Non-invasive Electrostimulation Research Articles

Non-invasive electrical stimulation in patients with neurodegenerative ataxia and spasticity: A systematic review and meta-analysis of randomized controlled trials.

There are limited treatment options for patients with neurodegenerative ataxia and spasticity. Non-invasive electrostimulation (NES) is receiving increasing interest because of its ease of implementation, cost-effectiveness and safety. A meta-analysis was conducted to evaluate the efficacy of NES. MEDLINE and Embase were screened for studies using NES in ataxias and spasticity. Key outcome measurements of effectiveness included changes in (1) Modified Ashworth Scale (MAS) scores, (2) cerebellar brain inhibition (CBI), (3) the nine-hole peg test (9HPT), (4) the 8-m walking time (8MWT), (5) International Cooperative Ataxia Rating Scale (ICARS) score and (6) the Scale for Assessment and Rating of Ataxia (SARA) scores. Seven randomized controlled trials involving 203 patients were included. There were significant improvements in MAS (mean difference [MD] -0.42, 95% confidence interval [CI] -0.76 to -0.08, p=0.015), CBI (MD -0.35%, 95% CI -0.42 to -0.28, p < 0.001), 8MWT (MD -1.88 s, 95% CI -3.26 to -0.49, p=0.008), ICARS (MD -7.84, 95% CI -11.90 to -3.78, p < 0.001) and SARA (MD -3.01, 95% CI -4.74 to -1.28, p < 0.001). There was almost no heterogeneity across all outcomes except for CBI (I2 = 79%). No significant changes in the 9HPT were observed comparing NES to a sham procedure (MD -3.52 s, 95% CI -9.15 to 2.10, p=0.220). Most included studies were at low risk of bias, and no severe adverse effects were reported. It was demonstrated that NES is an effective treatment for improving coordination and balance and increased exercise capacity in patients with ataxia and spasticity. There was also a significant modulation of CBI in ataxic patients.

Influence of Robotic Mechanotherapy in Various Combinations with Non-Invasive Electrostimulation of Muscles and Spinal Cord on the Postural Balance in Children with Severe Forms of Cerebral Palsy

Introduction. Postural disorders are significant in severe forms of cerebral palsy (CP). The aim of the work was to study the effect of locomotor training in combination with transcutaneous electrical stimulation of the spinal cord and functional electrical stimulation (FES) of the muscles of the lower extremities on the restoration of the function of maintaining a vertical posture in children with III level of limitation of motor activity according to the GMFCS classification. Materials and methods. 20 patients with CP at the age from 8 to 12 years old were examined. Patients of the main group (10 children) received 15 sessions of 45 minutes rehabilitation in the ≪Lokomat≫ robotic simulator in the sequence: 1) ≪Lokomat≫ in combination with FES, 2) ≪Lokomat≫ in combination with transcutaneous electrical stimulation of the spinal cord, 3) ≪Lokomat≫ in combination with FES and transcutaneous electrical stimulation of the spinal cord. The intervals between courses were 6 months. Patients from the control group (10 children) underwent only locomotor training. Results. The dynamics of regaining control of the upright posture in children was evaluated by the method of stabilometry, which revealed the active response of the musculoskeletal system in patients of the main group only in the case of combined robotic mechanotherapy and FES. This was manifested in a significant increase in the amplitude of oscillations A of the pressure center, a clear increase in the variance of the parameters of the LFS parameter, and a decrease in the strength of the correlation between the parameters LFS and A towards normalization. However, with a combination of locomotor training with FES and transcutaneous electrical stimulation of the spinal cord, there were no convincing signs of improving the regulation of the vertical posture. Conclusion. It is suggested that multilevel neurostimulation of patients with CP is necessary, which may be more effective, since it will affect the central components of motor activity.

Effectiveness evaluation of translingual neurostimulation in motor rehabilitation in children with spastic diplegia

Introduction. Cerebral palsy is one of the most common non-progressive neurological disorders caused by fetal or infant brain injury. Current rehabilitation for children with cerebral palsy involves a series of measures, including physical training, special massage techniques, physiotherapy, treatment by certain positions and postures, use of supporting orthoses and fixation devices for walking, and special orthopedic suits facilitating verticalization and motor activity of a child. Over the last few decades, computerized stimulators and robotics with virtual reality systems have been actively used in neurorehabilitation. However, most of these systems did not show significant efficiency in rehabilitation of children with cerebral palsy. In the last few years, different non-invasive electrostimulation techniques have been considered innovative and can be applied independently or in combination with existing procedures. One of such techniques is translingual neurostimulation.&#x0D; Aim. This study aimed to evaluate the effectiveness of a combination of translingual neurostimulation and physical rehabilitation for children with cerebral palsy.&#x0D; Materials and methods. In this study, we observed 134 children (63 girls and 71 boys) with spastic diplegia aged 2–17 years (mean age is 7.8 years old ± 0.3). Depending on the type of rehabilitation therapy, the patients were divided into two groups: active (main) and control. Active group consisted of 94 children who received standard restorative treatment in combination with translingual neurostimulation, whereas the control group consisted of 40 children who received only standard rehabilitation treatment without translingual neurostimulation.&#x0D; Results. Both groups of patients showed positive dynamics; however, patients in the active group showed greater improvements as evidenced by all grading scales. Improvements were observed in children of all ages, and the results were mostly stable for 12 months.&#x0D; Conclusion. Translingual neurostimulation is a novel approach to neurorehabilitation that shows promising results, in addition to its proven effectiveness and safety. As a result of neurostimulation, the patient’s brain becomes more susceptible to the applied therapeutic procedures aimed at restoring motor control and formation of new motor skills, thereby markedly increasing the effectiveness of neurorehabilitation. This study broadens the perspectives in the use and further development of translingual neurostimulation in rehabilitation of children with cerebral palsy.

