Citations
Method: The subjects were 13 hemiplegic patients with cerebral infarction and cerebral hemorrhage. Electrical stimulation was applied to skin over the biceps muscle and the triceps muscle for a period of twenty minutes. The evaluation of spasticity was done by using the modified Ashworth scale, free amount of elbow extension, active range of motion and motor strength of elbow flexion and extension at baseline, immediately, 1 week and 4 weeks after electrical stimulation.
Results: Immediately after treatment, free amount of elbowextension increased from 63.8±19.1 degrees to 77.7±22.5 degrees (p＜0.05) and active flexion of elbow flexor increased from 45.0±34.8 degrees to 55.3±39.1 degrees (p＜0.05). The active range of motion of elbow flexor was increased on the 4th week during elec trical stimulation (p＜0.05). The free amount of elbow extension and modified Ashworth scale of elbow flexor spasticity was improved on the 18th day after treatment cessation (p＜0.05).
Conclusion: The results of this study showed that spasticity tended to decrease and maintain a lower level after a varying number of treatment sessions.
Method: Fifteen rabbits were experimentally spinal cord injured at the T10 or T11 spinal cord level. Three kinds of stimulation frequency (10, 20, 40 Hz) and sham control stimulation were applied to the tibialis anterior muscle of each four group for 1 hour per day, for 2 weeks. Muscle fatigue index and peak torque were measured during electrical stimulation, and proportion of the type I muscle fiber was measured at ATPase (pH 9.4) staining.
Results: Complete paraplegia was obtained in all 12 rabbits. Muscle fatigue index and peak torque were not changed after 2 weeks of electrical stimulation in all four groups. The proportion of the type I muscle fiber was reduced in all four groups after 2 weeks. However, 40 Hz stimulation group showed less decline in proportion of type I muscle fiber than control or 10 Hz group.
Conclusion: High frequency electrical stimulation applied at an early stage of spinal cord injury is more effective in preserving muscle endurance than low frequency stimulation. (J Korean Acad Rehab Med 2003; 27: 410-417)
Objective: This study aimed to assess optimal stimulation intensity and to investigate other variables on functional electrical stimulation (FES) for hemiplegic upper limb.
Method: We divided hemiplegic subjects into two groups, acute (n=28) and chronic (n=18), and control subjects into old (n=26) and young (n=27). Electrical stimulation was performed on the forearm of both sides in hemiplegic patients and of the nondominant side in normal controls. The stimulation site that aimed at open hand motion was targeted to the extensor digitorum and extensor pollicis brevis muscles. We measured the peak to peak amount of current and skin impedance while making hand extension.
Results: The acute and chronic hemiplegic groups required a greater current than the control groups (p＜0.01). The hemiplegic side required a greater current than the non- hemiplegic side (p＜0.001). There was no significant difference of current amount between the acute and chronic hemiplegic groups. The current amount was significantly correlated with subject's age (p=0.001). No difference of skin impedance was found among any of the groups.
Conclusion: Irrespective of disease duration on hemiplegia, a greater current is required in the hemiplegic upper limb than in the normal upper limb. Age was an important factor in determining stimulation intensity. (J Korean Acad Rehab Med 2002; 26: 379-384)
Objective: This study was purposed to find the ideal carrier waveform in burst wave in Functional Electrical Stimulation (FES) for upper limbs after selection of proper site of electrode.
Method: The 10 healthy men's non-dominant hands were studied. In 5 muscles (adductor pollicis, flexor digitorum sublimis, flexor pollicis longus, extensor digitorum communis and extensor pollicis brevis), the site where electric stimulus induced the best of purposed response was selected. A burst wave contains three carrier waveforms : sine, triphasic & rectangular. The amount of mean current was measured during key grip and open motion. Discomfort of subject was scored by three degree and compared among three waveforms.
