Safety and effectiveness of neuromuscular electrical stimulation in cardiac surgery:A systematic review

BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction and a common complication of patients after cardiac surgery,and may be a risk factor for prolonged duration of mechanical ventilation,associated with a higher risk of readmission and higher mortality.Early mobilization in the ICU after cardiac surgery has been found to be low with a significant trend to increase over ICU stay and is also associated with a reduced duration of mechanical ventilation and ICU length of stay.Neuromuscular electrical stimulation(NMES)is an alternative modality of exercise in patients with muscle weakness.A major advantage of NMES is that it can be applied even in sedated patients in the ICU,a fact that might enhance early mobilization in these patients.AIM To evaluate safety,feasibility and effectiveness of NMES on functional capacity and muscle strength in patients before and after cardiac surgery.METHODS We performed a search on Pubmed,Physiotherapy Evidence Database(PEDro),Embase and CINAHL databases,selecting papers published between December 2012 and April 2023 and identified published randomized controlled trials(RCTs)that included implementation of NMES in patients before after cardiac surgery.RCTs were assessed for methodological rigor and risk of bias via the PEDro.The primary outcomes were safety and functional capacity and the secondary outcomes were muscle strength and function.RESULTS Ten studies were included in our systematic review,resulting in 703 participants.Almost half of them performed NMES and the other half were included in the control group,treated with usual care.Nine studies investigated patients after cardiac surgery and 1 study before cardiac surgery.Functional capacity was assessed in 8 studies via 6MWT or other indices,and improved only in 1 study before and in 1 after cardiac surgery.Nine studies explored the effects of NMES on muscle strength and function and,most of them,found increase of muscle strength and improvement in muscle function after NMES.NMES was safe in all studies without any significant complication.CONCLUSION NMES is safe,feasible and has beneficial effects on muscle strength and function in patients after cardiac surgery,but has no significant effect on functional capacity.

Evaluating neuromuscular electrical stimulation for preventing and managing intensive care unit-acquired weakness:Current evidence and future directions

Intensive care unit-acquired weakness(ICU-AW)is a prevalent issue in critical care,leading to significant muscle atrophy and functional impairment.Aiming to address this,Neuromuscular Electrical Stimulation(NMES)has been explored as a therapy.This systematic review assesses NMES's safety and effectiveness in enhancing functional capacity and mobility in pre-and post-cardiac surgery patients.NMES was generally safe and feasible,with intervention sessions varying in frequency and duration.Improvements in muscle strength and 6-minute walking test distances were observed,particularly in preoperative settings,but postoperative benefits were inconsistent.NMES showed promise in preventing muscle loss and improving strength,although its impact on overall functional capacity remained uncertain.Challenges such as short ICU stays and body composition affecting NMES efficacy were noted.NMES also holds potential for other conditions like cerebral palsy and stroke.Further research is needed to optimize NMES protocols and better understand its full benefits in preventing ICU-AW and improving patient outcomes.

Analysis on the Effect of Yiqi Huoxue Decoction Combined with Neuromuscular Electrical Stimulation in Improving ICU-Acquired Debility in Mechanically Ventilated Patients

Objective:To investigate the effect of Yiqi Huoxue decoction combined with neuromuscular electrical stimulation on improving intensive care unit(ICU)acquired debility in mechanically ventilated patients.Methods:50 patients who were admitted to the ICU and received mechanical ventilation treatment in our hospital from June 2022 to June 2023 and were complicated with ICU-acquired neurasthenia were selected,and randomly grouped using the randomized envelope method into two groups:control group with 25 patients who received neuromuscular electrical stimulation alone;observation group with 25 patients who received the traditional Chinese medicine Yiqi Huoxue decoction.Comparison indexes:treatment efficiency,degree of emotional recovery(APACHEⅡscore),muscle strength status(MRC score),motor status(FAC rating),and self-care ability(BI index score).Results:The treatment efficiency of patients in the observation group patients was higher as compared to those in the control group(P<0.05).There was no significant difference in the comparison of the results of the scores(ratings)of each index between the two groups before treatment(P>0.05).After the treatment,the APACHEⅡscores of patients in the observation group were significantly lower as compared to those in the control group,while the MRC scores,FAC ratings,and BI index scores were higher in the observation group than those of the control group patients(P<0.05).Conclusion:The combined application of Yiqi Huoxue decoction and neuromuscular electrical stimulation in the treatment of patients with ICU-acquired neurasthenia complicated by mechanical ventilation significantly enhanced the clinical efficacy,the patient’s muscle strength,motor status,and ability of self-care.Hence,it has high application value and is worthy to be popularized.

