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Bayraktar HEN, Yalçin E, Şipal MS, Akyüz M, Akinci MG, Ü Delialioğlu S. The effect of electromyography triggered electrical stimulation to abdominal muscles on sitting balance, respiratory functions, and abdominal muscle thickness in complete spinal cord injury: a randomized controlled trial. Int J Rehabil Res 2024; 47:87-96. [PMID: 38501227 DOI: 10.1097/mrr.0000000000000620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Complete thoracic spinal cord injury (SCI) results in a loss of innervation to the abdominal muscles, which affects trunk stability and performance of activities of daily living from a sitting position. Respiratory function is also affected, leading to frequent pulmonary complications. Given the importance of trunk stability and respiratory function, we investigated the effects of electromyography triggered electrical stimulation (EMG-ES) applied to the abdominal muscles on sitting balance, respiratory functions and abdominal muscle thickness in individuals with complete thoracic SCI. This randomized controlled study included 34 participants with complete thoracic SCI who were randomly allocated to the experimental group ( n = 17) and the control group ( n = 17). During the 4-week intervention period, the experimental group received EMG-ES to their abdominal muscles, while the control group received isometric abdominal exercises three times per week. Both groups continued with their routine rehabilitation program (active or passive range of motion exercises, stretching, and balance coordination exercises). The primary outcome measures were the modified functional reach test (mFRT) and trunk control test (TCT). Secondary outcome measures included a pulmonary function test (PFT) and the bilateral abdominal muscle thicknesses using ultrasonography. At the end of the study, the experimental group showed significantly greater improvements in both primary outcomes. The mean difference in pre-post changes between the groups for the mFRT area was 242.8 cm² [95% confidence interval (CI): 181.3-329.8; effect size 0.92; P < 0.001] and 5.0 points for TCT (95% CI: 3.9-6.0; effect size 0.98, P < 0.001). The increase in the abdominal muscle thickness was also significantly greater in the experimental group ( P < 0.001) without significant differences in the PFT ( P > 0.05). We conclude that adding EMG-ES of abdominal muscles may further improve sitting balance and abdominal muscle thickness in individuals with complete thoracic SCI.
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Affiliation(s)
- Handan E N Bayraktar
- Department of Physical Medicine and Rehabilitation, Ankara Bilkent City Hospital, Physical Therapy and Rehabilitation Hospital, Ankara
| | - Elif Yalçin
- Department of Physical Medicine and Rehabilitation, Ankara Bilkent City Hospital, Physical Therapy and Rehabilitation Hospital, Ankara
| | - Meriç S Şipal
- Department of Physical Medicine and Rehabilitation, Ankara Bilkent City Hospital, Physical Therapy and Rehabilitation Hospital, Ankara
| | - Müfit Akyüz
- Department of Physical Medicine and Rehabilitation, Karabük University Faculty of Medicine, Karabük
| | - Meltem G Akinci
- Department of Physical Medicine and Rehabilitation, Denizli State Hospital, Denizli, Turkey
| | - Sibel Ü Delialioğlu
- Department of Physical Medicine and Rehabilitation, Ankara Bilkent City Hospital, Physical Therapy and Rehabilitation Hospital, Ankara
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Akagi R, Miyokawa Y, Shiozaki D, Yajima Y, Yamada K, Kano K, Hashimoto Y, Okamoto T, Ando S. Eight-week neuromuscular electrical stimulation training produces muscle strength gains and hypertrophy, and partial muscle quality improvement in the knee extensors. J Sports Sci 2023; 41:2209-2228. [PMID: 38390833 DOI: 10.1080/02640414.2024.2318540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 02/07/2024] [Indexed: 02/24/2024]
Abstract
This study investigated the effect of an 8-week neuromuscular electrical stimulation (NMES) training programme (3 days/week) on muscle quantity and quality and single-joint performance in the knee extensors. Thirty-nine untrained young male participants were randomly assigned to NMES training (n = 21) and control (n = 18) groups. The 8-week NMES training induced significant increase in the isometric maximal voluntary contraction (MVC) torque of the knee extensors (≈9.3%), muscle volume of the individual and entire quadriceps muscles determined by magnetic resonance imaging (≈3.3%-6.4%), and a significant decrease in the ultrasound echo intensity of the vastus lateralis (≈-4.0%); however, hypertrophy of the vastus intermedius (i.e., the deep muscle) was limited (≈3.3%). In the NMES training group, the repeated measures correlations of the isometric MVC torque with the muscle volume of the entire quadriceps muscle and each quadriceps muscle were significant (rrm (20) = 0.551-0.776), whereas that of the isometric MVC torque with the ultrasound echo intensity of the vastus lateralis was not significant. These findings suggest that NMES training produces muscle strength gains, muscle hypertrophy, and partial muscle quality improvement and that the NMES training-induced muscle strength gains is caused by muscle hypertrophy in the knee extensors.
