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Kim SH, Joung JY, Lee YH, Son CG. Anatomical Exploration of the KI1 Acupoint: Implications for Medial and Lateral Plantar Nerve Stimulation. Medicina (Kaunas) 2024; 60:535. [PMID: 38674181 PMCID: PMC11051973 DOI: 10.3390/medicina60040535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: This study aims to identify the precise anatomical location and therapeutic mechanisms of the KI1 acupoint (Yongquan) in relation to foot muscles and nerves, known for treating neurological disorders and pain. Materials and Methods: Dissection of six cadavers at Chungnam National University College of Medicine examined KI1's relation to the foot's four-layer structure. Results: The KI1 acupoint was located in the superficial and deep layers of the plantar foot, adjacent to significant nerves like the medial and lateral plantar nerves. Differences in the acupoint's exact location between genders were noted, reflecting variances in foot morphology. KI1 acupuncture was found to stimulate the muscle spindles and nerve fibers essential for balance and bipedal locomotion. This stimulation may enhance sensory feedback, potentially improving cognitive functions and balance control. Conclusions: This anatomical insight into KI1 acupuncture underpins its potential in neurological therapies and pain management.
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Affiliation(s)
- Sang Hyun Kim
- Catholic Institute for Applied Anatomy, The Catholic University of Korea, Seoul 06591, Republic of Korea;
| | - Jin-Yong Joung
- Department of Korean Medicine, Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34530, Republic of Korea;
| | - Young Ho Lee
- Department of Anatomy, College of Medicine, Chungnam National University, 266, Munhwa-ro, Jung-gu, Daejeon 35015, Republic of Korea
| | - Chang-Gue Son
- Department of Korean Medicine, Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34530, Republic of Korea;
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Pollet J, Buraschi R, Ranica G, Pancera S, Anastasi D, Fazio R, Monteleone S, Lena E, Floridi V, Zucchini F, Falso MV. The Effect of Personalized Shoe Insoles on Parkinson's Disease Subjects: A Triple-Blind Randomized Controlled Trial. J Clin Med 2023; 12:7204. [PMID: 38068255 PMCID: PMC10707212 DOI: 10.3390/jcm12237204] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/10/2023] [Accepted: 11/16/2023] [Indexed: 04/19/2024] Open
Abstract
Subjects with Parkinson's Disease (PD) display different motor and non-motor symptoms. Different therapies have been shown to be effective, such as plantar foot stimulation, which has proved to be effective for motor symptoms. Different stimulation methods were proposed and tested through specific devices, or insoles. Our aim was to assess the effect of a newly designed custom-made insole called PRO-STEP compared with a flat sham insole on subjects with PD. Subjects were randomized 1:1 into two arms and were asked to wear PRO-STEP or sham insoles for at least 6 h per day for 10 weeks. Participants were evaluated at four timepoints. Forty-two subjects were randomly assigned to the PRO-STEP (EG) or sham group (SG). The comparison of the EG and SG without and with insoles (T0-T1) did not show significant differences in the TUG time and in the 10MWT gait parameters. At T1, T2, and T3 TUG time, BBS, SF12-MC, and SF12-PC did not show significant differences. The satisfaction level with the PRO-STEP or sham insoles was high in both groups. PD patients were satisfied with PRO-STEP insoles; however, plantar foot stimulation is not effective from a functional perspective. Future studies should consider possible modifications to the proposed stimulation to improve its effectiveness in patients with PD.
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Affiliation(s)
- Joel Pollet
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
| | - Riccardo Buraschi
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
| | - Giorgia Ranica
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
| | - Simone Pancera
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
| | - Denise Anastasi
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
| | | | | | - Eleonora Lena
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
| | - Valeria Floridi
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
| | | | - Maurizio Vincenzo Falso
- IRCCS Fondazione Don Carlo Gnocchi, 20162 Milan, Italy; (J.P.); (R.B.); (S.P.); (D.A.); (E.L.); (V.F.); (M.V.F.)
