Therapeutic Effects Of Electrical Stimulation Research Articles

Therapeutic electrical stimulation in cerebral palsy: a randomized, controlled, crossover trial

The aim of this study was to evaluate the effect of therapeutic electrical stimulation (TES) applied to antagonists of spastic leg muscles on gross motor function in children with spastic diplegic cerebral palsy. Twelve children between 5 and 12 years of age completed a 24‐month crossover study in which six were randomly assigned to receive TES for the first 12 months and the remaining six for the last 12 months. Physiotherapy and a home training program were not altered. All were evaluated blindly in terms of tests of motor function and video recordings at the start and at 12 and 24 months. At the end of the study parents/carers gave a subjective assessment of the effect of TES. No significant effect of TES on motor or ambulatory function was found on the blinded evaluation, but parents of 11 of the 12 children stated that TES had a significant effect. We conclude that it is unlikely that TES has a significant effect on motor and ambulatory function in spastic diplegia.

Lower Extremity Applications of Functional Neuromuscular Stimulation After Spinal Cord Injury

This paper reviews the therapeutic and neuroprosthetic applications of functional neuromuscular stimulation (FNS), also known as functional electrical stimulation (FES), for lower extremity rehabilitation after spinal cord injury and summarizes the important clinical and technical issues involved in its use. The therapeutic effects of electrical stimulation on disuse atrophy, muscle strength and endurance, cardiopulmonary status, and tissue viability in terms of risk of pressure sore development are summarized. Neuroprosthetic uses of surface and implanted technologies for standing, ambulation, and personal mobility are also described. Health and functional benefits, contraindications, and other clinical considerations are discussed, along with the potential of the technology to be an important component in the overall rehabilitation of persons with spinal cord injuries.

Initial Experience With Home Therapeutic Electrical Stimulation for Continence in the Myelomeningocele Population

Purpose In an attempt to enhance bladder and bowel continence 29 patients underwent long duration, low intensity transcutaneous therapeutic electrical stimulation. This technology has previously been shown to be effective for inducing regenerative hypertrophy of disuse atrophied skeletal muscle, and it has been associated with improved continence in the myelomeningocele population. Our objectives were to enhance urinary and fecal continence, and evaluate the mechanisms by which therapeutic electrical stimulation influences continence. Materials and Methods A total of 29 children with lumbar or sacral myelomeningocele underwent therapeutic electrical stimulation at home during sleep using a commercially available stimulator with a safety sensing circuit and 2 sets of electrodes placed on the skin at bedtime. Left and right side electrode placement was alternated on 6 of 7 consecutive nights. In 9 boys and 2 girls with more than 9 months of followup initial and subsequent cystometrography, urethral pressure profile, electromyography, voiding cystourethrography and renal ultrasound studies were evaluated. Results In the 11 children there was no radiographic evidence of urinary tract or musculoskeletal deterioration during treatment. Mean actual bladder capacity increased from 133 to 196 ml. (p <0.05). Mean bladder capacity, as a percent of maximum predicted bladder capacity for a normal age matched child without myelomeningocele, also significantly increased from 59 before to 76% after 9 months of therapeutic electrical stimulation (p <0.05). No significant change was noted in urethral pressure profile. A subjective improvement in the sensation of pelvic fullness was also observed. Conclusions When administered at home by parents while the child sleeps, therapeutic electrical stimulation is safe for bladder and bowel continence in the myelomeningocele population. It seems to increase significantly bladder capacity, does not appear to change urethral pressure profile and results in a subjectively improved sensation of pelvic fullness, enhancing urinary and fecal continence. The most beneficial effect of therapeutic electrical stimulation seems to be on the bladder wall and less so on the striated pelvic floor musculature with subjective enhancement of pelvic fullness also contributing positively.

DC electrical stimulation for chronic wound healing enhancement Part 1. Clinical study and determination of electrical field distribution in the numerical wound model

Notwithstanding several past clinical studies demonstrating the beneficial impact of electrical stimulation with steady direct current on the healing of chronic cutaneous wounds, the basic mechanisms underlying its effects on regenerative processes remain to be elucidated and the stimulation regime optimized. In the present study, an attempt is made towards the optimization of steady direct current stimulation of wound healing with respect to the shape and positioning of stimulation electrodes. The effects of direct current stimulation on wound healing were studied in a double-blind clinical trial involving fifty patients with spinal cord injuries, suffering from pressure ulcers. The therapeutic effect of electrical stimulation was found to depend on the positioning and shape of the electrodes. Healing of pressure ulcers was significantly enhanced by direct current, with the positive stimulation electrode overlaying the wound surface and the negative electrode placed on intact skin around the wound. By contrast, stimulation by the second type of electrode configuration - which assumed positioning of both stimulation electrodes on intact skin at the opposite sides of the wound - had only a non-significant effect on pressure ulcer healing. Numerical modelling showed that direct current stimulation using two types of electrode arrangements induced different electric field distributions in the stimulated tissue in the wound area. Endogenous electric conditions in the skin were closely approached with external electrical stimulation when the wound surface was covered with the positive stimulation electrode, while the negative electrode surrounded the wound. With such stimulation, highly significant acceleration of wound healing was observed in the clinical study, leading to the assumption that endogenous electrical phenomena in injured skin are not just side effects, but play an active role in healing. The agreement of the externally induced electric field with the endogenous electric field distribution in injured skin was adopted as the basis for optimization of direct current electrical stimulation for wound healing enhancement.