Results: The amount of mean current in key grip and open motion is lowest at triphasic wave (31.3 mA, 50.5 mA) and highest at rectangular wave (79.4 mA, 82.1 mA). For the discomfort, rectangular waveform provoke the greatest discomfort in key grip and open motion. There is no statistical difference between sine and triphasic waveform.
Conclusion: In FES of upper limbs, triangular wave can be an useful carrier waveform which require less amount of current for performing the same motion and less discomfort than rectangular or sine waveform.
Objective: The purpose of this study is to evaluate the effect of functional electrical stimulation (FES) on hemiplegic shoulder subluxation in post-acute stroke patients.
Method: Forty-four patients who had shoulder subluxation as a consequence of their first stroke were included and randomly assigned to either a control group (22 subjects) or a study group (22 subjects). Patients in both groups received physiotherapy and used an arm sling. The study group received, FES therapy to shoulder muscles (supraspinatus and posterior deltoid) for 30 minutes, five days a week for 6 weeks. The effect of FES therapy was evaluated by assessment of the severity of subluxation using radiologic measurements before and after treatment.
Results: 1) The severity of subluxation was significantly increased after 6 weeks (p＜0.05) in the control group. In the study group, it was reduced but the difference was not statistically significant (p＞0.05). 2) In the group of patients with early treatment (onset duration, less than 6 months), the control group showed a significant increase in subluxation (p＜0.05), but the study group showed significantly reduced (p＜0.05) shoulder subluxation after treatment period. 3) In the group of patients with mild shoulder subluxation before treatment (less than 1 finger breadth), the control group showed a significant increase in subluxation (p＜0.05), but the study group showed significantly reduced (p＜0.05) shoulder subluxation after treatment period.
Conclusion: The FES therapy is effective in preventing and reducing the severity of hemiplegic shoulder subluxation in post-acute stroke patients, especially if duration since stroke onset was less than six months and the severity of subluxation before treatment was mild.
Objective: To investigate the changes of gait patterns in hemiplegic patients with ankle foot orthosis (AFO) and with functional electrical stimulation (FES).
Method: Fifteen hemiplegic patients who can walk independently with cane participated in this study. Kinematic gait analysis was performed for all subjects using three-dimensional gait analysis system in barefoot, wearing AFO, and applying FES. The mean values of each gait trials were taken and statistically analysed by repeated measures of ANOVA.
Results: Genu recurvatum at stance phase and excessive ankle plantar flexion at stance and swing phase were decreased after wearing AFO. Excessive ankle plantar flexion at swing phase were decreased after applying FES.
Conclusion: The results showed that the FES is useful for the correction of hemiplegic gait as mush as of wearing AFO.
Objective: To determine the effects of abdominal functional electrical stimulation(FES) on the ability to clear the broncheal secretion in high spinal cord injury(SCI) patients.
Method: Eleven cervical SCI male patients were assessed for the pulmonary function using a routine pulmonary function test. Maximal expiratory pressure(MEP) and peak expiratory flow rate(PEFR) measurements were recorded during (1) spontaneous cough attempts and (2) cough attempts with FES applied to the abdominal wall. Each measurement was recorded in supine and sitting positions. The portable FES unit was set at 24 Hz, with a pulse width of 150 microsecond(ㄍs), an asymmetrical biphasic waveform and a maximal intensity to 90 mA.
Results: All subjects had a decreased vital capacity, peak expiratory flow and increased ratio of forced expiratory volume at one second(FEV1) to the forced vital capacity(FVC) in a routine pulmonary function test. These cervical SCI patients were greatly reduced the MEP and the PEFR when they coughed spontaneously. FES-assisted coughing increased the MEP and PEFR in all patients in a supine and sitting positions with statistical significance(p＜0.05).
Conclusion: By increasing the MEP and PEFR, abdominal FES could enhance the coughs in high SCI patients. Abdominal FES can be a useful physical therapy for the prevention and treatment of pulmonary complications in high SCI patients at the bed side as well as at homes.
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