Objective:To analyze the effect of limb rehabilitation therapy combined with transcranial magnetic stimulation therapy on muscle activity in patients with upper limb dysfunction after cerebral infarction(CI).Methods:3...Objective:To analyze the effect of limb rehabilitation therapy combined with transcranial magnetic stimulation therapy on muscle activity in patients with upper limb dysfunction after cerebral infarction(CI).Methods:320 patients with upper limb dysfunction after CI were selected,all of whom were treated in our hospital between June 2021 and June 2023.They were randomly grouped according to the lottery method into the control group(limb rehabilitation therapy,160 cases)and the intervention group(transcranial magnetic stimulation therapy+limb rehabilitation therapy,160 cases).The upper limb function scores,neuro-electrophysiological indicators,daily living ability scores,and quality of life scores of the two groups were compared.Results:Compared with the control group,upper limb function scores and daily living ability scores in the intervention group were higher after treatment,and the neuro-electrophysiological indicators of the intervention group were lower after treatment(P<0.05).Conclusion:Transcranial magnetic stimulation therapy combined with limb rehabilitation therapy has significant effects in patients with upper limb dysfunction after CI and is worthy of promotion and application.展开更多
Low-frequency repetitive transcranial magnetic stimulation(LF-r TMS) to the contralesional hemisphere and intensive occupational therapy(i OT) have been shown to contribute to a significant improvement in upper li...Low-frequency repetitive transcranial magnetic stimulation(LF-r TMS) to the contralesional hemisphere and intensive occupational therapy(i OT) have been shown to contribute to a significant improvement in upper limb hemiparesis in patients with chronic stroke. However, the effect of the combined intervention program of LF-r TMS and i OT on cognitive function is unknown. We retrospectively investigated whether the combined treatment influence patient's Trail-Making Test part B(TMT-B) performance, which is a group of easy and inexpensive neuropsychological tests that evaluate several cognitive functions. Twenty-five patients received 11 sessions of LF-r TMS to the contralesional hemisphere and 2 sessions of i OT per day over 15 successive days. Patients with right- and left-sided hemiparesis demonstrated significant improvements in upper limb motor function following the combined intervention program. Only patients with right-sided hemiparesis exhibited improved TMT-B performance following the combined intervention program, and there was a significant negative correlation between Fugl-Meyer Assessment scale total score change and TMT-B performance. The results indicate the possibility that LF-r TMS to the contralesional hemisphere combined with i OT improves the upper limb motor function and cognitive function of patients with right-sided hemiparesis. However, further studies are necessary to elucidate the mechanism of improved cognitive function.展开更多
Drug treatment, electric stimulation and decimeter wave therapy have been shown to promote the repair and regeneration of the peripheral nerves at the injured site. This study prepared a Mackinnon’s model of rat scia...Drug treatment, electric stimulation and decimeter wave therapy have been shown to promote the repair and regeneration of the peripheral nerves at the injured site. This study prepared a Mackinnon’s model of rat sciatic nerve compression. Electric stimulation was given immediately after neurolysis, and decimeter wave radiation was performed at 1 and 12 weeks post-operation. Histological observation revealed that intraoperative electric stimulation and decimeter wave therapy could improve the local blood circulation of repaired sites, alleviate hypoxia of compressed nerves, and lessen adhesion of compressed nerves, thereby decreasing the formation of new entrapments and enhancing compressed nerve regeneration through an improved microenvironment for regeneration. Immunohistochemical staining results revealed that intraoperative electric stimulation and decimeter wave could promote the expression of S-100 protein. Motor nerve conduction velocity and amplitude, the number and diameter of myelinated nerve fibers, and sciatic functional index were significantly increased in the treated rats. These results verified that intraoperative electric stimulation and decimeter wave therapy contributed to the regeneration and the recovery of the functions in the compressed nerves.展开更多
Despite emerging contemporary biotechnological methods such as gene-and stem cell-based therapy,there are no clinically established therapeutic strategies for neural regeneration after spinal cord injury.Our previous ...Despite emerging contemporary biotechnological methods such as gene-and stem cell-based therapy,there are no clinically established therapeutic strategies for neural regeneration after spinal cord injury.Our previous studies have demonstrated that transplantation of genetically engineered human umbilical cord blood mononuclear cells producing three recombinant therapeutic molecules,including vascular endothelial growth factor(VEGF),glial cell-line derived neurotrophic factor(GDNF),and neural cell adhesion molecule(NCAM)can improve morpho-functional recovery of injured spinal cord in rats and mini-pigs.To investigate the efficacy of human umbilical cord blood mononuclear cells-mediated triple-gene therapy combined with epidural electrical stimulation in the treatment of spinal cord injury,in this study,rats with moderate spinal cord contusion injury were intrathecally infused with human umbilical cord blood mononuclear cells expressing recombinant genes VEGF165,GDNF,NCAM1 at 4 hours after spinal cord injury.Three days after injury,epidural stimulations were given simultaneously above the lesion site at C5(to stimulate the cervical network related to forelimb functions)and below the lesion site at L2(to activate the central pattern generators)every other day for 4 weeks.Rats subjected to the combined treatment showed a limited functional improvement of the knee joint,high preservation of muscle fiber area in tibialis anterior muscle and increased H/M ratio in gastrocnemius muscle 30 days after spinal cord injury.However,beneficial cellular outcomes such as reduced apoptosis and increased sparing of the gray and white matters,and enhanced expression of heat shock and synaptic proteins were found in rats with spinal cord injury subjected to the combined epidural electrical stimulation with gene therapy.This study presents the first proof of principle study of combination of the multisite epidural electrical stimulation with ex vivo triple gene therapy(VEGF,GDNF and NCAM)for treatment of spinal cord injury in rat models.The animal protocols were approved by the Kazan State Medical University Animal Care and Use Committee(approval No.2.20.02.18)on February 20,2018.展开更多
The concept of Network Centric Therapy represents an amalgamation of wearable and wireless inertial sensor systems and machine learning with access to a Cloud computing environment. The advent of Network Centric Thera...The concept of Network Centric Therapy represents an amalgamation of wearable and wireless inertial sensor systems and machine learning with access to a Cloud computing environment. The advent of Network Centric Therapy is highly relevant to the treatment of Parkinson’s disease through deep brain stimulation. Originally wearable and wireless systems for quantifying Parkinson’s disease involved the use a smartphone to quantify hand tremor. Although originally novel, the smartphone has notable issues as a wearable application for quantifying movement disorder tremor. The smartphone has evolved in a pathway that has made the smartphone progressively more cumbersome to mount about the dorsum of the hand. Furthermore, the smartphone utilizes an inertial sensor package that is not certified for medical analysis, and the trial data access a provisional Cloud computing environment through an email account. These concerns are resolved with the recent development of a conformal wearable and wireless inertial sensor system. This conformal wearable and wireless system mounts to the hand with the profile of a bandage by adhesive and accesses a secure Cloud computing environment through a segmented wireless connectivity strategy involving a smartphone and tablet. Additionally, the conformal wearable and wireless system is certified by the FDA of the United States of America for ascertaining medical grade inertial sensor data. These characteristics make the conformal wearable and wireless system uniquely suited for the quantification of Parkinson’s disease treatment through deep brain stimulation. Preliminary evaluation of the conformal wearable and wireless system is demonstrated through the differentiation of deep brain stimulation set to “On” and “Off” status. Based on the robustness of the acceleration signal, this signal was selected to quantify hand tremor for the prescribed deep brain stimulation settings. Machine learning classification using the Waikato Environment for Knowledge Analysis (WEKA) was applied using the multilayer perceptron neural network. The multilayer perceptron neural network achieved considerable classification accuracy for distinguishing between the deep brain stimulation system set to “On” and “Off” status through the quantified acceleration signal data obtained by this recently developed conformal wearable and wireless system. The research achievement establishes a progressive pathway to the future objective of achieving deep brain stimulation capabilities that promote closed-loop acquisition of configuration parameters that are uniquely optimized to the individual through extrinsic means of a highly conformal wearable and wireless inertial sensor system and machine learning with access to Cloud computing resources.展开更多
Forty-eight cases with dysmenorrhoea were treated by nerve stimulation therapy.Of these 32 cases (66. 7%) were clinically cured, 3 (16.6%) remarkably improved, 5 (0. 4%)improved, the total effective rate was 93. 8%.