Application of non-invasive electrostimulation of the autonomic nervous system in the complex treatment of children with psychosomatic disorders

Objectives: To evaluate efficiency of non-invasive correction of the sympathetic nervous system (SNS) by the “SYMPATHOCOR-01” neuro-electrostimulation device in integrated treatment of children with psychosomatic disorders.

Acupuncture-Point Stimulation for Chemotherapy-Induced Nausea and Vomiting [Ezzo J, Vickers A et al. J Clin Oncol 2005; 28: 7188–7199

PurposeAssess the effectiveness of acupuncture-point stimulation on acute and delayed chemotherapy-induced nausea and vomiting incancer patients. Materials and MethodsRandomized trials of acupuncture-point stimulation by needles, electricalstimulation, magnets, or acupressure were retrieved. Data were provided by investigators of the original trials and pooled using a fixed-effects model. ResultsEleven trials (N 1,247) were pooled. Overall, acupuncture-point stimulation reduced the proportion of acute vomiting (relativerisks [RR] 0.82; 95% CI, 0.69 to 0.99; P .04), but not the mean number of acute emetic episodes or acute or delayed nausea severity compared with controls. By modality, stimulation with needles reduced the proportion of acute vomiting (RR 0.74; 95% CI, 0.58 to 0.94; P. 01), but not acute nausea severity. Electroacupuncture reduced the proportion of acute vomiting (RR 0.76; 95% CI, 0.60 to 0.97; P.02), but manual acupuncture did not; delayed symptoms were not reported. Acupressure reduced mean acute nausea severity (standardized mean difference 0.19; 95% CI, 0.38 to 0.01; P .03) and most severe acute nausea, but not acute vomiting or delayed symptoms. Noninvasive electrostimulation showed no benefit for any outcome. All trials used concomitant pharmacologic antiemetics, and all, except electroacupuncture trials, used state-of-the-art antiemetics. ConclusionThis review complements data on postoperative nausea and vomiting, suggesting a biologic effect of acupuncture-point stimulation. Electroacupuncture has demonstrated benefit for chemotherapy-induced acute vomiting, but studies with state-of-the-art antiemetics as well as studies for refractory symptoms are needed to determine clinical relevance. Acupressure seems to reduce chemotherapy-induced acute nausea severity, though studies didnot involve a placebo control. Noninvasive electrostimulation seems unlikely to have a clinically relevant impact when patients are given state-of-the-art pharmacologic antiemetic therapy.

Acupuncture-Point Stimulation for Chemotherapy-Induced Nausea and Vomiting

Assess the effectiveness of acupuncture-point stimulation on acute and delayed chemotherapy-induced nausea and vomiting in cancer patients. Randomized trials of acupuncture-point stimulation by needles, electrical stimulation, magnets, or acupressure were retrieved. Data were provided by investigators of the original trials and pooled using a fixed-effects model. Eleven trials (N = 1,247) were pooled. Overall, acupuncture-point stimulation reduced the proportion of acute vomiting (relative risks [RR] = 0.82; 95% CI, 0.69 to 0.99; P = .04), but not the mean number of acute emetic episodes or acute or delayed nausea severity compared with controls. By modality, stimulation with needles reduced the proportion of acute vomiting (RR = 0.74; 95% CI, 0.58 to 0.94; P = .01), but not acute nausea severity. Electroacupuncture reduced the proportion of acute vomiting (RR = 0.76; 95% CI, 0.60 to 0.97; P = .02), but manual acupuncture did not; delayed symptoms were not reported. Acupressure reduced mean acute nausea severity (standardized mean difference = -0.19; 95% CI, -0.38 to -0.01; P = .03) and most severe acute nausea, but not acute vomiting or delayed symptoms. Noninvasive electrostimulation showed no benefit for any outcome. All trials used concomitant pharmacologic antiemetics, and all, except electroacupuncture trials, used state-of-the-art antiemetics. This review complements data on postoperative nausea and vomiting, suggesting a biologic effect of acupuncture-point stimulation. Electroacupuncture has demonstrated benefit for chemotherapy-induced acute vomiting, but studies with state-of-the-art antiemetics as well as studies for refractory symptoms are needed to determine clinical relevance. Acupressure seems to reduce chemotherapy-induced acute nausea severity, though studies did not involve a placebo control. Noninvasive electrostimulation seems unlikely to have a clinically relevant impact when patients are given state-of-the-art pharmacologic antiemetic therapy.

Aiding Lipreading by Non-Invasive Electrostimulation of the Auditory Tract

Some totally deaf people may have hearing sensations when their auditory tract is electrically stimulated by means of electrodes inserted into external ear canals /non-invasive/. This phenomenon can be utilized for rehabilitation of the deaf. The rate of information transmission by means of such stimulation is too low to enable the deaf to understand the speech but it is sufficient for aiding lipreading. The lipreading aid must provide the deaf with information that is complementary /not supplementary/ to what he obtains by lipreading. The necessary processing of the speech signal must be determined experimentally for each deaf. A special apparatus has been designed for this purpose and preliminary measurements have been done.