Neuromuscular electrical stimulation and testosterone did not influence heterotopic ossification size after spinal cord injury: A case series

Neuromuscular electrical stimulation(NMES) and testosterone replacement therapy(TRT) are effective rehabilitation strategies to attenuate muscle atrophy and evoke hypertrophy in persons with spinal cord injury(SCI). However both interventions might increase heterotopic ossification(HO) size in SCI patients. We present the results of two men with chronic traumatic motor complete SCI who also had pre-existing HO and participated in a study investigating the effects of TRT or TRT plus NMES resistance training(RT) on body composition. The 49-year-old male, Subject A, has unilateral HO in his right thigh. The 31-year-old male, Subject B, has bilateral HO in both thighs. Both participants wore transdermal testosterone patches(4-6 mg/d) daily for 16 wk. Subject A also underwent progressive NMES-RT twice weekly for 16 wk. Magnetic resonance imaging scans were acquired prior to and post intervention. Cross-sectional areas(CSA) of thewhole thigh and knee extensor skeletal muscles, femoral bone, and HO were measured. In Subject A(NMES-RT + TRT), the whole thigh skeletal muscle CSA increased by 10%, the knee extensor CSA increased by 17%, and the HO + femoral bone CSA did not change. In Subject B(TRT), the whole thigh skeletal muscle CSA increased by 13% in the right thigh and 6% in the left thigh. The knee extensor CSA increased by 7% in the right thigh and did not change in the left thigh. The femoral bone and HO CSAs in both thighs did not change. Both the TRT and NMES-RT + TRT protocols evoked muscle hypertrophy without stimulating the growth of preexisting HO.

Neuromuscular electrical stimulation for a dysphagic stroke patient with cardiac pacemaker using magnet mode change: A case report

BACKGROUND Electromagnetic interference(EMI),means disturbance to the operation of implanted electrical devices caused by external sources.If cardiac pacemaker is implanted into the body,the risk of EMI should be considered when performing neuromuscular electrical stimulation(NMES).So far,no case has been reported that clinical magnets are used to safely manage the EMI risk of patients with cardiac pacemaker in NMES.CASE SUMMARY A 72-year-old male with swallowing disorder due to pure motor lacunar syndrome was transferred to rehabilitation department six days after the symptom onset.EMI risk needed be considered when implementing NMES on pharyngeal muscles,since cardiac pacemaker was implanted on his left chest due to the sick sinus syndrome.In the first NMES,the function of the pacemaker was directly monitored using telemetric instruments.From the second day,by a simple method of placing a magnet on the pacemaker,we chose to move the pacemaker into a mode that the device was not influenced by external stimulus.This magnet method has been used repeatedly for a year for the safe NMES treatment.We could remove Levin tube four months after the initial symptom and dysphagia related symptoms had not been noted during two-year follow-up period.CONCLUSION This report is the first case of dysphagia rehabilitation that EMI risk was handled using mode change of pacemaker with magnet.This method is unfamiliar to doctors,but safe and easy approach.This paper could be guidance for clinicians who need to treat patients with EMI risk.