Objective:To explore the treatment of Morita therapy combined with transcranial magnetic stimulation in postpartum depression of primipara and its effect on prolactin.Method:From May 2018 to November 2019,92 cases of ...Objective:To explore the treatment of Morita therapy combined with transcranial magnetic stimulation in postpartum depression of primipara and its effect on prolactin.Method:From May 2018 to November 2019,92 cases of postpartum depression and postpartum women who were treated in our hospital were randomly divided into 2 groups,46 cases each.The control group was treated with transcranial magnetic stimulator,and the observation group was treated with Morita therapy on the basis of the control group.Both groups were treated continuously for 6 weeks.The degree of depression and prolactin levels of the two groups was observed.Results:After 6 weeks of treatment,the HAMD scores of the two groups were lower than before the treatment,and the observation group was the lowest.The prolactin levels of the two groups were higher than before the treatment,and the observation group was the highest.The difference was statistically significant(P<0.05).Conclusion:Morita therapy combined with transcranial magnetic stimulation can effectively improve the postpartum depression of primiparas,increase the level of prolactin,and have a good clinical effect.展开更多
Objective To observe the effects of repetitive transcranial magnetic stimulation(rTMS)and cognitive behavioral therapy(CBT)on cognitive function in alcohol-dependent patients.Methods Data from 285 alcohol-dependent pa...Objective To observe the effects of repetitive transcranial magnetic stimulation(rTMS)and cognitive behavioral therapy(CBT)on cognitive function in alcohol-dependent patients.Methods Data from 285 alcohol-dependent patients were collected from Mudanjiang Medical University and Sun Yat-sen Memorial Hospital at Sun Yat-sen University between 2019 and 2021.The patients were divided into groups depending on alcohol abstinence and non-abstinence.There were 43 patients in the alcohol consumption(AC)group.The patients in the abstinence group were randomly assigned to treatment regimens with different combinations of rTMS and CBT using the Elton system.There were 49 patients in the TB+C0 group,36 in the TB+C1 group,44 in the TL+C0 group,36 in the TL+C1 group,37 in the TR+C0 group,and 40 in the TR+C1 group.Cognitive function was assessed by using the Montreal Cognitive Assessment Scale(MoCA).Results The proportion of patients with cognitive impairment in the AC group at 24 weeks was higher than that at baseline(P<0.05),whereas the proportion of cognitive impairment in the other groups did not differ significantly over time.The percentage of patients with cognitive impairment at 24 weeks was 52.3%in the TL+C0 group and 47.2%in the TL+C1 group,which was significantly lower than that in the AC group(P<0.05).MoCA scores at different time points in the AC group were significantly higher than those in the TB+C0,TL+C0,TL+C1,TR+C0,and TR+C1 groups,respectively.MoCA scores were significantly higher at 12 weeks compared with the baseline in the TB+C0,TL+C0,TL+C1,TR+C0,and TR+C1 groups(P<0.05),and similar changes were observed at 24 weeks.The MoCA scores in the TL+C1 and TL+C0 groups were higher than those in the TR+C0 group at 12 weeks after the intervention(P<0.05).Furthermore,MoCA scores in each of the TB+C1,TL+C1,TL+C0,TR+C1,and TR+C0 groups were higher than those in the AC group at 24 weeks(P<0.05).Conclusion Alcohol consumption impairs cognitive function,as evidenced by a significantly higher proportion of cognitive impairment after 24 weeks of non-abstinence.Most of the tested treatment regimens improved cognitive function.High frequency rTMS of the left dorsolateral prefrontal cortex(DLPFC)was associated with a greater improvement in cognitive function than that of the right DLPFC in alcohol-dependent patients at 12 weeks of abstinence.There does not appear to be a therapeutic advantage of CBT for cognitive impairment in alcohol-dependent patients.Screening for impaired cognitive function should be seriously considered for patients who engage in heavy drinking,and measures should be taken to reduce the risk of dementia induced by alcohol dependence.展开更多
Gait disorders drastically affect the quality of life of stroke survivors,making post-stroke rehabilitation an important research focus.Noninvasive brain stimulation has potential in facilitating neuroplasticity and i...Gait disorders drastically affect the quality of life of stroke survivors,making post-stroke rehabilitation an important research focus.Noninvasive brain stimulation has potential in facilitating neuroplasticity and improving post-stroke gait impairment.However,a large inter-individual variability in the response to noninvasive brain stimulation interventions has been increasingly recognized.We first review the neurophysiology of human gait and post-stroke neuroplasticity for gait recovery,and then discuss how noninvasive brain stimulation techniques could be utilized to enhance gait recovery.While post-stroke neuroplasticity for gait recovery is characterized by use-dependent plasticity,it evolves over time,is idiosyncratic,and may develop maladaptive elements.Furthermore,noninvasive brain stimulation has limited reach capability and is facilitative-only in nature.Therefore,we recommend that noninvasive brain stimulation be used adjunctively with rehabilitation training and other concurrent neuroplasticity facilitation techniques.Additionally,when noninvasive brain stimulation is applied for the rehabilitation of gait impairment in stroke survivors,stimulation montages should be customized according to the specific types of neuroplasticity found in each individual.This could be done using multiple mapping techniques.展开更多
For decades visual field defects were considered irreversible because it was thought that in the visual system the regeneration potential of the neuronal tissues is low.Nevertheless,there is always some potential for ...For decades visual field defects were considered irreversible because it was thought that in the visual system the regeneration potential of the neuronal tissues is low.Nevertheless,there is always some potential for partial recovery of the visual field defect that can be achieved through induction of neuroplasticity.Neuroplasticity refers to the ability of the brain to change its own functional architecture by modulating synaptic efficacy.It is maintained throughout life and just as neurological rehabilitation can improve motor coordination,visual field defects in glaucoma,diabetic retinopathy or optic neuropathy can be improved by inducing neuroplasticity.In ophthalmology many new treatment paradigms have been tested that can induce neuroplastic changes,including non-invasive alternating current stimulation.Treatment with alternating current stimulation(e.g.,30 minutes,daily for 10 days using transorbital electrodes and^10 Hz)activates the entire retina and parts of the brain.Electroencephalography and functional magnetic resonance imaging studies revealed local activation of the visual cortex,global reorganization of functional brain networks,and enhanced blood flow,which together activate neurons and their networks.The future of low vision is optimistic because vision loss is indeed,partially reversible.展开更多
