Neuromuscular electrical stimulation

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Effects of neuromuscular electrical stimulation, laser therapy and LED therapy on the masticatory system and the impact on sleep variables in cerebral palsy patients: a randomized, five arms clinical trial

Effects of neuromuscular electrical stimulation, laser therapy and LED therapy on the masticatory system and the impact on sleep variables in cerebral palsy patients: a randomized, five arms clinical trial

Methods/design: 50 patients with CP, both gender, aged between 19 and 60 years will be enrolled in this study. The inclusion criteria are: voluntary participation, patient with hemiparesis, quadriparesis or diparetic CP, with ability to understand and respond to verbal commands. The exclusion criteria are: patients undergoing/underwent orthodontic, functional maxillary orthopedic or botulinum toxin treatment. Polysomnographic and surface electromyographic exams on masseter, temporalis and suprahyoid will be carry out in all sample. Questionnaire assessing oral characteristics will be applied. The sample will be divided into 5 treatment groups: Group 1: neuromuscular electrical stimulation; Group 2: laser therapy; Group 3: LED therapy; Group 4: neuromuscular electrical stimulation and laser therapy and Group 5: neuromuscular electrical stimulation and LED therapy. All patients will be treated during 8 consecutive weeks. After treatment, polysomnographic and electromiographic exams will be collected again.
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Safety of neuromuscular electrical stimulation among critically ill patients: systematic review

Safety of neuromuscular electrical stimulation among critically ill patients: systematic review

Methods: A systematic review was conducted; a literature search was performed of the MEDLINE (via PubMed), PEDro, Cochrane CENTRAL and EMBASE databases, and a further manual search was performed among the references cited in randomized studies. Randomized clinical trials that compared neuromuscular electrical stimulation to a control or placebo group in the intensive care unit and reporting on the technique safety in the outcomes were included. Hemodynamic variables and information on adverse effects were considered safety parameters. Articles were independently analyzed by two reviewers, and the data analysis was descriptive.
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Therapeutic efficacy of neuromuscular electrical stimulation and electromyographic biofeedback on Alzheimer’s disease patients with dysphagia

Therapeutic efficacy of neuromuscular electrical stimulation and electromyographic biofeedback on Alzheimer’s disease patients with dysphagia

Neuromuscular electrical stimulation and EMG-biofeedback treatment can improve swallowing function in patients with Alzheimer ’s disease and significantly reduce the incidence of adverse outcomes. Thus, they should be promoted in clinical practice. Abbreviations: AD = Alzheimer’s disease, ALB = serum albumin, DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th ed, EMG-biofeedback = electromyographic biofeedback, Hb = hemoglobin, MMSE = Mini-mental state examination, MNA = Mini Nutritional Assessment, NINCDS ADRDA = National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer ’s Disease and Related Disorders Association, NMES = neuromuscular electrical stimulation, WST = water swallow test.
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REACH AND PALMAR GRASP IN TETRAPLEGICS WITH NEUROMUSCULAR ELECTRICAL STIMULATION ALCANCE E PREENSÃO PALMAR EM TETRAPLÉGICOS COM ESTIMULAÇÃO ELÉTRICA NEUROMUSCULAR ALCANCE Y PRENSIÓN PALMAR EN TETRAPLÉJICOS CON ESTIMULACIÓN ELÉCTRICA NEUROMUSCULAR

REACH AND PALMAR GRASP IN TETRAPLEGICS WITH NEUROMUSCULAR ELECTRICAL STIMULATION ALCANCE E PREENSÃO PALMAR EM TETRAPLÉGICOS COM ESTIMULAÇÃO ELÉTRICA NEUROMUSCULAR ALCANCE Y PRENSIÓN PALMAR EN TETRAPLÉJICOS CON ESTIMULACIÓN ELÉCTRICA NEUROMUSCULAR