Quantifying Neuromuscular Electrical Stimulation Dosage after Knee Arthroplasty

Recovering functional ability after total knee arthroplasty （TKA） requires recovery of strength and voluntary activation. Short-term recovery of strength and activation are enhanced following a protocol combining strength training with neuromuscular electrical stimulation （NMES）. The purpose of the study was to determine if a dose response curve could be constructed for patients who received NMES as part of their treatment after TKA. NMES dosage was quantified as the electrically evoked knee extensor torque, expressed as a percentage of the subject＇s maximal voluntary contraction. Dose-response curves were generated, with the associations between NMES training intensity and quadriceps strength, voluntary activation, and lean muscle cross-sectional area examined using Pearson Product-Moment Correlation Coefficients. Significantly, linear correlations were observed between NMES training intensity and both quadriceps strength and voluntary activation, but not lean muscle cross-sectional area. These results suggest that maximizing the elicited training force during rehabilitation will enhance short-term recovery following TKA.

The Effect of Neuromuscular Electrical Stimulation in Treatment of Acute Cerebral Infarction with Dysphagia and Psychological Disorder

Objective:To explore the effect of neuromuscular electrical stimulation in treatment of acute cerebral infarction with dysphagia and psychological disorder.Methods:78 cases of patients with acute cerebral infarction with dysphagia and psychological disorder were selected and randomly divided into two groups.Control group were treated with conventional drug treatment and swallowing training while neuromuscular electrical stimulation was used to additionally treat the experimental group.Profile of Mood States(Poms)and Robson self-esteem questionnaire(RSEQ-30)scores were used to evaluate the effect of neuromuscular electrical stimulation in the two groups before and after treatment.Results:In control group,both Poms and RSEQ-30 scores were not significant different before treatment.In experimental group,Poms and RSEQ-30 scores were significantly lower and higher than before treatment(P<0.05),respectively.Similarly,after treatment,Poms and RSEQ-30 scores in the experimental group were significantly lower and higher than control group(P<0.05),respectively.Conclusion:Neuromuscular electrical stimulation in treatment of acute cerebral infarction with dysphagia and psychological disorder could eliminate the patient's psychological barriers and improve their quality of life.

Effects of Neuromuscular Electrical Stimulation in Combination with Glutamine Administration on Skeletal Muscle Atrophy in Colon-26 Tumor-Bearing Mice

The depressed protein synthetic response,a phenomenon termed anabolic resistance,has been shown to be involved in muscle wasting induced by cancer cachexia.Moreover,a positive relationship between the protein synthetic rate and intracellular glutamine(GLN)concentration has been found in skeletal muscles.This study investigated the effects of neuromuscular electrical stimulation(ES)and GLN administration on muscle wasting and GLN metabolism in colon-26(C-26)tumor-bearing mice.CD2F1 mice were divided into 8 groups:control(CNT),CNT+ES,CNT+GLN,CNT+ES+GLN,C-26,C-26+ES,C-26+GLN,C-26+ES+GLN.Cancer cachexia was induced by subcutaneous injection of C-26 cells and developed for four weeks.ES was performed on the left plantar flexor muscles every other day,and GLN(1 g/kg)was administered daily intraperitoneally starting one day after the C-26 injection.Tumor-free body mass and fast-twitch gastrocnemius(Gas)muscle weight were lower in the C-26 group than in the CNT group(-19%and-17%,respectively).Neither ES training nor GLN administration,alone or in combination,ameliorated the loss of Gas muscle weight in the C-26 mice.However,ES training in combination with GLN administration inhibited the increased expression of GLN synthetase(GS)in the C-26 muscles.Thus,it is likely that GLN plays a critical role in muscle protein metabolism and,therefore,can be targeted as a tentative treatment of cancer cachexia.

Clinical observation of acupoint injection combined with nerve electrical stimulation in the treatment of post-stroke dysphagia