Objective: To investigate the application value of electrostimulation biofeedback therapy in combination with vaginal dumbbell therapy to postpartum pelvic floor dysfunction. Methods: Retrospective analysis of 200 cas...Objective: To investigate the application value of electrostimulation biofeedback therapy in combination with vaginal dumbbell therapy to postpartum pelvic floor dysfunction. Methods: Retrospective analysis of 200 cases of postpartum pelvic floor dysfunction patients discharged from the hospital from January 2016 to March 2019 as study subjects who were excluded other underlying diseases and were randomly divided into two groups of 100 cases per group, using electrostimulation biofeedback therapy combined vaginal dumbbell therapy as a treatment group. The treatment of electrostimulation biofeedback therapy in combination with kegel was treated as a control group. Then the curative effects of the two groups were compared and statistically analyzed. Results: There was no significant difference in EMG value of postpartum pelvic floor treatment, type I muscle strength, type II muscle strength, muscle type I fatigue, type II fatigue and POP-Q detection results between the two groups before treatment, p > 0.05. There were significant differences in type I muscle strength, type II muscle strength and muscle type I fatigue between the pelvic floor muscles and the muscles at the end of the treatment day, the sixth month and one year after treatment, p ?There was no statistically significant difference at?the end of muscle type II fatigue?treatment day, p > 0.05;while after the treatment of six months and one year, the difference was statistically significant, p 0.05. In addition, the treatment group and the control group were compared before and after treatment, the difference of myoelectric potential value, pelvic floor muscle type I muscle strength, type II muscle strength, muscle type I fatigue degree, type II fatigue degree and POP-Q test result were significant, and the changes in the indicators before and after treatment in the treatment group were significantly higher than the control group. Comparison of urinary incontinence between the two groups before and after treatment, the difference between pre-treatment and the end of treatment day was not statistically significant, p > 0.05;there was significant difference between half a year and one year after treatment (p 0.05, respectively). Comparing?the satisfaction with sexual life after the time of treatment day, half a year and one year after the end of treatment, the difference was statistically significant (p ?Conclusion: Electrical stimulation biofeedback therapy combined with vaginal dumbbell therapy has a good effect in the treatment of postpartum pelvic floor dysfunction, and it is worthy of popularization and application.展开更多
AIM:To investigate normal value range of low-frequent repeated nerve stimulation(RNS):whether different low-frequent stimulation and different muscles have different normal value range.METHODS:Low-frequent (3c /s and ...AIM:To investigate normal value range of low-frequent repeated nerve stimulation(RNS):whether different low-frequent stimulation and different muscles have different normal value range.METHODS:Low-frequent (3c /s and 5c /s)RNS of 30healthy people and 27myasth enia gravis(MG)patients were test.RESULTS:Superior limit of amplitude of wave a ttenuation value of low-frequent RNS(x±2.5s)of different muscles(orbicularis oculi muscle,deltoid muscle and abductor muscle of little finger)of healthy people was 5.45%-7.55%.According to our normal value standard,RNS positive rate of MG group was 85%;according to the current criteria(amplitude of wave attenuation value >10%),positive rate of MG group was 70%,th ere was no apparent difference in RNS positive rate(P>0.1).Some labs adopted the criteria that amplitude of wave attenuation value >15%,ac-cording to this criteria,positive r ate of MG group was 51%.Compared with positive rate(85%)obtained according to our criteria,there was apparent difference(P<0.01).CONCLUSION:Each labs should establish their own normal value standard according to difference muscle and different f re-quent.If adopt universal standard,amplitude of wave attenuation value8%or 10%was suggested.展开更多
Pain interventional therapy,known as the most promising medical technology in the 21st century,refers to clinical treatment technology based on neuroanatomy,neuroimaging,and nerve block technology to treat pain diseas...Pain interventional therapy,known as the most promising medical technology in the 21st century,refers to clinical treatment technology based on neuroanatomy,neuroimaging,and nerve block technology to treat pain diseases.Compared with traditional destructive surgery,interventional pain therapy is considered a better and more economical choice of treatment.In recent years,a variety of minimally invasive pain interventional therapy techniques,such as neuroregulation,spinal cord electrical stimulation,intervertebral disc ablation,and intrasheath drug infusion systems,have provided effective solutions for the treatment of patients with post-herpetic neuralgia,complex regional pain syndrome,cervical/lumbar disc herniation,and refractory cancer pain.展开更多
Post-concussion syndrome (PCS) is a complex disorder with various symptoms. There is limited evidence to support that any intervention enhances recovery after a concussion. This pilot study aimed to examine the effica...Post-concussion syndrome (PCS) is a complex disorder with various symptoms. There is limited evidence to support that any intervention enhances recovery after a concussion. This pilot study aimed to examine the efficacy of neck paraspinal muscles electrical stimulation (ES) in conjunction with physical therapy (PT) on reducing the severity of post concussive symptoms. Twenty-four individuals with PCS were randomly assigned to the ES group (PT + ES) or the control group (PT only). Both groups received the intervention twice a week for eight weeks. Clinical measures including the Concussion Signs/Symptoms Checklist, balance error scoring system, King-Devick test, ImPACT, and the Standardized Assessment of Concussion were used to evaluate the symptoms. We investigated the recovery rate by calculating slopes of changes over time for each participant. A changing slope was derived by linearly fitting the symptoms severity over time with the initial severity score as the intercept. Significant overall improvement was observed in both groups after the interventions. There was no significant difference seen in total symptom recovery rate between two groups (-1.49 ± 1.59 versus -1.2 ± 1.56, p = 0.32). The cognitive symptoms recovery rate of the ES group was faster than the control group (-0.5 ± 0.49 and -0.13 ± 0.46 respectively, p = 0.04). Physical therapy targeting the cervical region is beneficial for persons with PCS. Moreover, peripheral electrical stimulation on the paraspinal muscles surrounding the neck region could potentially advance the cognitive function recovery of persons with PCS.展开更多