Objective: To evaluate the movement strategies of quadriplegics, assisted by neuromuscular electrical stimulation, on reach and palmar grasp using objects of different weights. Methods: It was a prospective clinical trial. Four chronic quadriplegics (C5-C6), with injuries of traumatic origin, were recruited and all of them had their reach and palmar grasp movement captured by four infrared cameras and six retro-reflective markers attached to the trunk and right arm, as- sisted or not by neuromuscular electrical stimulation to the triceps, extensor carpi radialis longus, extensor digitorum communis, flexor digitorum superficialis, opponens pollicis and lumbricals. It was measured by a Neurological and Functional Classification of Spinal Cord Injuries of the American Spinal Injury Association, Functional Independence Measure and kinematic variables. Results: The patients were able to reach and execute palmar grasp in all cylinders using the stimulation sequences assisted by neuromuscular electrical stimulation. The quadriplegics produced lower peak velocity, a shorter time of movement and reduction in movement segmentation, when assisted by neuromuscular electrical stimulation. Conclusion: This study showed that reach and palmar grasp movement assisted by neuromuscular electrical stimulation was able to produce motor patterns more similar to healthy subjects. Level of evidence IV; Case series.
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Safety of neuromuscular electrical stimulation among critically ill patients: systematic review

Safety of neuromuscular electrical stimulation among critically ill patients: systematic review

Methods: A systematic review was conducted; a literature search was performed of the MEDLINE (via PubMed), PEDro, Cochrane CENTRAL and EMBASE databases, and a further manual search was performed among the references cited in randomized studies. Randomized clinical trials that compared neuromuscular electrical stimulation to a control or placebo group in the intensive care unit and reporting on the technique safety in the outcomes were included. Hemodynamic variables and information on adverse effects were considered safety parameters. Articles were independently analyzed by two reviewers, and the data analysis was descriptive.
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Effects of Neuromuscular Electrical Stimulation Combined with Exercises versus an Exercise Program on the Pain and the Function in Patients with Knee Osteoarthritis: A Randomized Controlled Trial

Effects of Neuromuscular Electrical Stimulation Combined with Exercises versus an Exercise Program on the Pain and the Function in Patients with Knee Osteoarthritis: A Randomized Controlled Trial

Neuromuscular electrical stimulation (NMES) is deined as the application of electrical stimulation using surface elec- trodes placed over skeletal muscles to produce visible muscle contraction through the activation of intramuscular nerve branches [8]. his technique can also be used as a form of physical therapy in the treatment of patients with knee OA. he goals of rehabilitation protocols that include NMES are to provide additional stimulus to increase muscle strength in patients with knee OA [9]. he methods and indings of previ- ous studies on the efectiveness of NMES in knee OA difer in the modulation of NMES parameters, choice of the outcomes used to evaluate the patients, and characteristics of the control groups. his leads to a lack of consensus regarding the efect- iveness attained from including NMES in conventional reha- bilitation protocols. Major laws with regard to methodolog- ical quality were found in clinical trials testing the use of NMES in the conservative treatment of patients with knee OA. Only one of these studies reported using allocation con- cealment, blinded assessment, and intention-to-treat analysis [10].
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Is neuromuscular electrical stimulation effective for improving pain, function and activities of daily living of knee osteoarthritis patients? A randomized clinical trial

Is neuromuscular electrical stimulation effective for improving pain, function and activities of daily living of knee osteoarthritis patients? A randomized clinical trial

X-rays in the last 12 months; and osteoarthritis grade 2 or more based on the  radiographic classiication developed by Kellgren and Lawrence. he exclusion criteria were: use of a pacemaker, unstable cardiac status, attendance in a physical activity program more than twice a week (to avoid inluence on the protocol to be tested), inability to ride a stationary bicycle, inability to walk and previous knee arthroplasty. Ater the screening procedures, the patients were assigned to one of two diferent groups. he groups were as follows: 1) neuromuscular electrical stimulation group (NMES group; n = 50); and 2) control group (n = 50).
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Effect of Low Frequency Neuromuscular Electrical Stimulation on Glucose Profile of Persons with Type 2 Diabetes: A Pilot Study

Effect of Low Frequency Neuromuscular Electrical Stimulation on Glucose Profile of Persons with Type 2 Diabetes: A Pilot Study

he purpose of this study was to examine the efect of low-frequency neuromuscular electrical stimulation (NMES) on glucose proile in persons with type 2 diabetes mellitus (T2DM). Eight persons with T2DM (41 to 65 years) completed a glucose toler- ance test with and without NMES delivered to the knee extensors for a 1-hour period at 8 Hz. hree blood samples were collect- ed: at rest, and then 60 and 120 minutes ater consumption of a glucose load on the NMES and control days. In NMES groups glucose concentrations were signiicantly lower (P<0.01) than in the control conditions. Moreover, a signiicant positive correla- tion (r=0.9, P<0.01) was obtained between the intensity of stimulation and changes in blood glucose. Our results suggest that low-frequency stimulation seem suitable to induce enhance glucose uptake in persons with T2DM. Moreover, the intensity of stimulation relecting the motor contraction should be considered during NMES procedure.
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Effects of neuromuscular electrical stimulation on the masticatory muscles and physiologic sleep variables in adults with cerebral palsy: a novel therapeutic approach