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Affiliation(s)
- Ryota Akagi
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Yusuke Miyokawa
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Daigo Shiozaki
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Yoshinari Yajima
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Koki Yamada
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Kosuke Kano
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
| | - Yuto Hashimoto
- Department of Exercise Physiology, Nippon Sport Science University, Tokyo, Japan
| | - Takanobu Okamoto
- Department of Exercise Physiology, Nippon Sport Science University, Tokyo, Japan
| | - Soichi Ando
- Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
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Pion AM, Roy AA, Ma X, Beaumont E, Lin JC. Transcutaneous and Direct Electrical Stimulation of Mouse Sciatic Nerve Accelerates Functional Recovery After Nerve Transection and Immediate Repair. Ann Plast Surg 2023; 90:237-241. [PMID: 36796045 DOI: 10.1097/sap.0000000000003463] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND Electrical stimulation can accelerate peripheral nerve regeneration after injury and repair. Clinically, direct electrical stimulation (DES) may involve longer operating times, increasing risks of perioperative complications. Transcutaneous electrical stimulation (TCES) is a noninvasive alternative. In this study, we investigate how transcutaneous and DES compare for accelerating functional nerve recovery in a mouse sciatic nerve model. METHODS Twenty-eight mice were divided into sham (n = 4), axotomy (n = 8), DES (n = 8), and TCES (n = 8) groups. After sciatic nerve transection and repair, the proximal nerve was subjected to DES or TCES at 20 Hz for 1 hour. Sciatic functional index was measured before the injury, and at weeks 1, 2, 4, 6, 8, 10, and 12 by walking-track analysis. Electrophysiological measures were taken at week 12. RESULTS Kinematic studies showed significant improvement from the 8th week to the 12th week for both electrical stimulation groups compared with the axotomy group (P < 0.05), with no difference between the electrical stimulation groups. At the 12th week, both DES and TCES groups had significantly faster average conduction velocity than the axotomy group. CONCLUSIONS Functional recovery was significantly better from 8 weeks onward in mice receiving either DES or TCES stimulation when compared with axotomy and repair alone. Transcutaneous electrical stimulation is a minimally invasive alternative treatment for accelerating functional recovery after peripheral nerve injury.
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Affiliation(s)
- Anne-Marie Pion
- From the Plastic Surgery, Faculty of Medicine, University of Montréal, Montreal, Quebec, Canada
| | - Andrée-Anne Roy
- From the Plastic Surgery, Faculty of Medicine, University of Montréal, Montreal, Quebec, Canada
| | - Xiya Ma
- From the Plastic Surgery, Faculty of Medicine, University of Montréal, Montreal, Quebec, Canada
| | - Eric Beaumont
- Faculty of Medicine, East Tennessee State University, Johnson City, TN
| | - Jenny C Lin
- From the Plastic Surgery, Faculty of Medicine, University of Montréal, Montreal, Quebec, Canada
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Hwang UJ, Kwon OY. Effect of electrical stimulation training and detraining on abdominal muscle function. J Back Musculoskelet Rehabil 2023:BMR210335. [PMID: 36872765 DOI: 10.3233/bmr-210335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
BACKGROUND Electrical muscle stimulation (EMS) has been applied in many rehabilitation settings for muscle strengthening, facilitation of muscle contraction, re-education of muscle action, and maintenance of muscle strength and size during prolonged immobilization. OBJECTIVE The purpose of this study was to investigate effect of 8 weeks of EMS training on abdominal muscle function and to determine whether the training effect could be maintained after 4 weeks of EMS detraining. METHODS Twenty-five subjects performed EMS training for 8 weeks. Before and after 8 weeks of EMS training, and after 4 weeks of EMS detraining, muscle size (cross-sectional area [CSA] of the rectus abdominals [RA] and lateral abdominal wall [LAW]), strength, endurance, and lumbopelvic control (LC) were measured. RESULTS There were significant increases in CSA [RA (p< 0.001); LAW (p< 0.001)], strength [trunk flexor (p= 0.005); side-bridge (p< 0.05)], endurance [trunk flexor (p= 0.010); side-bridge (p< 0.05)], and LC (p< 0.05) after 8 weeks of EMS training. The CSA of the RA (p< 0.05) and the LAW (p< 0.001) were measured after 4 weeks of detraining and they were greater than that of the baseline. There were no significant differences in abdominal strength, endurance, and LC between baseline measurements and post-detraining. CONCLUSION The study indicates that there is less of a detraining effect on muscle size than on muscle strength, endurance, and LC.