Background:Post-stroke dysphagia is one of the common clinical symptoms in the rehabilitation department of primary hospitals,which seriously affects the quality of life of patients and their families.Majority of medical workers have comprehensively studied post-stroke dysphagia as it easily induces inhalation pneumonia,asphyxia,and many other complications.At present,many methods for post-stroke dysphagia have been proved to be effective.With regard to comprehensive treatment effect,patient compliance,technology promotion difficulty,grassroots hospital operability,and other factors,we found that acupoint injection combined with nerve electrical stimulation is a good method worthy of promotion.Methods:A total of 130 patients with dysphagia after stroke were randomly divided into nerve electrical stimulation group(n=41),acupoint injection group(n=40),and comprehensive treatment group(nerve electrical stimulation plus acupoint injection,n=49).The therapeutic effect in each group was evaluated before treatment and 20 days after treatment using the improved water swallow test,video fluoroscopic swallowing study,and standardized swallowing assessment.Results:After 20 days of treatment,significant differences were noted in each group.The scores of improved water swallow test decreased from 4.10±0.74 to 2.12±0.95 in the nerve electrical stimulation group,4.00±0.78 to 2.28±1.04 in the acupoint injection group,and 4.16±0.77 to 1.73±0.79 in the comprehensive treatment group;video fluoroscopic swallowing study scores increased from 3.71±2.16 to 5.05±2.111 in the nerve electrical stimulation group,3.80±1.94 to 5.20±1.942 in the acupoint injection group,and 3.73±2.22 to 6.24±2.21 in the comprehensive treatment group;and standardized swallowing assessment scores of the three groups also decreased from 35.13±3.38 to 28.17±3.42,34.66±3.46,and 34.48±3.26 to 26.39±3.86,respectively.The overall scores of each group after treatment were significantly different from those before treatment(P<0.05),indicating that both nerve electrical stimulation and acupoint injection were effective for post-stroke dysphagia;the scores of nerve electrical stimulation group and acupoint injection group were similar,but those of the comprehensive treatment group were significantly better than the single treatments(P<0.05).It shows that the two treatment methods have synergistic effect,and combined treatments have more benefits.Conclusion:Nerve electrical stimulation and acupoint injection have a synergistic therapeutic effect on post-stroke dysphagia.The combined treatment is more beneficial to patients with post-stroke dysphagia than the single treatments.

Effects of Eccentric Contractions Induced Electrical Stimulation Training System on Quadriceps Femoris Muscle

We developed an eccentric contraction induced electrical stimulation (ES) training system. The purpose of this study was to investigate whether the eccentric contraction induced ES enhance the knee extension torque compared with typical ES. Twenty-two young untrained men (age: 23 ± 3 years) in the acute response trial (single training) and seven untrained men in the long period training trial (for 6 weeks) were studied. We measured muscle thickness and knee extension torque evoked by ES with eccentric contraction training system (ES + ECC) or ES alone for the quadriceps muscle of men. The levels of pain and discomfort were evaluated using numeric rating scale (NRS) and heart rate variability. The knee extension torque of ES + ECC was higher than that of ES alone in the acute response trial. There were no significant differences in the levels of pain and discomfort between ES and ES + ECC. Additionally, ES + ECC training for 6 weeks was effective on the quadriceps muscle thickness and knee extension torque. In contrast, the ES alone training failed to increase muscle thickness and knee extension torque. These results suggest that eccentric contraction induced ES would have the potential to become an effective intervention to promote muscle strengthening.

Early application of percutaneous neuromuscular electric stimulation in interfering motor function of limbs and difference in temperature of axilla of patients with ischemic stroke