Effects of neuromuscular electrical stimulation on the masticatory muscles and physiologic sleep variables in adults with cerebral palsy: a novel therapeutic approach

Neuromuscular electrical stimulation (NMES) is a promising therapy for strengthening muscles in patients with CP [13]. This safe, noninvasive method induces the action potential in motor nerves, causing the activation of motor units. NMES involves the administration of pulses of electrical current though electrodes (cathode and anode) placed over the muscle. The benefits of NMES include the preservation of muscle strength, a reduction in spasticity, improved flexibility and an increase in the range of motion of the affected limb, allowing vol- untary efforts to become more effective; moreover, adverse effects are either nonexistent or negligible [14]. For individuals with CP, NMES has been recommended for the stimulation of muscles in the limbs and trunk and can lead to significant improvements in muscle strength and range of motion [13, 15,16] as well as the modulation of excessive muscle tone and enhanced coordination [17]. Considering the success of NMES regarding other muscle groups, it seems plausible that the use of this therapy on the masticatory muscles would be equally ben- eficial for the treatment of spasticity in this musculature. However, there are no records in the literature of studies addressing the effectiveness of NMES on the masticatory muscles in adult individuals with CP.
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Tolerance and physiological correlates of neuromuscular electrical stimulation in COPD: a pilot study.

Tolerance and physiological correlates of neuromuscular electrical stimulation in COPD: a pilot study.

Muscle fatigue induced by NMES. NMES can induce muscle fatigue in healthy subjects [25] and patients with COPD [12] but this was observed when the stimulation intensity was determined by the investigator. In the present study, we confirmed the existence of quadriceps fatigue after the last NMES training session, using stimulation intensities that were self-determined by patients. Using paired magnetic twitch stimuli, we found that low- frequency-fatigue predominantly occurred after 10 Hz magnetic stimulation (Table 3), suggesting that contractile rather than neural properties were altered after NMES (low frequency fatigue), similarly to previous findings in healthy human [22]. This result could constitute a rationale for further investigation on the nature of muscle fatigue induced by NMES training. However, our findings suggest that muscle fatigue does not influence tolerance to NMES.
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Neuromuscular electrical stimulation improves exercise tolerance in chronic obstructive pulmonary disease patients with better preserved fat-free mass

Neuromuscular electrical stimulation improves exercise tolerance in chronic obstructive pulmonary disease patients with better preserved fat-free mass

dual-channel NME stimulator (DualpexH 961 Sport, Quark Produtos Me´dicos, Brazil). The following training protocol was chosen to minimize the effects of fatigue on muscle contractility: (i) symmetrical, biphasic, square-pulsed cur- rent at 50 Hz; (ii) duty cycle: 2 s on and 10 s off (16%) in the first week, 5 s on and 25 s (18%) off in the second week, 10 s on and 30 s off (25%) in the third and fourth weeks, 10s on and 20 s off (33%) thereafter; and (iii) pulses 300- to 400-ms wide, using the highest tolerable amplitude (15-20 mA at the start of the training session, increasing up to 60 mA). This training protocol was applied to each leg of the sequence (15 minutes at a time the first week, 30 minutes at a time the second week and 60 minutes at a time thereafter) five times per week for six weeks. The sham stimulation protocol consisted of (i) a symmetrical, biphasic, square-pulsed current at 50 Hz; (ii) a duty cycle: 2 s on and 10 s off (16%); (iii) pulses fixed at 200 ms; and (iv) a constant current intensity of 10 mA. We certified that these settings were not too high to elicit effective muscle contraction in all patients. The sham stimulation was applied to each leg for 15 minutes at a time, three times per week for 6 weeks.
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Rev. bras. geriatr. gerontol.  vol.18 número3

