The effects of neuromuscular electrical stimulation for dysphagia in opercular syndrome: a case study.
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SUBMITTER: Baijens LW
PROVIDER: S-EPMC2440926 | biostudies-other | 2008 Jul
REPOSITORIES: biostudies-other
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Project description: Not available
| S-EPMC6486051 | biostudies-literature
Project description:ObjectivesTo describe the acceptability, safety and effectiveness of neuromuscular electrical stimulation (NMES) in infants and young children with neurological impairment (NI) who have severe dysphagia.DesignA prospective pilot study using a before and after study design.SettingThe Hospital for Sick Children, Toronto, Canada.PatientsTen infants and young children (0-24 months) with NI and severe dysphagia on videofluoroscopic swallow study (VFSS) who were referred to an occupational therapist (OT). Those with neurodegenerative conditions were excluded.InterventionNMES treatments lasting 20-45 min twice weekly for the duration of 2-4 months. The NMES was administered during feeding therapy sessions by a trained OT.Main outcome measuresImprovement in swallowing function as measured by VFSS and the need for tube feeding, adverse events and parental acceptability.ResultsSeven of 10 enrolled subjects (median age, 8.9 months) completed biweekly NMES treatments (median number of treatments per subject, 18). All of the seven (100%) subjects who completed treatment showed an improvement in swallow function on VFSS. Of the five patients who were not safe to orally feed on any consistency of liquid or puree at baseline, three established full oral feeding and two established partial oral feeding. At baseline, 5/7 children were completely fed by tube versus 0/7 at the end of treatment. No adverse events occurred other than mild skin irritation at the site of electrode placement. Five of seven caregivers felt that feeding was improved and were satisfied with the intervention.ConclusionsOur prospective pilot study of NMES in seven neurologically impaired infants and young children with severe dysphagia suggests that NMES is safe, acceptable to parents and has potential efficacy. Trials are needed to determine if any treatment benefit exists.Trial registrationClinicalTrials.gov NCT01723358.
| S-EPMC6347906 | biostudies-literature
Project description:IntroductionSpinal cord injury (SCI) may cause impairments of the motor, sensory, and autonomic nervous systems, which result in adverse changes in body composition and cardiovascular health. Functional electrical stimulation (FES) cycling may provide an effective alternative approach to perform exercise and improve cardiovascular health after SCI. Persons with an injury at or above T6 level are at high risk of developing a life-threatening complication of autonomic dysreflexia (AD).Case presentationTwo participants with motor-complete C6 SCI completed either 12 weeks of passive range of motion or surface neuromuscular electrical stimulation (NMES) resistance training, followed by 12 weeks of functional electrical stimulation (FES) lower extremity cycling for both participants. Systolic and diastolic blood pressure (BP) were measured to determine the effects of NMES-resistance training and FES-lower extremity cycling during rest and exercise.DiscussionThe difference between mean value of BP during FES-lower extremity cycling exercise and resting BP averaged for 24 sessions was smaller for participant A (31.25?mmHg for systolic BP and 10.44?mmHg for diastolic BP), who received NMES-resistance training, as compared with participant B (58.62?mmHg for systolic BP and 35.07?mmHg for diastolic BP). The results of these case reports suggest that 12 weeks of NMES-resistance training preceding FES-lower extremity cycling may attenuate the development of AD after SCI. Risk of AD, triggered by noxious stimuli, may be dampened with FES-lower extremity cycling training in persons with SCI.
| S-EPMC7054544 | biostudies-literature
Project description:Aerobic exercise (AE) and non-aerobic neuromuscular electric stimulation (NMES) are common interventions used in physical therapy. We explored the dose-dependency (low, medium, high) of these interventions on biochemical factors, such as brain derived neurotrophic growth factor (BDNF), vascular endothelial growth factor-A (VEGF-A), insulin-like growth factor-1 (IGF-1) and Klotho, in the blood and brain of normal rats, as well as a treadmill-based maximum capacity test (MCT). A medium dose of AE produced the most improvement in MCT with dose-dependent changes in Klotho in the blood. A dose-dependent increase of BDNF was evident following completion of an NMES protocol, but there was no improvement in MCT performance. Gene expression in the hippocampus was increased after both AE and NMES, with IGF-1 being a signaling molecule that correlated with MCT performance in the AE conditions, but also highly correlated with VEGF-A and Klotho. Blood Klotho levels can serve as a biomarker of therapeutic dosing of AE, whereas IGF-1 is a key molecule coupled to gene expression of other molecules in the hippocampus. This approach provides a translatable paradigm to investigate the mode and mechanism of action of interventions employed in physical therapy that can improve our understanding of how these factors change under pathological conditions.
| S-EPMC5589775 | biostudies-literature
Project description:Facial neuromuscular electrical stimulation (NMES) is the application of an electrical current to the skin to induce muscle contractions and has enormous potential for basic research and clinical intervention in psychology and neuroscience. Because the technique remains largely unknown, and the prospect of receiving electricity to the face can be daunting, willingness to receive facial NMES is likely to be low and gender differences might exist in the amount of concern for the sensation of pain and skin burns. We investigated these questions in 182 healthy participants. The likelihood of taking part (LOTP) in a hypothetical facial NMES study was measured both before and after presenting a detailed vignette about facial NMES including its risks. Results showed that LOTP was generally high and that participants remained more likely to participate than not to, despite a decrease in LOTP after the detailed vignette. LOTP was significantly predicted by participants' previous knowledge about electrical stimulation and their tendency not to worry about the sensations of pain, and it was inversely related to concerns for burns and loss of muscle control. Fear of pain was also inversely related to LOTP, but its effect was mediated by the other concerns. We conclude that willingness to receive facial NMES is generally high across individuals in the studied age range (18-45) and that it is particularly important to reassure participants about facial NMES safety regarding burns and loss of muscle control. The findings are relevant for scholars considering using facial NMES in the laboratory.