The efficacy of traditional treatment for post-traumatic stress disorder(PTSD)is still unsatisfactory.Repetitive transcranial magnetic stimulation(rTMS)has been widely used in the treatment of various types of mental ...The efficacy of traditional treatment for post-traumatic stress disorder(PTSD)is still unsatisfactory.Repetitive transcranial magnetic stimulation(rTMS)has been widely used in the treatment of various types of mental disorders,including PTSD.Although rTMS has been demonstrated to be effective in many cases,there are still arguments regarding its mechanism and protocol.This review aims to summarize the origin,development,principle,and future direction of rTMS and introduce this neuro-stimulation therapy to relevant clinicians.展开更多
Deep brain stimulation offers an advanced means of treating Parkinson’s disease in a patient specific context. However, a considerable challenge is the process of ascertaining an optimal parameter configuration. Impe...Deep brain stimulation offers an advanced means of treating Parkinson’s disease in a patient specific context. However, a considerable challenge is the process of ascertaining an optimal parameter configuration. Imperative for the deep brain stimulation parameter optimization process is the quantification of response feedback. As a significant improvement to traditional ordinal scale techniques is the advent of wearable and wireless systems. Recently conformal wearable and wireless systems with a profile on the order of a bandage have been developed. Previous research endeavors have successfully differentiated between deep brain stimulation “On” and “Off” status through quantification using wearable and wireless inertial sensor systems. However, the opportunity exists to further evolve to an objectively quantified response to an assortment of parameter configurations, such as the variation of amplitude, for the deep brain stimulation system. Multiple deep brain stimulation amplitude settings are considered inclusive of “Off” status as a baseline, 1.0 mA, 2.5 mA, and 4.0 mA. The quantified response of this assortment of amplitude settings is acquired through a conformal wearable and wireless inertial sensor system and consolidated using Python software automation to a feature set amenable for machine learning. Five machine learning algorithms are evaluated: J48 decision tree, K-nearest neighbors, support vector machine, logistic regression, and random forest. The performance of these machine learning algorithms is established based on the classification accuracy to distinguish between the deep brain stimulation amplitude settings and the time to develop the machine learning model. The support vector machine achieves the greatest classification accuracy, which is the primary performance parameter, and <span style="font-family:Verdana;">K-nearest neighbors achieves considerable classification accuracy with minimal time to develop the machine learning model.</span>展开更多
Healthy homeostasis is a principal driving force of the dynamic equilibrium of living organisms. The dynamical basis of homeostasis is the complex and interconnected feedback mechanisms, which are fundamentally govern...Healthy homeostasis is a principal driving force of the dynamic equilibrium of living organisms. The dynamical basis of homeostasis is the complex and interconnected feedback mechanisms, which are fundamentally governed by the nervous system, mainly the balance of the sympathetic and parasympathetic controlling actions. The balancing regulation is well presented in the heart’s sinus node and can be measured by the time-domain heart-rate variation (HRV) of its frequency domain to analyze the constitutional frequencies of the variation. This last is a fluctuation that shows 1/f time fractal arrangement (f is the composing frequency). The time-fractal arrangement could depend on the structural fractal of the His-Purkinje system of the heart and personally modify the HRV. The cancers gradually destroy the homeostatic harmony, starting locally and finishing systemically. The controlling activity of vagus-nerve changes the HRV or the power density spectrum of the signal fluctuations in malignant development, presenting an appropriate control of the cancerous processes. The modified spectrum by a non-invasive radiofrequency treatment could arrest the tumor growth. An appropriate modulation could support the homeostatic control and force reconstructing of the broken complexity.展开更多
Effective and safe electrical stimulation of the retinal ganglion cells is at the heart of retinal prosthesis design.However,the effectiveness and safety demand of the electrical stimulation is often at odds against e...Effective and safe electrical stimulation of the retinal ganglion cells is at the heart of retinal prosthesis design.However,the effectiveness and safety demand of the electrical stimulation is often at odds against each other.Besides,the nerve fiber layer above retinal ganglion cells limits the spatial resolution of stimulation.Also,current retinal prosthesis still cannot selectively activate the ON or OFF visual pathways,thus cannot relay the correct luminance information to the brain.With decades of development,the stimulation protocol for retinal implants began to tackle these problems.We believe that a novel design of electrical stimulation scheme,combined with gene therapy technique,can improve the selectivity and spatial resolution of retinal implants and further lower the damage caused by electric stimulation.展开更多
Intensive care units’ acquired muscle weakness is present in approximately 50% of the patients. Although active muscle training can attenuate weakness, a large proportion of critical patients cannot participate in an...Intensive care units’ acquired muscle weakness is present in approximately 50% of the patients. Although active muscle training can attenuate weakness, a large proportion of critical patients cannot participate in any active mobilization. Neuromuscular electrical stimulation may be an alternative strategy to reverse muscle weakness. The objective of the study was to review the scientific publications on the use of neuromuscular electrical stimulation and its parameters and the main results in patients hospitalized in intensive care units. This is an integrative review surveying studies in online databases. The studies were selected from the following descriptors: neuromuscular electrical stimulation AND parameters AND intensive care units AND muscle weakness. The inclusion criteria included articles that addressed the topic of neuromuscular electrical stimulation and the parameters used in patients admitted to intensive care units, aged 18 years or older. Exclusion criteria were studies involving animals, case reports, letters to the editor and book chapters. The search comprised articles in the Portuguese, English and Spanish languages from January 2013 to March 2019. Of the 185 articles identified, nine met the eligibility criteria. The studies were evaluated assessing the level of evidence, and the relevant information was presented in the table and discussed. The parameters of the neuromuscular electrical stimulation employed in the studies showed positive results for the maintenance of strength and muscle mass. There was evidence of benefits in the local and systemic microcirculation, potentially mobilizing endothelial stem cells, to prevent atrophy, to reduce mechanical ventilation time and stay in intensive care unit;and when incorporated into the usual physiotherapy care, proved to be more effective than usual care. Its use is safe and viable in critically ill patients.展开更多