BACKGROUND： Temperature of axilla could be affected due to motor dysfunction of limbs and neural changes of vessel after ischemic stroke. OBJECTIVE： To observe the effect of percutaneous neuromuscular electric stimulation （PNES） on difference in temperature of axilla and analyze the relationship between function of limbs and difference in temperature of axilla. DESIGN： Randomized grouping and controlled observation SETTING： Department of Neurology, General Hospital of Shenyang Military Area Command of Chinese PLA PARTICIPANTS： Sixty patients with ischemic stroke were selected from Neurological Department of General Hospital of Shenyang Military Area Command of Chinese PLA from January to June 2003. All cases were diagnosed with clinical diagnosis criteria of ischemic stroke established by the Fourth Chinese Classification of Cerebrovasular Disease and CT examination and received neuromuscular electric stimulation （NES）. Patients were randomly divided into control group and treatment group with 30 in each group. METHODS： Control group： Patients received routinely neurological therapy. Treatment group： Except routine therapy, patients suffered from NES at 48 hours after hospitalization. NMT-91 NES equipment was used to stimulated injured limbs with low frequency once 30 minutes a day in total of 10 times a course, especially extensor muscle of upper limb and flexor muscle of lower limb. Prescription of hemiplegia was internally decided by equipment with the output frequency of 200 Hz. Intensity of electric output could cause muscle contraction. The therapy needed two or three courses. Temperature of bilateral axilla was measured every day to calculate the difference with the formula of （temperature of axilla on the injured side - temperature of axilla on the healthy side）. Motor function of limbs was measured with FugI-Meyer Motor Assessment （FMA） during hospitalization and at 2 and 4 hours after hospitalization. Among 90 points, upper and lower limb function was 54, equilibrium function 10, sensory function 10, and motion of joint 16. The higher the scores were, the better the function was. Correlation of data was dealt with linear correlation analysis. MAIN OUTCOME MEASURES ： Assessment and correlation between difference in temperature of axilla and motor function of injured limbs during hospitalization and at 2 and 4 weeks after hospitalization. RESULTS： All 60 patients with ischemic stroke were involved in the final analysis. ① Difference in temperature： Difference of 2 and 4 weeks after hospitalization was lower than that in control group and at just hospitalization [treatment group： （0.056±0.000）, （0.024±0.003） ℃; control group： （0.250±0.001）, （0.131 ±0.001）℃; hospitalization; （0.513±0.001） ℃, P 〈 0.05-0,01]. ② FMA scores： Scores of 2 and 4 weeks after hospitalization were higher than those in control group and at just hospitalization [treatment group; （43.50±15.09）, （67.97 ±18.21） points; control group： （33.33 ±13.54）, （40.87±19.34） points; hospitalization： （26.43 ±11.87） points, P 〈 0.05-0.01]. ③ Correlation： Difference in temperature of axilla was negative correlation with FMA scores （c=- -0.255 1, P 〈 0.05）. CONCLUSION： ① PNES can accelerate recovery of limb function and decrease temperature of axilla of patients with ischemic stroke. ② The lower the difference in temperature is, the better the functional recovery is.

Therapeutic efficacy of swallowing neuromuscular electrical stimulation combined with acupuncture for post-stroke dysphagia

Objective To seek a better therapy for treating post-stroke dysphagia. Methods Patients with stroke and swallowing disorders were randomly divided into ordinary acupuncture group （group A, 58 cases） and swallowing neuromuscular electrical stimulation combined with acupuncture group （group B, 62 cases）. Two-group patients were given the same basic internal medical treatment. In addition, group A was given normal acupuncture treatment with the choice of local points： Junjin （金津 EX-HN 12）, Yuye（玉液 EX-HN 23）, Fengchi （风池 GB 20）, Yifeng （翳风 TE 17）, Lianquan （廉泉 CV 23）, Wangu （完骨 GB 12）. Group B was given swallowing neuromuscular electrical stimulation combined with acupuncture： GB 20, Fengfu （风夜 GV 16）, TE 17, Yiming （翳明 EX-HN 14）, Yamen （哑门 GV 15）, Tianrong（天容 SI 17）, Tianchuang （天窗 SI 16）, CV 23, the uniform reinforcing-reducing manipulation was used; EX- HN 12, EX-HN 13, the piercing and blood-letting method （1-2 mL blood） was used; at the same time, the swallowing neuromuscular electrical stimulation therapy device was used to electrically stimulate the nerves and muscles in the throat and neck at specific output pulse current （50-100 Hz）. Treatment was made twice a day, 30 minutes each time. Two weeks after the treatment, the patients were assessed in symptoms improvement and clinical efficacy. Results The total effective rate in group B was 91.4% and 75.8% in group A; in the total efficiency comparison in both groups, χ^2=5.232, P〈0.05. The difference in improvement of symptoms with post-stroke dysphagia treated with above mentioned combination treatment was statistically significant between both groups （P〈0.05）. Conclusion The above mentioned swallowing neuromuscular electrical stimulation combined with acupuncture treatment has a better clinical effect when compared with ordinary acupuncture.