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Affiliation(s)
- Ui-Jae Hwang
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, Korea
| | - Oh-Yun Kwon
- Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis, Yonsei University, Wonju, Korea
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Jia P, Zhang M. EFFECTS OF FUNCTIONAL TRAINING ON PROPRIOCEPTION IN SPORT ATHLETES. REV BRAS MED ESPORTE 2022. [DOI: 10.1590/1517-8692202228062022_0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction Physical training is a well-known training method in competitive sports. However, in the majority of the physical training classes, the focus is still on the traditional exercises of physical conditioning as strength, speed, resistance, etc., directed for young athletes that are in the growth and development phase, without a literary base to assure actual effectiveness in the load increases for the athletic performance facing the risks in the athletes’ physical proprioception. Objective Explores the effect of functional training on the physical sensibility of sports athletes. Methods The data collection method is used in the daily training of six notable athletes in a district sports school: judo, martial arts, wrestling, tennis team, swimming team, and table tennis team, adding the functional training protocol in body movement. Results The average performance of the groups before and after the experiment was collected and confronted, the difference test was performed, and the test result found P>0.05. The athletes in the experimental group not only improved the footwork speed and physical coordination, the movement speed of the footwork and the speed of the connection between movements increased significantly in the sixth week, reflecting more excellent stability and motor coordination in the movements. Proprioception is one of the essential sports qualities of the human body; it is directly related to physical qualities such as speed and strength and is also closely related to the different neural pathways. Conclusion Functional training can improve athletes’ physical flexibility and motor coordination; it can also stimulate body proprioceptors, increase athletes’ confidence, and make training more efficient and effective. Evidence level II; Therapeutic Studies - Investigating the results.
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Affiliation(s)
- Peng Jia
- Langfang Normal University, China
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Reyes DRA, Barbosa AMP, Juliana FF, Sofia QBCV, Costa SMB, Hallur RLS, Enriquez EMA, Oliveira RG, de Souza Rossignolli P, Pedroni CR, Alves FCB, Garcia GA, Abbade JF, Carvalho CNF, Sobrevia L, Rudge MVC, Calderon IIMP. Viability of ex-vivo myography as a diagnostic tool for rectus abdominis muscle electrical activity collected at Cesarean section within a diamater cohort study. Biomed Eng Online 2022; 21:76. [PMID: 36242084 PMCID: PMC9563120 DOI: 10.1186/s12938-022-01042-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 09/20/2022] [Indexed: 11/11/2022] Open
Abstract
Background Ex-vivo myography enables the assessment of muscle electrical activity response. This study explored the viability of determining the physiological responses in muscles without tendon, as rectus abdominis muscle (RAM), through ex-vivo myography to assess its potential as a diagnostic tool. Results All tested RAM samples (five different samples) show patterns of electrical activity. A positive response was observed in 100% of the programmed stimulation. RAM 3 showed greater weight (0.47 g), length (1.66 cm), and width (0.77 cm) compared to RAM 1, RAM 2, RAM 4 and RAM 5 with more sustained electrical activity over time, a higher percentage of fatigue was analyzed at half the time of the electrical activity. The order of electrical activity (Mn) was RAM 3 > RAM 5 > RAM 1 > RAM 4 > RAM 2. No electrical activity was recorded in the Sham group. Conclusions This study shows that it is feasible to assess the physiological responses of striated muscle without tendon as RAM, obtained at C-section, under ex vivo myography. These results could be recorded, properly analyzed, and demonstrated its potential as a diagnostic tool for rectus abdominis muscle electrical activity.