Rev. bras. geriatr. gerontol. vol.18 número3

Introduction: Aging affects the musculoskeletal system, which can lead to osteoarthritis, causing degeneration of the articular cartilage and consequently resulting in functional impairment among elderly patients. However, neuromuscular electrical stimulation (NMES) training can be used as a mode of muscle strengthening. Objective: To investigate the effects of eight weeks of NMES training of the knee extensors on the RMS/torque ratio of elderly persons with osteoarthritis. Methods: Twenty-four elderly women were assigned into two groups: a healthy group (HE; n=12) and an osteoarthritis group (OA; n=12). The OA group was submitted to eight weeks of NMES training. Results: In the OA group, the RMS values increased from the pre-training to the post-training periods ( p<0.05). The HE group did not differ from the OA group in the post-training period ( p>0.05). Quadriceps torque was higher in the OA group in the post-training period at 90º of knee flexion ( p<0.05) but the torque in the HE group remained higher than in the OA group for all the angles evaluated ( p<0.05). The RMS/torque ratios increased in the post-training period at 60º, 75º and 90º of knee flexion ( p<0.05), but did not differ between the HE and OA groups ( p>0.05). Conclusion: Eight weeks of NMES training resulted in a significant increase in the RMS and torque values of the quadriceps, but these neural adaptations were not sufficient to improve the osteoarthritis group to levels similar to the healthy group.
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Response of the arterial blood pressure of quadriplegic patients to treadmill gait training

Response of the arterial blood pressure of quadriplegic patients to treadmill gait training

Neuromuscular electrical stimulation (NMES) permits the activation of paralyzed muscles through the electrical stimulation of intact peripheral motoneurons (16). NMES has been used to provide a functional gait (17) and to study the action of the spinal cord in the control of movement through basic motor patterns generated by sensory inputs, using the concept of task-oriented training (18,19). The functional muscle activity gen- erated by NMES in the lower limbs im- proves venous return, increases cardiac preload, systolic volume and cardiac output, which in turn increase blood pressure during
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Einstein (São Paulo)  vol.8 número3

Einstein (São Paulo) vol.8 número3

Treadmill gait training with neuromuscular electrical stimulation (NMES) in quadriplegic subjects is capable of improving movements (even quadriplegics with complete lesions), metabolic and cardio respiratory responses and bone mineral density. It was reported that these findings are associated with a better coordination of voluntary and autonomic functions of muscles and nervous pathways; however, there is no unanimous understanding on how and why it happens (4-6) .

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Efeitos de oito semanas de treinamento com estimulação elétrica neuromuscular nas razões de ativação muscular / torque de idosas com osteoartrite.

Efeitos de oito semanas de treinamento com estimulação elétrica neuromuscular nas razões de ativação muscular / torque de idosas com osteoartrite.

Com o objetivo de reverter o processo de fraqueza muscular, diferentes métodos de reabilitação têm sido propostos. Entre os diversos metódos, a neuromuscular electrical stimulation (NMES) vem sendo utilizada como tratamento para reduzir os fatores de risco associados ao desenvolvimento e agravamento do processo degenerativo da OA. Seu objetivo principal é o ganho de força da musculatura que se encontra inibida devido à dor articular, por meio da geração artificial de contração muscular. 9-14 Entretanto, existem

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Neuromuscular electrical and thermal-tactile stimulation for dysphagia caused by stroke: a randomized controlled trial

Neuromuscular electrical and thermal-tactile stimulation for dysphagia caused by stroke: a randomized controlled trial

Although patients with dysphagia after a stoke can recover their swallow function spontaneously, a mean of tube-feeding was needed for 15–60 weeks, and 30% of all patients continued on total tube-feeding for one year after their stroke (16). In our study, 19 of the total of 26 patients (65%) had required tube- feeding after their stroke. However, the tube-feeding ratio was decreased to 46% after the study. On the other hand, we found that 6 out of 12 patients in the experimental group who had had tube-feeding were able to progress to oral feeding, while only one out of 7 patients in the control group was able to progress to oral feeding. These findings also showed that neuromuscular electrical stimulation combined with TTS can help the recovery of dysphagia more effectively than TTS alone.
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Rev. CEFAC  vol.18 número5