A Hemodynamic Study of the Effect of Neuromuscular Electrical Stimulation on Enhancing Popliteal Venous Flow

Neuromuscular electrical stimulation has been studied to be a method of prophylaxis for deep venous thrombosis by activating the calf muscle pump. However, there is little evidence of the effects of different stimulating parameters on hemodynamics and comfort levels. The objective of this paper is to compare the effects of different stimulating parameters(current amplitude, pulse-width) on hemodynamic alterations of the popliteal vein and the comfort levels in a group of fourteen healthy subjects. Doppler ultrasound detection of peak venous velocity and blood volume were taken from baseline, twelve sequential electrical stimulations and foot dorsiflexion for each subject. A visual analogue scale was used to assess the subjects' pain perception of neuromuscular electrical stimulation. The results showed that peak venous velocity and blood volume augmented as current amplitude and pulse-width increased while pain level also increased. A compromise was reached that parameters consisting of an amplitude of 10 m A and a pulse-width of 500 μs would obtain a high-peak venous velocity and blood flow volume with a relatively comfortable perception. In addition, parameters consisting of an amplitude of 20 m A and a pulse-width of 300 μs were also shown to be a promising choice. However, further studies need to be done to validate and enrich these findings.

神经肌肉电刺激联合口腔感觉训练对重症病毒性脑炎合并吞咽障碍患儿的康复效果

目的探讨神经肌肉电刺激(NMES)联合口腔感觉训练对重症病毒性脑炎(SVE)合并吞咽障碍患儿的康复效果、吞咽功能、神经功能、营养状况的影响。方法选择河北省儿童医院2021-01—2023-03收治的SVE合并吞咽障碍患儿108例。随机数字表法分为口腔感觉训练组和NMES联合组各54例。2组患者均进行抗病毒、降颅内压、去高热、控制惊厥、保护脑神经等对症支持治疗。口腔感觉训练组给予口腔感觉运动训练,NMES联合组在口腔感觉训练基础上进行NMES康复治疗。比较2组患者康复效果、吞咽功能[吞咽障碍调查量表(DDS)]、神经功能指标[血清脑源性的神经营养因子(BDNF)、神经元特异性的烯醇化酶(NSE)水平]、营养状况[主观的综合性营养评分量表(SGA)]、生活质量[吞咽障碍特异性生存质量量表(SWAL-QOL)]。结果康复治疗4周后,NMES联合组康复总有效率为92.59%,高于口腔感觉训练组的72.22%(P<0.05);NMES联合组口腔期、咽期、食管期DDS评分、SGA评分、SWAL-QOL评分、血清BDNF水平明显高于口腔感觉训练组,血清NSE水平低于口腔感觉训练组(P<0.05)。结论NMES联合口腔感觉训练用于SVE合并吞咽障碍患儿的康复治疗,可有效提升康复效果,进一步改善吞咽功能和神经功能,改善患儿的营养不良状况,提升患儿生活质量。

神经肌肉电刺激系统联合康复训练在脑卒中后肢体功能障碍患者康复中的应用价值

目的:探究神经肌肉电刺激系统联合康复训练在脑卒中后肢体功能障碍患者康复中的应用价值。方法:选取2022年1—12月第九〇九医院收治的95例脑卒中后肢体功能障碍患者作为研究对象。按照随机数字表法分为对照组(n=47)和观察组(n=48)。观察组行康复训练联合神经肌肉电刺激系统干预,对照组仅接受康复训练干预,两组均持续干预3个月。比较两组干预前后改良Ashworth量表(MAS)评分、患肢各关节主动活动度、脑卒中康复运动功能评定量表(STREAM)评分。结果:干预前,两组MAS评分、患肢各关节主动活动度、STREAM评分比较,差异均无统计学意义(P>0.05);干预后,两组患侧上肢肌肉痉挛、下肢肌肉痉挛评分均低于干预前,且观察组均低于对照组,差异均有统计学意义(P<0.05);干预后,两组肩关节外展、肘关节屈曲、腕关节掌屈、手掌指关节屈曲、髋关节内外旋、膝关节屈伸主动活动度均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。干预后,两组上肢运动、下肢运动、基本活动评分及总分均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。结论:在脑卒中后肢体功能障碍患者康复中应用神经肌肉电刺激系统联合康复训练可以有效缓解其肌肉痉挛情况,改善关节活动度,提高肢体运动功能。