Based on related elaboration of the Yellow Emperor’s Canon of Medicine, this article analyzed and summarized the clinical meaning, application principles and the basic operating methods of Traditional Acupuncture (TA...Based on related elaboration of the Yellow Emperor’s Canon of Medicine, this article analyzed and summarized the clinical meaning, application principles and the basic operating methods of Traditional Acupuncture (TA), and demonstrated that the TA is completely different to modern needle stimulation. TA has a specific application background, direct-viewing thinking mode and clear operational connotation. The key of operation in TA is how to grasp and control Qi, which typically reflect the unique image of the Chinese civilization with intuitive perceptual characteristics of thinking. In contrast, modern needle-stimulation uses needles as a stimulus, to activate a series of physical and functional reactions in a body. There have great differences between the two. It was indicated that correctly understanding with the basic principle and specific meaning of TA is very important in acupuncture clinical and research works.展开更多
文摘Objective:To analyze the effect of limb rehabilitation therapy combined with transcranial magnetic stimulation therapy on muscle activity in patients with upper limb dysfunction after cerebral infarction(CI).Methods:320 patients with upper limb dysfunction after CI were selected,all of whom were treated in our hospital between June 2021 and June 2023.They were randomly grouped according to the lottery method into the control group(limb rehabilitation therapy,160 cases)and the intervention group(transcranial magnetic stimulation therapy+limb rehabilitation therapy,160 cases).The upper limb function scores,neuro-electrophysiological indicators,daily living ability scores,and quality of life scores of the two groups were compared.Results:Compared with the control group,upper limb function scores and daily living ability scores in the intervention group were higher after treatment,and the neuro-electrophysiological indicators of the intervention group were lower after treatment(P<0.05).Conclusion:Transcranial magnetic stimulation therapy combined with limb rehabilitation therapy has significant effects in patients with upper limb dysfunction after CI and is worthy of promotion and application.
文摘Low-frequency repetitive transcranial magnetic stimulation(LF-r TMS) to the contralesional hemisphere and intensive occupational therapy(i OT) have been shown to contribute to a significant improvement in upper limb hemiparesis in patients with chronic stroke. However, the effect of the combined intervention program of LF-r TMS and i OT on cognitive function is unknown. We retrospectively investigated whether the combined treatment influence patient's Trail-Making Test part B(TMT-B) performance, which is a group of easy and inexpensive neuropsychological tests that evaluate several cognitive functions. Twenty-five patients received 11 sessions of LF-r TMS to the contralesional hemisphere and 2 sessions of i OT per day over 15 successive days. Patients with right- and left-sided hemiparesis demonstrated significant improvements in upper limb motor function following the combined intervention program. Only patients with right-sided hemiparesis exhibited improved TMT-B performance following the combined intervention program, and there was a significant negative correlation between Fugl-Meyer Assessment scale total score change and TMT-B performance. The results indicate the possibility that LF-r TMS to the contralesional hemisphere combined with i OT improves the upper limb motor function and cognitive function of patients with right-sided hemiparesis. However, further studies are necessary to elucidate the mechanism of improved cognitive function.
文摘Drug treatment, electric stimulation and decimeter wave therapy have been shown to promote the repair and regeneration of the peripheral nerves at the injured site. This study prepared a Mackinnon’s model of rat sciatic nerve compression. Electric stimulation was given immediately after neurolysis, and decimeter wave radiation was performed at 1 and 12 weeks post-operation. Histological observation revealed that intraoperative electric stimulation and decimeter wave therapy could improve the local blood circulation of repaired sites, alleviate hypoxia of compressed nerves, and lessen adhesion of compressed nerves, thereby decreasing the formation of new entrapments and enhancing compressed nerve regeneration through an improved microenvironment for regeneration. Immunohistochemical staining results revealed that intraoperative electric stimulation and decimeter wave could promote the expression of S-100 protein. Motor nerve conduction velocity and amplitude, the number and diameter of myelinated nerve fibers, and sciatic functional index were significantly increased in the treated rats. These results verified that intraoperative electric stimulation and decimeter wave therapy contributed to the regeneration and the recovery of the functions in the compressed nerves.
基金supported by the grant of Russian Science Foundation,No.16-15-00010(to RRI)supported by the Russian Government Program of Competitive Growth of Kazan Federal University。
文摘Despite emerging contemporary biotechnological methods such as gene-and stem cell-based therapy,there are no clinically established therapeutic strategies for neural regeneration after spinal cord injury.Our previous studies have demonstrated that transplantation of genetically engineered human umbilical cord blood mononuclear cells producing three recombinant therapeutic molecules,including vascular endothelial growth factor(VEGF),glial cell-line derived neurotrophic factor(GDNF),and neural cell adhesion molecule(NCAM)can improve morpho-functional recovery of injured spinal cord in rats and mini-pigs.To investigate the efficacy of human umbilical cord blood mononuclear cells-mediated triple-gene therapy combined with epidural electrical stimulation in the treatment of spinal cord injury,in this study,rats with moderate spinal cord contusion injury were intrathecally infused with human umbilical cord blood mononuclear cells expressing recombinant genes VEGF165,GDNF,NCAM1 at 4 hours after spinal cord injury.Three days after injury,epidural stimulations were given simultaneously above the lesion site at C5(to stimulate the cervical network related to forelimb functions)and below the lesion site at L2(to activate the central pattern generators)every other day for 4 weeks.Rats subjected to the combined treatment showed a limited functional improvement of the knee joint,high preservation of muscle fiber area in tibialis anterior muscle and increased H/M ratio in gastrocnemius muscle 30 days after spinal cord injury.However,beneficial cellular outcomes such as reduced apoptosis and increased sparing of the gray and white matters,and enhanced expression of heat shock and synaptic proteins were found in rats with spinal cord injury subjected to the combined epidural electrical stimulation with gene therapy.This study presents the first proof of principle study of combination of the multisite epidural electrical stimulation with ex vivo triple gene therapy(VEGF,GDNF and NCAM)for treatment of spinal cord injury in rat models.The animal protocols were approved by the Kazan State Medical University Animal Care and Use Committee(approval No.2.20.02.18)on February 20,2018.