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Tedeschi R. Automated mechanical peripheral stimulation for gait rehabilitation in Parkinson's disease: A comprehensive review. Clin Park Relat Disord 2023; 9:100219. [PMID: 37780489 PMCID: PMC10539662 DOI: 10.1016/j.prdoa.2023.100219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/22/2023] [Indexed: 10/03/2023] Open
Abstract
Background Automated Mechanical Peripheral Stimulation (AMPS) has emerged as a potential rehabilitative intervention for gait abnormalities in Parkinson's disease (PD). However, the long-term effects and combined therapy with physical exercise remain unclear. This review aimed to explore the effects of automated mechanical peripheral stimulation (AMPS) on gait and motor performance in individuals with Parkinson's disease (PD). Methods A research was conducted in relevant databases to identify studies investigating the effects of AMPS on gait and motor outcomes in PD patients. Inclusion criteria were set based on Population, Concept, and Context (PCC) criteria. Data extraction and analysis were performed to synthesize the findings. Results Ten studies met the inclusion criteria and were included in the review. The studies collectively demonstrated positive effects of AMPS on gait parameters, such as walking velocity, stride length, and walking stability. Some studies also reported improvements in functional performance and muscle activation during walking. Conclusions The findings suggest that AMPS holds promise as a potential intervention to improve gait and motor performance in individuals with PD. However, the evidence is limited, and further well-designed randomized controlled trials are needed to establish the long-term efficacy and optimal protocols for AMPS in PD rehabilitation.
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Affiliation(s)
- Roberto Tedeschi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Brognara L, Mafla-España MA, Gil-Molina I, Castillo-Verdejo Y, Cauli O. The Effects of 3D Custom Foot Orthotics with Mechanical Plantar Stimulation in Older Individuals with Cognitive Impairment: A Pilot Study. Brain Sci 2022; 12:brainsci12121669. [PMID: 36552129 PMCID: PMC9775314 DOI: 10.3390/brainsci12121669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Recent scientific evidence supports the idea that foot plantar stimulation increases the functional connectivity of brain regions involved in visuo-spatial and sensory-motor integration. In this before−after, non-randomised intervention study we assessed the change in several gait and postural parameters using inertial sensor measurements after acute plantar stimulation using custom 3D-printed insoles. The pilot study was performed on 22 institutionalised, older individuals with a high comorbidity burden who either walked autonomously or with the help of a cane. The intensity of the effects in the first mechanical plantar stimulation session (at one week) strongly predicted a change in the 180° turn duration (p < 0.05) and the standard deviation of the step duration (p < 0.05) during the timed up-and-go test. Based on these effects, researchers also predicted decreases in some postural parameters such as the root mean square of displacement on the anterior−posterior axis (p < 0.01). Thus, these preliminary findings provide a strong rationale for performing controlled clinical trials with larger samples to investigate the efficacy and mechanisms of mechanical plantar stimulation in frail elderly individuals.