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Affiliation(s)
- David R A Reyes
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, CEP18618-687, Brazil
| | - Angelica M P Barbosa
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, CEP18618-687, Brazil.,Department of Physiotherapy and Occupational Therapy, School of Philosophy and Sciences, São Paulo State University (UNESP), Marilia, Brazil
| | - Floriano F Juliana
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, CEP18618-687, Brazil
| | - Quiroz B C V Sofia
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, CEP18618-687, Brazil
| | - Sarah M B Costa
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, CEP18618-687, Brazil
| | - Raghavendra L S Hallur
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, CEP18618-687, Brazil.,Centre for Biotechnology, Pravara Institute of Medical Sciences (Deemed to Be University), Loni-413736, Rahata Taluk, Ahmednagar District, Ahmednagar, Maharashtra, India
| | - Eusebio M A Enriquez
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, CEP18618-687, Brazil
| | - Rafael G Oliveira
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, CEP18618-687, Brazil
| | - Patricia de Souza Rossignolli
- Department of Physiotherapy and Occupational Therapy, School of Philosophy and Sciences, São Paulo State University (UNESP), Marilia, Brazil
| | - Cristiane Rodrigues Pedroni
- Department of Physiotherapy and Occupational Therapy, School of Philosophy and Sciences, São Paulo State University (UNESP), Marilia, Brazil
| | - Fernanda C B Alves
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, CEP18618-687, Brazil
| | - Gabriela A Garcia
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, CEP18618-687, Brazil
| | - Joelcio F Abbade
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, CEP18618-687, Brazil
| | - Carolina N F Carvalho
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, CEP18618-687, Brazil
| | - Luis Sobrevia
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, CEP18618-687, Brazil.,Cellular and Molecular Physiology Laboratory (CMPL), Department of Obstetrics, Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, 8330024, Santiago, Chile.,Department of Physiology, Faculty of Pharmacy, Universidad de Sevilla, 41012, Seville, Spain.,University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston, QLD, 4029, Australia.,Department of Pathology and Medical Biology, Division of Pathology, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Marilza V C Rudge
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, CEP18618-687, Brazil.
| | - Iracema I M P Calderon
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, CEP18618-687, Brazil
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Lee JH, Chun YM, Kim DS, Lee DH, Shin SJ. Effects of neuromuscular electrical muscle stimulation on the deltoid for shoulder function restoration after reverse total shoulder arthroplasty in the early recovery period: a prospective randomized study. Arch Orthop Trauma Surg 2022; 143:3037-3046. [PMID: 35804165 DOI: 10.1007/s00402-022-04515-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Neuromuscular electrical stimulation (NMES) is a treatment modality that has been used to accelerate the rehabilitation of patients with neurological damage. However, it is unclear whether NMES of the deltoid can lead to the early restoration of shoulder function after reverse total shoulder arthroplasty (RSA). MATERIALS AND METHODS In this prospective and randomized study, 88 patients who underwent RSA with the same prosthesis design for cuff tear arthropathy or irreparable rotator cuff tear were assessed. The patients were divided into two groups (NMES group and non-NMES group, 44 patients each). For the NMES group, two pads of the NMES device were placed over the middle and posterior deltoid area, and NMES was maintained for 1 month after surgery. Shoulder functional outcomes and deltoid thickness were compared at 3, 6, and 12 months postoperatively. Shoulder functional outcomes were assessed based on the visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES), and Constant scores and the range of motion (ROM) and power of the affected shoulder. The thickness of the anterior, middle, and posterior deltoid was measured by ultrasonography. RESULTS A total of 76 patients (NMES group, 33 patients; non-NMES group, 43 patients) were enrolled in the final analysis. The preoperative demographics and status of the remaining rotator cuff of both groups were not significantly different. At postoperative 3 months, the ROM and power of external rotation of the NMES group were significantly greater than those of the non-NMES group (ROM, 36° ± 14° vs. 29° ± 12°; P = .003; power, 4.8 kg ± 1.8 kg vs. 3.8 kg ± 1.0 kg; P < .002). The ROM of external rotation of the NMES group at postoperative 6 months was also greater than that of the non-NMES group (41° ± 12° vs. 34° ± 11°; P = .013). However, there was no significant difference in the VAS, ASES, and Constant scores at all follow-up points despite gradual improvements until 1 year postoperatively. Serial measurements of the thickness of the anterior, middle, and posterior deltoid of both groups did not show significant differences. CONCLUSIONS Postoperative NMES of the deltoid after RSA contributed to significantly faster ROM restoration and considerable improvement in the power of external rotation. Therefore, NMES following RSA could lead to the early restoration of external rotation and recovery of deltoid function.
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Affiliation(s)
- Jae-Hoo Lee
- Department of Orthopaedic Surgery, Inje University, Ilsan Paik Hospital, Goyang-si, Republic of Korea
| | - Yong-Min Chun
- Department of Orthopaedic Surgery, College of Medicine, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University, Seoul, Republic of Korea
| | - Doo-Sup Kim
- Department of Orthopaedic Surgery, Wonju College of Medicine, Wonju Severance Christian Hospital, Yonsei University, Wonju, Republic of Korea
| | - Doo-Hyung Lee
- Department of Orthopaedic Surgery, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Sang-Jin Shin
- Department of Orthopaedic Surgery, Ewha Shoulder Disease Center, Seoul Hospital, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
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de Carvalho AR, Reginato A, Reginato GA, Schuck KSR, Neves M, Bertolini GRF. Aussie current and quadriceps muscle endurance: a randomized clinical trial. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-00918-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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