文摘The concept of Network Centric Therapy represents an amalgamation of wearable and wireless inertial sensor systems and machine learning with access to a Cloud computing environment. The advent of Network Centric Therapy is highly relevant to the treatment of Parkinson’s disease through deep brain stimulation. Originally wearable and wireless systems for quantifying Parkinson’s disease involved the use a smartphone to quantify hand tremor. Although originally novel, the smartphone has notable issues as a wearable application for quantifying movement disorder tremor. The smartphone has evolved in a pathway that has made the smartphone progressively more cumbersome to mount about the dorsum of the hand. Furthermore, the smartphone utilizes an inertial sensor package that is not certified for medical analysis, and the trial data access a provisional Cloud computing environment through an email account. These concerns are resolved with the recent development of a conformal wearable and wireless inertial sensor system. This conformal wearable and wireless system mounts to the hand with the profile of a bandage by adhesive and accesses a secure Cloud computing environment through a segmented wireless connectivity strategy involving a smartphone and tablet. Additionally, the conformal wearable and wireless system is certified by the FDA of the United States of America for ascertaining medical grade inertial sensor data. These characteristics make the conformal wearable and wireless system uniquely suited for the quantification of Parkinson’s disease treatment through deep brain stimulation. Preliminary evaluation of the conformal wearable and wireless system is demonstrated through the differentiation of deep brain stimulation set to “On” and “Off” status. Based on the robustness of the acceleration signal, this signal was selected to quantify hand tremor for the prescribed deep brain stimulation settings. Machine learning classification using the Waikato Environment for Knowledge Analysis (WEKA) was applied using the multilayer perceptron neural network. The multilayer perceptron neural network achieved considerable classification accuracy for distinguishing between the deep brain stimulation system set to “On” and “Off” status through the quantified acceleration signal data obtained by this recently developed conformal wearable and wireless system. The research achievement establishes a progressive pathway to the future objective of achieving deep brain stimulation capabilities that promote closed-loop acquisition of configuration parameters that are uniquely optimized to the individual through extrinsic means of a highly conformal wearable and wireless inertial sensor system and machine learning with access to Cloud computing resources.
文摘Forty-eight cases with dysmenorrhoea were treated by nerve stimulation therapy.Of these 32 cases (66. 7%) were clinically cured, 3 (16.6%) remarkably improved, 5 (0. 4%)improved, the total effective rate was 93. 8%.
文摘Objective:To explore the treatment of Morita therapy combined with transcranial magnetic stimulation in postpartum depression of primipara and its effect on prolactin.Method:From May 2018 to November 2019,92 cases of postpartum depression and postpartum women who were treated in our hospital were randomly divided into 2 groups,46 cases each.The control group was treated with transcranial magnetic stimulator,and the observation group was treated with Morita therapy on the basis of the control group.Both groups were treated continuously for 6 weeks.The degree of depression and prolactin levels of the two groups was observed.Results:After 6 weeks of treatment,the HAMD scores of the two groups were lower than before the treatment,and the observation group was the lowest.The prolactin levels of the two groups were higher than before the treatment,and the observation group was the highest.The difference was statistically significant(P<0.05).Conclusion:Morita therapy combined with transcranial magnetic stimulation can effectively improve the postpartum depression of primiparas,increase the level of prolactin,and have a good clinical effect.
基金National Key Research and Development Program(2018YFC1314400)Key R&D plan of Heilongjiang Province(GA21C010)。
文摘Objective To observe the effects of repetitive transcranial magnetic stimulation(rTMS)and cognitive behavioral therapy(CBT)on cognitive function in alcohol-dependent patients.Methods Data from 285 alcohol-dependent patients were collected from Mudanjiang Medical University and Sun Yat-sen Memorial Hospital at Sun Yat-sen University between 2019 and 2021.The patients were divided into groups depending on alcohol abstinence and non-abstinence.There were 43 patients in the alcohol consumption(AC)group.The patients in the abstinence group were randomly assigned to treatment regimens with different combinations of rTMS and CBT using the Elton system.There were 49 patients in the TB+C0 group,36 in the TB+C1 group,44 in the TL+C0 group,36 in the TL+C1 group,37 in the TR+C0 group,and 40 in the TR+C1 group.Cognitive function was assessed by using the Montreal Cognitive Assessment Scale(MoCA).Results The proportion of patients with cognitive impairment in the AC group at 24 weeks was higher than that at baseline(P<0.05),whereas the proportion of cognitive impairment in the other groups did not differ significantly over time.The percentage of patients with cognitive impairment at 24 weeks was 52.3%in the TL+C0 group and 47.2%in the TL+C1 group,which was significantly lower than that in the AC group(P<0.05).MoCA scores at different time points in the AC group were significantly higher than those in the TB+C0,TL+C0,TL+C1,TR+C0,and TR+C1 groups,respectively.MoCA scores were significantly higher at 12 weeks compared with the baseline in the TB+C0,TL+C0,TL+C1,TR+C0,and TR+C1 groups(P<0.05),and similar changes were observed at 24 weeks.The MoCA scores in the TL+C1 and TL+C0 groups were higher than those in the TR+C0 group at 12 weeks after the intervention(P<0.05).Furthermore,MoCA scores in each of the TB+C1,TL+C1,TL+C0,TR+C1,and TR+C0 groups were higher than those in the AC group at 24 weeks(P<0.05).Conclusion Alcohol consumption impairs cognitive function,as evidenced by a significantly higher proportion of cognitive impairment after 24 weeks of non-abstinence.Most of the tested treatment regimens improved cognitive function.High frequency rTMS of the left dorsolateral prefrontal cortex(DLPFC)was associated with a greater improvement in cognitive function than that of the right DLPFC in alcohol-dependent patients at 12 weeks of abstinence.There does not appear to be a therapeutic advantage of CBT for cognitive impairment in alcohol-dependent patients.Screening for impaired cognitive function should be seriously considered for patients who engage in heavy drinking,and measures should be taken to reduce the risk of dementia induced by alcohol dependence.
基金supported by the National Natural Science Foundation of China,No.30973165,81372108a grant from Clinical Research 5010 Program Mission Statement of Sun Yat-Sen University,China,No.2014001
文摘Gait disorders drastically affect the quality of life of stroke survivors,making post-stroke rehabilitation an important research focus.Noninvasive brain stimulation has potential in facilitating neuroplasticity and improving post-stroke gait impairment.However,a large inter-individual variability in the response to noninvasive brain stimulation interventions has been increasingly recognized.We first review the neurophysiology of human gait and post-stroke neuroplasticity for gait recovery,and then discuss how noninvasive brain stimulation techniques could be utilized to enhance gait recovery.While post-stroke neuroplasticity for gait recovery is characterized by use-dependent plasticity,it evolves over time,is idiosyncratic,and may develop maladaptive elements.Furthermore,noninvasive brain stimulation has limited reach capability and is facilitative-only in nature.Therefore,we recommend that noninvasive brain stimulation be used adjunctively with rehabilitation training and other concurrent neuroplasticity facilitation techniques.Additionally,when noninvasive brain stimulation is applied for the rehabilitation of gait impairment in stroke survivors,stimulation montages should be customized according to the specific types of neuroplasticity found in each individual.This could be done using multiple mapping techniques.