神经肌肉电刺激通过调控白细胞介素6/信号转导子及转录激活子3信号通路促进脊髓损伤后小鼠运动功能恢复

目的观察神经肌肉电刺激(NMES)对脊髓损伤后小鼠白细胞介素6(IL-6)/STAT3信号通路的影响,探讨其对运动功能恢复的机制。方法选取SPF级小鼠72只随机分成假手术(sham)组、脊髓损伤组(SCI)和NMES组。利用BMS评分、斜坡实验与电生理(EMG)评估小鼠脊髓损伤后肢体运动恢复情况。Western blotting和Real-time PCR检测各组小鼠脊髓组织中相关炎症因子、IL-6/STAT3信号通路与胶质纤维酸性蛋白(GFAP)和脑源性神经营养因子(BDNF)的表达。HE染色观察各组小鼠脊髓形态结构。结果NMES组BMS评分和小鼠斜坡实验均高于SCI组(P<0.05);NMES组小鼠运动诱发电位(MEP)最大振幅高于SCI组(P<0.05);NMES组脊髓组织TNF-α、IL-12A与GFAP表达量均低于SCI组(P<0.05),TGF-β、IL-10与BDNF表达量均高于SCI组(P<0.05);与SCI组相比,NMES组小鼠脊髓空洞较少,脊髓形态修复较好;与SCI组相比,NMES组IL-6/STAT3信号通路蛋白表达均低于SCI组(P<0.05)。结论神经肌肉电刺激通过抑制IL-6/STAT3信号通路发挥抗炎作用,从而促进脊髓损伤后小鼠后肢运动功能的恢复。

腹壁强化训练联合神经肌肉电刺激治疗产后腹直肌分离的临床研究

目的研究腹壁强化训练联合神经肌肉电刺激治疗产后腹直肌分离的临床效果。方法选取2021年1月至2022年12月江苏省江阴市中医院收治的108例产后腹直肌分离患者,按照随机数字表法将其分为三组,每组36例。腹壁强化组采用腹壁强化训练治疗,电刺激组采用神经肌肉电刺激治疗,联合组采用腹壁强化训练联合神经肌肉电刺激治疗,治疗3个疗程。比较两组临床疗效;比较两组治疗前后腹直肌超声指标、腹部核心肌群肌力、生活质量评分。结果联合组临床疗效优于腹壁强化组、电刺激组(P<0.05)。治疗后,三组腹直肌间距小于治疗前,腹直肌厚度、弹性模量值、剪切波速度高于治疗前;且联合组腹直肌间距小于腹壁强化组、电刺激组,腹直肌厚度、弹性模量值、剪切波速度高于腹壁强化组、电刺激组(P<0.05)。治疗后,三组腹直肌、腹横肌、腹斜肌肌力高于治疗前,且联合组高于腹壁强化组、电刺激组(P<0.05)。治疗后,三组躯体功能、社会功能、心理功能和物质生活状态评分高于治疗前,且联合组高于腹壁强化组、电刺激组(P<0.05)。结论腹壁强化训练联合神经肌肉电刺激治疗产后腹直肌分离的效果显著,可增强患者腹部核心肌群肌力,提高生活质量。