| S-EPMC9080168 | biostudies-literature
Project description:Objective. Obesity and obstructive sleep apnea (OSA) are closely interconnected conditions both leading to high cardiovascular risk. Inactivity is frequent and physical activity programs remain difficult in these patients. We investigated the acute feasibility of two neuromuscular electrical stimulation (NMES) modalities in extremely inactive obese patients with OSA. Design. A randomized cross-over study, with two experimental sessions (one per condition: multipath NMES versus conventional NMES). Setting. Outpatient research hospital. Subjects. Twelve patients with obesity, already treated for OSA. Interventions. No intervention. Measures. Feasibility outcomes included NMES current intensity, knee extension force evoked by NMES, and self-reported discomfort. Results. We found higher current intensity, a trend to significantly higher evoked force and lower discomfort during multipath NMES versus conventional NMES, suggesting better tolerance to the former NMES modality. However, patients were rapidly limited in the potential of increasing current intensity of multipath NMES. Conclusion. Both NMES modalities were feasible and relatively well tolerated by obese patients with OSA, even if multipath NMES showed a better muscle response/discomfort ratio than conventional NMES. There is an urgent need for a proof-of-concept study and interventional randomized controlled trials comparing NMES therapy versus current care to justify its utilization in obese and apneic patients with low physical activity levels.
| S-EPMC5282432 | biostudies-literature
Project description:Neuromuscular electrical stimulation (NMES) applied to skeletal muscles is an effective rehabilitation and exercise training modality. However, the relatively low muscle force and rapid muscle fatigue induced by NMES limit the stimulus provided to the neuromuscular system and subsequent adaptations. We hypothesize that adaptations to NMES will be enhanced by the use of specific stimulation protocols and adjuvant interventions.
| S-EPMC8460078 | biostudies-literature
Project description:Swallowing impairment (dysphagia) post-stroke results in poorer outcomes. Pharyngeal electrical stimulation (PES) is a potential treatment for post-stroke dysphagia. In a post hoc analysis, we investigated PES using videofluoroscopy swallow studies (VFSS) from the STEPS trial incorporating multiple measures of safety (penetration aspiration scale-PAS), speed and duration (timing), and efficiency (clearance), as opposed to the original trial which only measured PAS scores. 81 randomised participants (PES (N = 43) versus sham (N = 38)) were analysed at baseline and 2 weeks. Participants swallowed up to 6 × 5 ml and 1 × 50 ml of thin liquid barium at 40% w/v, images at ≥25 fps. Based on PAS, the 5 ml mode bolus (most frequently occurring PAS from 6 × 5 ml) and the worst 50 ml bolus were chosen for further analysis. Eight timing measures were performed, including stage transition duration (STD) and pharyngeal transit time (PTT). Clearance measures comprised oral and pharyngeal residue and swallows to clear. Comparisons of change of scoring outcomes between PES and sham were done at 2 weeks. Wilcoxon Signed Ranks Test was also used to evaluate longitudinal changes from both groups' combined results at two weeks. Between-group analysis showed no statistically significant differences. Issues with suboptimal image quality and frame rate acquisition affected final numbers. At two weeks, both groups demonstrated a significant improvement in most safety scores (PAS) and STD, possibly due to spontaneous recovery or a combination of spontaneous recovery and swallowing treatment and usual care. A nonsignificant trend for improvement was seen in other timing measures, including PTT. This study, which conducted additional measurements of kinematic and residue analysis on the STEPS data did not detect "missed" improvements in swallowing function that the PAS is not designed to measure. However, more studies with greater numbers are required.
| S-EPMC8205591 | biostudies-literature
Project description:RationaleNeuromuscular electrical stimulation (NMES) of the lower limbs is an emerging training strategy in patients with COPD. The efficacy of this technique is related to the intensity of the stimulation that is applied during the training sessions. However, little is known about tolerance to stimulation current intensity and physiological factors that could determine it. Our goal was to find potential physiological predictors of the tolerance to increasing NMES stimulation intensity in patients with mild to severe COPD.Methods20 patients with COPD (FEV1?=?54±14% pred.) completed 2 supervised NMES sessions followed by 5 self-directed sessions at home and one final supervised session. NMES was applied simultaneously to both quadriceps for 45 minutes, at a stimulation frequency of 50 Hz. Spirometry, body composition, muscle function and aerobic capacity were assessed at baseline. Cardiorespiratory responses, leg discomfort, muscle fatigue and markers of systemic inflammation were assessed during or after the last NMES session. Tolerance to NMES was quantified as the increase in current intensity from the initial to the final NMES session (?Int).ResultsMean ?Int was 12±10 mA. FEV1, fat-free-mass, quadriceps strength, aerobic capacity and leg discomfort during the last NMES session positively correlated with ?Int (r?=?0.42 to 0.64, all p?0.06) while post/pre NMES IL-6 ratio negatively correlated with ?Int (r?=?-0.57, p?=?0.001). FEV1, leg discomfort during last NMES session and post/pre IL-6 ratio to NMES were independent factors of variance in ?Int (r2?=?0.72, p?=?0.001).ConclusionLower tolerance to NMES was associated with increasing airflow obstruction, low tolerance to leg discomfort during NMES and the magnitude of the IL-6 response after NMES.Trial registrationClinicalTrials.gov NCT00809120.
| S-EPMC4015894 | biostudies-literature
Project description: Not available
| S-EPMC6486105 | biostudies-literature