EG improved significantly at the end of the study, but no statistically significant differences were observed between the two groups (p > 0.05).ConclusionAmong participants with chronic LBP, three intervention therapies appear effective in reducing pain, diminishing disability, and enhancing quality of life. Also, combined therapy significantly improved pain and disability compared to the other two monotherapies; moreover, combined therapy and core muscle exercise provided similar benefits in terms of core muscle function after 12 weeks of intervention therapy.

Comparative analysis of post-operative rehabilitation approaches for medial patellar luxation in small-breed dogs

Background and Aim: Electrical stimulation (ES) and light amplification by stimulated emission of radiation (LASER) therapy are frequently used in post-operative rehabilitation; however, there is currently insufficient research comparing their effectiveness. This study aimed to assess the effectiveness of post-operative rehabilitation following medial patellar luxation (MPL) surgical correction by comparing ES and LASER therapy when combined with exercise. This was compared with a control group that consisted solely of post-operative home exercise implemented by the owner. Materials and Methods: We conducted a prospective clinical trial on dogs that had undergone surgical treatment for MPL. The dogs were categorized into the following three groups: The control group, which did not participate in any post-operative rehabilitation program; the ES group, which received post-operative rehabilitation involving ES therapy; and the LASER group, which underwent post-operative rehabilitation featuring LASER therapy. Results: There were no significant differences among the groups regarding the evaluation parameters, including lameness score, pain score, thigh muscle circumference, and range of motion. Although there may have been a difference in pain score in some groups, it could be attributed to the pre-operative condition of patients. These results aligned with the owner questionnaires’ canine brief pain inventory assessments, showing no significant differences between treatment groups. Conclusion: Post-operative rehabilitation for MPL correction may enhance limb usage, joint function, muscle mass, and pain relief. However, the duration and level of post-operative pain may influence the necessity for rehabilitation. In addition, ES and LASER therapy offer similar pain-relieving effects after MPL surgery; therefore, the choice between these methods depends on the availability of equipment and veterinarian preferences. Keywords: electrical stimulation, light amplification by stimulated emission of radiation therapy, medial patellar luxation, post-operative management, rehabilitation.

A short review on the effect of mechanical vibration in the evaluation and replacement of bone cement-anchored implants in human bone

Mechanical vibration can be defined as the regular or irregular repetitive movement that makes the body leave its resting state. Mechanical vibrations have an important role in keeping the bones and joints healthy. This review study aimed to investigate the effect of mechanical vibration in the evaluation and replacement of bone cement-anchored implants in human bone. The empirical studies related to mechanical vibrations and bone cement-anchored implants were reviewed. The combinations used to search for studies related to the topic included mechanical vibrations, evaluation, replacement, bone, cement-anchored implants, and human bone. The reviewed studies show that mechanical vibration, either local or whole-body, promotes bone growth in and around the implant. The stimulation of bone growth is important for the strength and durability of cement-anchored bone implants. Through the reviewed studies, it was concluded that local or whole-body mechanical vibration improves the stability and durability of bone and bone implants. Mechanical vibration achieves this effect by increasing bone formation in and around the implants and by improving the contact between the implant and the bone.

Evaluation of Pain Perception During Orthodontic Debonding of Metallic Brackets with Simultaneous Application of TENS Therapy.

The objective of the present study was to evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy on pain during the debonding procedure. A placebo-controlled, randomized split - mouth study was conducted on 30 orthodontic patients. The right and left anterior teeth in the maxilla and mandible were randomly allocated to the control and experimental groups (EG) and were stimulated. TENS application was made through a modified electrode probe that was used from an ammeter. The control group (CG) received the mechanical application of the device with no current, whereas the EG received progressively increasing current from 0.1 mA to the point where the patient experienced a mild tingling sensation for 60 s for each tooth. This was followed by a debonding procedure using an orthodontic debonding plier. Pain perception was recorded on a numerical rating scale after debonding each tooth. The mean pain score was higher in the CG than in the EG, and the difference between the two groups was significant (p=0.001). The pain score was higher in the mandibular teeth than in the maxillary teeth, and the difference between the two groups was also significant (p=0.021). Pain score was higher in female subjects than in male subjects, and the difference between the two groups was significant (p=0.015). The application of TENS therapy results in pain reduction during the debonding procedure. The female subjects experienced more pain. Higher pain scores were recorded for the mandibular anterior teeth than for the maxillary teeth.

Comparison of the efficiency of transcutaneous electrical nerve stimulation and manual therapy in children with cerebral palsy with lower urinary system dysfunction- a randomized prospective trial

Neurological defects in children with cerebral palsy (CP) not only affect their motor skills but also lead to bladder and bowel problems. Although most children with CP have achieved urinary control, more than 50% of cases experience lower urinary tract symptoms (LUTS). Common LUTS complaints observed in CP include delayed toilet training, urinary incontinence, increased frequency of urination, urgency, urinary hesitancy, and recurrent urinary tract infections. This study aimed to prospectively evaluate and compare the effectiveness of two different physiotherapy approaches, sacral Transcutaneous Electrical Nerve Stimulation (TENS) and massage, on lower urinary tract dysfunction in children with CP. A total of 54 children with CP who had the Dysfunctional Voiding Scoring System (DVISS) of 8.5 or higher were included in the study. Children were randomized to the TENS (TG; n=27) and Manual Therapy (MG; n=27) groups. TENS application was performed 2 sessions in a week for 20min for a total of 12 weeks. The electrodes used during the application were adhered bilaterally to the parasacral region (S2-S4). 4 electrodes of 5×5cm were used. Classical bowel massage was applied to the MG with the friction massage technique twice a week for 12 weeks. Manual therapy applications were performed in the form of abdominal, colon, and friction massage, twice a week for 20min by the physiotherapist. Massage was applied to the abdominal region between the lower subcostal border and the anterior superior iliac spine. Questionnaires were applied before and after treatment interventions: DVISS, functional bladder capacity (FBC), frequency of voiding, and urinary incontinence episodes evaluated by bladder diary, Bristol Gaita Scale, and Pediatric Incontinence Quality of Life Scale (PIN-Q) used. The decrease in the episodes of incontinence was higher in the TG (p=0.037; p<0.05). FBC increased after treatment in both groups, but there was no statistically significant difference between the groups (p=0.683; p>0.05). Manual therapy was more effective in improving constipation symptoms. In both groups, DVISS and PIN-Q values decreased after treatment, but the decrease in TG was statistically significant in the evaluation made between groups (p=0.001; p<0.01). Both parasacral TENS and massage provided a significant improvement in LUTS, constipation, and quality of life but TENS showed a bigger improvement. We suggest adding these interventions to the treatment of bladder and bowel problems in CP children.