文摘For decades visual field defects were considered irreversible because it was thought that in the visual system the regeneration potential of the neuronal tissues is low.Nevertheless,there is always some potential for partial recovery of the visual field defect that can be achieved through induction of neuroplasticity.Neuroplasticity refers to the ability of the brain to change its own functional architecture by modulating synaptic efficacy.It is maintained throughout life and just as neurological rehabilitation can improve motor coordination,visual field defects in glaucoma,diabetic retinopathy or optic neuropathy can be improved by inducing neuroplasticity.In ophthalmology many new treatment paradigms have been tested that can induce neuroplastic changes,including non-invasive alternating current stimulation.Treatment with alternating current stimulation(e.g.,30 minutes,daily for 10 days using transorbital electrodes and^10 Hz)activates the entire retina and parts of the brain.Electroencephalography and functional magnetic resonance imaging studies revealed local activation of the visual cortex,global reorganization of functional brain networks,and enhanced blood flow,which together activate neurons and their networks.The future of low vision is optimistic because vision loss is indeed,partially reversible.
文摘Objective: To investigate the application value of electrostimulation biofeedback therapy in combination with vaginal dumbbell therapy to postpartum pelvic floor dysfunction. Methods: Retrospective analysis of 200 cases of postpartum pelvic floor dysfunction patients discharged from the hospital from January 2016 to March 2019 as study subjects who were excluded other underlying diseases and were randomly divided into two groups of 100 cases per group, using electrostimulation biofeedback therapy combined vaginal dumbbell therapy as a treatment group. The treatment of electrostimulation biofeedback therapy in combination with kegel was treated as a control group. Then the curative effects of the two groups were compared and statistically analyzed. Results: There was no significant difference in EMG value of postpartum pelvic floor treatment, type I muscle strength, type II muscle strength, muscle type I fatigue, type II fatigue and POP-Q detection results between the two groups before treatment, p > 0.05. There were significant differences in type I muscle strength, type II muscle strength and muscle type I fatigue between the pelvic floor muscles and the muscles at the end of the treatment day, the sixth month and one year after treatment, p ?There was no statistically significant difference at?the end of muscle type II fatigue?treatment day, p > 0.05;while after the treatment of six months and one year, the difference was statistically significant, p 0.05. In addition, the treatment group and the control group were compared before and after treatment, the difference of myoelectric potential value, pelvic floor muscle type I muscle strength, type II muscle strength, muscle type I fatigue degree, type II fatigue degree and POP-Q test result were significant, and the changes in the indicators before and after treatment in the treatment group were significantly higher than the control group. Comparison of urinary incontinence between the two groups before and after treatment, the difference between pre-treatment and the end of treatment day was not statistically significant, p > 0.05;there was significant difference between half a year and one year after treatment (p 0.05, respectively). Comparing?the satisfaction with sexual life after the time of treatment day, half a year and one year after the end of treatment, the difference was statistically significant (p ?Conclusion: Electrical stimulation biofeedback therapy combined with vaginal dumbbell therapy has a good effect in the treatment of postpartum pelvic floor dysfunction, and it is worthy of popularization and application.
文摘AIM:To investigate normal value range of low-frequent repeated nerve stimulation(RNS):whether different low-frequent stimulation and different muscles have different normal value range.METHODS:Low-frequent (3c /s and 5c /s)RNS of 30healthy people and 27myasth enia gravis(MG)patients were test.RESULTS:Superior limit of amplitude of wave a ttenuation value of low-frequent RNS(x±2.5s)of different muscles(orbicularis oculi muscle,deltoid muscle and abductor muscle of little finger)of healthy people was 5.45%-7.55%.According to our normal value standard,RNS positive rate of MG group was 85%;according to the current criteria(amplitude of wave attenuation value >10%),positive rate of MG group was 70%,th ere was no apparent difference in RNS positive rate(P>0.1).Some labs adopted the criteria that amplitude of wave attenuation value >15%,ac-cording to this criteria,positive r ate of MG group was 51%.Compared with positive rate(85%)obtained according to our criteria,there was apparent difference(P<0.01).CONCLUSION:Each labs should establish their own normal value standard according to difference muscle and different f re-quent.If adopt universal standard,amplitude of wave attenuation value8%or 10%was suggested.
基金supported by the Lishui Science and Technology Plan Project(Grant Number:2022SJZC020)the Medical Health Science and Technology Project of the Zhejiang Provincial Health Commission(Grant Number:2020KY1084)
文摘Pain interventional therapy,known as the most promising medical technology in the 21st century,refers to clinical treatment technology based on neuroanatomy,neuroimaging,and nerve block technology to treat pain diseases.Compared with traditional destructive surgery,interventional pain therapy is considered a better and more economical choice of treatment.In recent years,a variety of minimally invasive pain interventional therapy techniques,such as neuroregulation,spinal cord electrical stimulation,intervertebral disc ablation,and intrasheath drug infusion systems,have provided effective solutions for the treatment of patients with post-herpetic neuralgia,complex regional pain syndrome,cervical/lumbar disc herniation,and refractory cancer pain.
文摘Post-concussion syndrome (PCS) is a complex disorder with various symptoms. There is limited evidence to support that any intervention enhances recovery after a concussion. This pilot study aimed to examine the efficacy of neck paraspinal muscles electrical stimulation (ES) in conjunction with physical therapy (PT) on reducing the severity of post concussive symptoms. Twenty-four individuals with PCS were randomly assigned to the ES group (PT + ES) or the control group (PT only). Both groups received the intervention twice a week for eight weeks. Clinical measures including the Concussion Signs/Symptoms Checklist, balance error scoring system, King-Devick test, ImPACT, and the Standardized Assessment of Concussion were used to evaluate the symptoms. We investigated the recovery rate by calculating slopes of changes over time for each participant. A changing slope was derived by linearly fitting the symptoms severity over time with the initial severity score as the intercept. Significant overall improvement was observed in both groups after the interventions. There was no significant difference seen in total symptom recovery rate between two groups (-1.49 ± 1.59 versus -1.2 ± 1.56, p = 0.32). The cognitive symptoms recovery rate of the ES group was faster than the control group (-0.5 ± 0.49 and -0.13 ± 0.46 respectively, p = 0.04). Physical therapy targeting the cervical region is beneficial for persons with PCS. Moreover, peripheral electrical stimulation on the paraspinal muscles surrounding the neck region could potentially advance the cognitive function recovery of persons with PCS.