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Affiliation(s)
- Lorenzo Brognara
- Department of Biomedical and Neuromotor Science, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy
- Correspondence:
| | - Mayra Alejandra Mafla-España
- Frailty and Cognitive Impairment Organized Group, University of Valencia, 46010 Valencia, Spain
- Department of Nursing, University of Valencia, Jaume Roig s/n, 46010 Valencia, Spain
| | | | | | - Omar Cauli
- Frailty and Cognitive Impairment Organized Group, University of Valencia, 46010 Valencia, Spain
- Department of Nursing, University of Valencia, Jaume Roig s/n, 46010 Valencia, Spain
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Fujikawa J, Morigaki R, Yamamoto N, Oda T, Nakanishi H, Izumi Y, Takagi Y. Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials. Front Aging Neurosci 2022; 14:807909. [PMID: 35462692 PMCID: PMC9020378 DOI: 10.3389/fnagi.2022.807909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/14/2022] [Indexed: 11/29/2022] Open
Abstract
Background Pharmacotherapy is the first-line treatment option for Parkinson’s disease, and levodopa is considered the most effective drug for managing motor symptoms. However, side effects such as motor fluctuation and dyskinesia have been associated with levodopa treatment. For these conditions, alternative therapies, including invasive and non-invasive medical devices, may be helpful. This review sheds light on current progress in the development of devices to alleviate motor symptoms in Parkinson’s disease. Methods We first conducted a narrative literature review to obtain an overview of current invasive and non-invasive medical devices and thereafter performed a systematic review of recent randomized controlled trials (RCTs) of these devices. Results Our review revealed different characteristics of each device and their effectiveness for motor symptoms. Although invasive medical devices are usually highly effective, surgical procedures can be burdensome for patients and have serious side effects. In contrast, non-pharmacological/non-surgical devices have fewer complications. RCTs of non-invasive devices, especially non-invasive brain stimulation and mechanical peripheral stimulation devices, have proven effectiveness on motor symptoms. Nearly no non-invasive devices have yet received Food and Drug Administration certification or a CE mark. Conclusion Invasive and non-invasive medical devices have unique characteristics, and several RCTs have been conducted for each device. Invasive devices are more effective, while non-invasive devices are less effective and have lower hurdles and risks. It is important to understand the characteristics of each device and capitalize on these.
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Affiliation(s)
- Joji Fujikawa
- Department of Advanced Brain Research, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
| | - Ryoma Morigaki
- Department of Advanced Brain Research, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
- Department of Neurosurgery, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
- *Correspondence: Ryoma Morigaki,
| | - Nobuaki Yamamoto
- Department of Advanced Brain Research, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
- Department of Neurology, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
| | - Teruo Oda
- Department of Advanced Brain Research, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
| | - Hiroshi Nakanishi
- Department of Neurosurgery, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
| | - Yuishin Izumi
- Department of Neurology, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
| | - Yasushi Takagi
- Department of Advanced Brain Research, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
- Department of Neurosurgery, Institute of Biomedical Sciences, Graduate School of Medicine, Tokushima University, Tokushima, Japan
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Song W, Raza HK, Lu L, Zhang Z, Zu J, Zhang W, Dong L, Xu C, Gong X, Lv B, Cui G. Functional MRI in Parkinson's disease with freezing of gait: a systematic review of the literature. Neurol Sci 2021; 42:1759-1771. [PMID: 33713258 DOI: 10.1007/s10072-021-05121-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/04/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Freezing of gait (FOG), a common and disabling symptom of Parkinson's disease (PD), is characterized by an episodic inability to generate effective stepping. Functional MRI (fMRI) has been used to evaluate abnormal brain connectivity patterns at rest and brain activation patterns during specific tasks in patients with PD-FOG. This review has examined the existing functional neuroimaging literature in PD-FOG, including those with treatment. Summarizing these articles provides an opportunity for a better understanding of the underlying pathophysiology in PD-FOG. METHODS According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed a literature review of studies using fMRI to investigate the underlying pathophysiological mechanisms of PD-FOG. RESULTS We initially identified 201 documents. After excluding the duplicates, reviews, and other irrelevant articles, 39 articles were finally identified, including 18 task-based fMRI studies and 21 resting-state fMRI studies. CONCLUSIONS Studies using fMRI techniques to evaluate PD-FOG have found dysfunctional connectivity in widespread cortical and subcortical regions. Standardized imaging protocols and detailed subtypes of PD-FOG are furthered required to elucidate current findings.
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Affiliation(s)
- Wenjing Song
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Hafiz Khuram Raza
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Li Lu
- Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Zuohui Zhang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Jie Zu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Wei Zhang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Liguo Dong
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Chuanying Xu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Xiangyao Gong
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Bingchen Lv
- Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Guiyun Cui
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China.
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