穴位按摩结合神经肌肉电刺激治疗脑卒中吞咽障碍的临床研究

目的探讨穴位按摩结合神经肌肉电刺激治疗脑卒中吞咽障碍的临床效果。方法选取2022年4月至2023年3月在佛山市第一人民医院康复医学科接受治疗的92例脑卒中吞咽障碍患者作为研究对象。根据不同的治疗方式将患者分为结合组(53例)和电刺激组(39例),电刺激组接受神经肌肉电刺激治疗,结合组在电刺激组的基础上增加穴位按摩。治疗后比较两组患者临床疗效、吞咽功能、渗漏-误吸(PAS)分级、舌压及口部肌肉运动评分等。结果结合组总有效率为92.45%,高于电刺激组的74.36%,差异有统计学意义(P<0.05);治疗后,结合组平均波幅及舌压高于电刺激组,且吞咽时限低于电刺激组,差异有统计学意义;结合组PAS及容积-黏度吞咽测试(V-VST)分级优于电刺激组,且安全性及有效性受损率低于电刺激组,差异有统计学意义(P<0.05);结合组标准化吞咽功能评定量表(SSA)评分低于电刺激组,差异有统计学意义(P<0.05);吞咽相关生活质量量表(SWAL-QOL)评分及口部肌肉运动评分高于电刺激组,差异有统计学意义(P<0.05)。结论穴位按摩结合神经肌肉电刺激治疗脑卒中吞咽障碍效果显著,能够有效提升患者口部运动及吞咽功能,缓解其吞咽障碍。

葛根黑苏汤联合神经肌肉电刺激、戊酸雌二醇治疗薄型子宫内膜不孕症临床研究

目的:观察葛根黑苏汤联合神经肌肉电刺激、戊酸雌二醇对薄型子宫内膜不孕症患者子宫内膜形态、血清白血病抑制因子(LIF)水平及妊娠成功率的影响。方法:选取150例薄型子宫内膜不孕症患者,按随机数字表法分为常规组、电刺激组、联合组各50例。常规组采用戊酸雌二醇口服治疗,电刺激组使用戊酸雌二醇联合神经肌肉电刺激进行治疗,联合组采用葛根黑苏汤、神经肌肉电刺激、戊酸雌二醇的方式进行治疗。比较3组治疗前后中医证候积分、子宫内膜形态、血清学指标值[血清白血病抑制因子(LIF)、白细胞介素-10(IL-10)]的变化,比较3组妊娠率。结果:治疗后,3组形寒肢冷、性欲低下、眩晕耳鸣中医证候积分均较治疗前下降,联合组上述3项中医证候积分均低于常规组、电刺激组(P<0.05)。治疗后,得到A型子宫内膜形态在常规组、电刺激组、联合组中分别占24.00%、48.00%、54.00%。联合组子宫内膜厚度高于常规组、电刺激组,子宫内膜形态及厚度与常规组、电刺激组比较,差异均有统计学意义(P<0.05)。治疗后,3组血清LIF、IL-10水平均较治疗前升高(P<0.05),联合组血清LIF、IL-10水平均高于常规组、电刺激组(P<0.05)。常规组妊娠成功率为16.00%,电刺激组妊娠成功率28.00%,联合组妊娠成功率38.00%,联合组妊娠成功率高于常规组、电刺激组(P<0.05)。结论:葛根黑苏汤联合神经肌肉电刺激、戊酸雌二醇可有效改善薄型子宫内膜不孕症患者的子宫内膜形态及血清LIF水平,提高妊娠率。

神经肌肉电刺激辅助康复治疗对脑卒中后认知功能障碍及日常生活能力的影响

目的探讨康复训练配合神经肌肉电刺激对脑卒中后认知功能障碍及生活能力的影响,为脑卒中后综合康复治疗提供依据。方法选择我院2021-2023年收治的100例脑卒中患者,随机分为对照组和观察组,每组50例。对照组给予常规康复训练治疗;观察组在此基础上增加神经肌肉电刺激治疗。比较两组临床疗效、血清皮质醇(Cor)、神经肽Y(NPY)水平、生活质量评分(SS-QOL量表)及神经功能评分(NIHSS量表)。结果与对照组相比,观察组总有效率更高(P<0.05);Cor、NPY水平均较对照组降低更多(P<0.05);SS-QOL评分提高更显著(P<0.05);NIHSS评分下降更明显(P<0.05)。结论康复训练配合神经肌肉电刺激可明显改善脑卒中后认知功能损害,减轻应激状态,提高日常生活能力和生活质量。该组合治疗策略优于单纯康复训练。