基金Science and Technology Innovation Plan of Hunan,China,No.2018JJ2592Hunan Key Research and Development Program,No.2018SK2136.
文摘The efficacy of traditional treatment for post-traumatic stress disorder(PTSD)is still unsatisfactory.Repetitive transcranial magnetic stimulation(rTMS)has been widely used in the treatment of various types of mental disorders,including PTSD.Although rTMS has been demonstrated to be effective in many cases,there are still arguments regarding its mechanism and protocol.This review aims to summarize the origin,development,principle,and future direction of rTMS and introduce this neuro-stimulation therapy to relevant clinicians.
文摘Deep brain stimulation offers an advanced means of treating Parkinson’s disease in a patient specific context. However, a considerable challenge is the process of ascertaining an optimal parameter configuration. Imperative for the deep brain stimulation parameter optimization process is the quantification of response feedback. As a significant improvement to traditional ordinal scale techniques is the advent of wearable and wireless systems. Recently conformal wearable and wireless systems with a profile on the order of a bandage have been developed. Previous research endeavors have successfully differentiated between deep brain stimulation “On” and “Off” status through quantification using wearable and wireless inertial sensor systems. However, the opportunity exists to further evolve to an objectively quantified response to an assortment of parameter configurations, such as the variation of amplitude, for the deep brain stimulation system. Multiple deep brain stimulation amplitude settings are considered inclusive of “Off” status as a baseline, 1.0 mA, 2.5 mA, and 4.0 mA. The quantified response of this assortment of amplitude settings is acquired through a conformal wearable and wireless inertial sensor system and consolidated using Python software automation to a feature set amenable for machine learning. Five machine learning algorithms are evaluated: J48 decision tree, K-nearest neighbors, support vector machine, logistic regression, and random forest. The performance of these machine learning algorithms is established based on the classification accuracy to distinguish between the deep brain stimulation amplitude settings and the time to develop the machine learning model. The support vector machine achieves the greatest classification accuracy, which is the primary performance parameter, and <span style="font-family:Verdana;">K-nearest neighbors achieves considerable classification accuracy with minimal time to develop the machine learning model.</span>
文摘Healthy homeostasis is a principal driving force of the dynamic equilibrium of living organisms. The dynamical basis of homeostasis is the complex and interconnected feedback mechanisms, which are fundamentally governed by the nervous system, mainly the balance of the sympathetic and parasympathetic controlling actions. The balancing regulation is well presented in the heart’s sinus node and can be measured by the time-domain heart-rate variation (HRV) of its frequency domain to analyze the constitutional frequencies of the variation. This last is a fluctuation that shows 1/f time fractal arrangement (f is the composing frequency). The time-fractal arrangement could depend on the structural fractal of the His-Purkinje system of the heart and personally modify the HRV. The cancers gradually destroy the homeostatic harmony, starting locally and finishing systemically. The controlling activity of vagus-nerve changes the HRV or the power density spectrum of the signal fluctuations in malignant development, presenting an appropriate control of the cancerous processes. The modified spectrum by a non-invasive radiofrequency treatment could arrest the tumor growth. An appropriate modulation could support the homeostatic control and force reconstructing of the broken complexity.
基金This study was supported by National Key R&D Program of China(Grant No.2017YFC0111202)(Z Xu)National Natural Science Foundation of China(Grant No.31800871)(Z Xu)Shenzhen Science and Technology Research Program(Grant No.JCYJ20170818163342873)(Z Xu).
文摘Effective and safe electrical stimulation of the retinal ganglion cells is at the heart of retinal prosthesis design.However,the effectiveness and safety demand of the electrical stimulation is often at odds against each other.Besides,the nerve fiber layer above retinal ganglion cells limits the spatial resolution of stimulation.Also,current retinal prosthesis still cannot selectively activate the ON or OFF visual pathways,thus cannot relay the correct luminance information to the brain.With decades of development,the stimulation protocol for retinal implants began to tackle these problems.We believe that a novel design of electrical stimulation scheme,combined with gene therapy technique,can improve the selectivity and spatial resolution of retinal implants and further lower the damage caused by electric stimulation.
基金funded in part by the Coordination of Improvement of Higher Level Personnel—Brazil(CAPES)—Finance Code 001by the National Council of Scientific and Technological Development—Brazil(CNPq)—Doctorate GD
文摘Intensive care units’ acquired muscle weakness is present in approximately 50% of the patients. Although active muscle training can attenuate weakness, a large proportion of critical patients cannot participate in any active mobilization. Neuromuscular electrical stimulation may be an alternative strategy to reverse muscle weakness. The objective of the study was to review the scientific publications on the use of neuromuscular electrical stimulation and its parameters and the main results in patients hospitalized in intensive care units. This is an integrative review surveying studies in online databases. The studies were selected from the following descriptors: neuromuscular electrical stimulation AND parameters AND intensive care units AND muscle weakness. The inclusion criteria included articles that addressed the topic of neuromuscular electrical stimulation and the parameters used in patients admitted to intensive care units, aged 18 years or older. Exclusion criteria were studies involving animals, case reports, letters to the editor and book chapters. The search comprised articles in the Portuguese, English and Spanish languages from January 2013 to March 2019. Of the 185 articles identified, nine met the eligibility criteria. The studies were evaluated assessing the level of evidence, and the relevant information was presented in the table and discussed. The parameters of the neuromuscular electrical stimulation employed in the studies showed positive results for the maintenance of strength and muscle mass. There was evidence of benefits in the local and systemic microcirculation, potentially mobilizing endothelial stem cells, to prevent atrophy, to reduce mechanical ventilation time and stay in intensive care unit;and when incorporated into the usual physiotherapy care, proved to be more effective than usual care. Its use is safe and viable in critically ill patients.
文摘Based on related elaboration of the Yellow Emperor’s Canon of Medicine, this article analyzed and summarized the clinical meaning, application principles and the basic operating methods of Traditional Acupuncture (TA), and demonstrated that the TA is completely different to modern needle stimulation. TA has a specific application background, direct-viewing thinking mode and clear operational connotation. The key of operation in TA is how to grasp and control Qi, which typically reflect the unique image of the Chinese civilization with intuitive perceptual characteristics of thinking. In contrast, modern needle-stimulation uses needles as a stimulus, to activate a series of physical and functional reactions in a body. There have great differences between the two. It was indicated that correctly understanding with the basic principle and specific meaning of TA is very important in acupuncture clinical and research works.