Rev. CEFAC vol.18 número5

Purpose: the purpose of this study is to verify the effect of Neuromuscular Electrical Stimulation on the suprahyoid muscle activity during swallowing, in post stroke subjects, with oropharyngeal dysphagia. Methods: participated eight post-stroke subjects with dysphagia, male and female, referred to speech- -language therapy to early swallowing rehabilitation. Before the irst rehabilitation session, the patient´s muscular electrical activity of suprahyoid muscle was measured using Surface Electromyography Biofeedback. Patients were randomly divided into two groups: Experimental Group (n=4): patients who received both traditional speech-language therapy and the application of Neuromuscular Electrical Stimulation. Control Group (n=4): patients submitted to traditional speech-language therapy. After eight sessions, all patients measured the suprahyoid activity with the Surface Electromyography Biofeedback. The pre and post treatment results were compared in both groups. Results: comparing the two groups average of time and amplitude of the muscle contraction during swallowing of saliva and two swallows of paste, no statistically signiicant differences were observed in the pre and post treatment values. Conclusion: the use of Neuromuscular Electrical Stimulation on the parameters and methodology used did not prove eficient in promoting greater contraction of the suprahyoid muscles during the swallowing, in post-stroke individuals with oropharyngeal dysphagia. The data obtained may be due to the methodo- logy used in this study relative to the protocol application and the way to measure the results.
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Eletroestimulação funcional associada a facilitação neuromuscular proprioceptiva de tronco em indivíduos com sequelas de acidente vascular encefálico isquêmico / Functional electrical stimulation associated with the proprioceptive neuromuscular facilitati

Eletroestimulação funcional associada a facilitação neuromuscular proprioceptiva de tronco em indivíduos com sequelas de acidente vascular encefálico isquêmico / Functional electrical stimulation associated with the proprioceptive neuromuscular facilitation in trunk with sequelae of ischemic cerebrovascular accident

Background: Cerebrovascular accident is an ischemic vascular disease with at least 24 hours showing focal brain function disorder characterized by a vascular occlusion by decreasing oxygen and nutrients to the brain tissue. Objectives To analyze effectiveness of electro stimulation on postural control and functional balance of individuals with sequelae of ischemic cerebrovascular accident. Methods: Study of type pilot controlled and randomized clinical trial with an initial sample of six individuals. The data were collected by application of postural control assessment scale (PASS) and berg balance scale (EEB). For analysis of the variables the Wilcoxon test was used for comparison of the pre-and post-intervention moments groups. All processing was supported by statistical software SPSS STATISTICS version 22.0. All findings were based on a 95% confidence interval and p < 0.05. Results: The intervention group showed improved balance (p = 0.002) compared to the control group (p = 0.516). The experimental group showed improvement in PASS with scale (p = 0.034). Conclusion: Relevant data that demonstrate the importance of the role of physical therapy in the rehabilitation of trunk and balance in patients with sequelae of ischemic cerebrovascular accident and consequent improvement in the quality of life of the population evaluated. Keywords: Stroke, Proprioceptive Neuromuscular Facilitation, Functional ElectroStimulation.
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Teste de estimulação repetitiva no músculo ancôneo para diagnóstico da miastenia grave: mapeamento da sua área de placa motora.

Teste de estimulação repetitiva no músculo ancôneo para diagnóstico da miastenia grave: mapeamento da sua área de placa motora.

ABSTRACT - Purpose: To map the motor end-plate area of the anconeus muscle and define the best place for positioning the recording electrodes in repetitive stimulation tests (RST) for the diagnosis of neuromus- cular transmission disorders. Method: The compound muscle action potential of the anconeus was recor- ded after stimulating the motor branch of the radial nerve that innervates it. By analyzing the waveforms registered at each point of the skin we were able to define the motor end-plate area. Results: The motor end-plate area of the anconeus is a line parallel to the ulna border. The best place for placing the “active” recording electrode is about 2cm distal to the olecranon and 1 cm lateral to the border of the ulna. Con- clusion: Performing RST in the anconeus muscle is simple and well tolerated. Stimulation of the anconeus almost doesn’t move the forearm and the procedure is virtually free of movement artifacts.
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Brain Computer Interface Boulevard of Smarter Thoughts

Brain Computer Interface Boulevard of Smarter Thoughts

article, since the electrical oomph in the brain changes in proportion to what the individual is doing. The rise of Electro- corticography (ECoG) has been a new hint podium for brain- computer interface systems. Consequently, it was anonymous whether further neuro-physiological substrates, such as the vocalization net, might be used to further develop on or harmonize on motor-based power paradigms. For the foremost instance, that ECoG signals allied with diverse, blatant and anticipated phoneme enunciation can facilitate invasively monitored patients to manage a one-dimensional computer pointer precisely.
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