Safety and effectiveness of electromyography-induced rehabilitation treatment after epidural electrical stimulation for spinal cord injury:study protocol for a prospective,randomized,controlled trial

Epidural electrical stimulation is a new treatment method for spinal cord injury(SCI).Its efficacy and safety have previously been reported.Rehabilitation treatment after epidural electrical stimulation is important to ensure and improve the postoperative efficacy of epidural electrical stimulation in patients with SCI.Considering that electromyography(EMG)-induced rehabilitation treatment can accurately match the muscle contraction of patients with SCI,we designed a study protocol for a prospective,randomized controlled trial.In this trial,on the premise of adjusting the spinal cord electrical stimulator to obtain the maximum EMG signal of the target muscle,patients with SCI receiving epidural electrical stimulation will undergo EMG-induced rehabilitation treatment.Recovery of muscle strength of key muscles,quality of life,safety and therapeutic effects will be monitored.Twenty patients with SCI who are scheduled to undergo epidural electrical stimulation in Shanghai Ruijin Rehabilitation Hospital will be randomly divided into two groups with 10 patients per group.The control group will receive conventional rehabilitation treatment.The EMG-induced rehabilitation group will receive EMG-induced rehabilitation treatment of the target muscles of the upper and lower limbs based on conventional rehabilitation treatment.After rehabilitation treatment,follow up for all patients will occur at 2 weeks and 1,3 and 6 months.The primary outcome measure of this trial will be evaluation of target muscle recovery using the Manual Muscle Testing grading scale.Secondary outcome measures will include modified Barthel Index scores,integrated EMG values,the visual analogue scale,Spinal Cord Independence Measure scores,and modified Ashworth scale scores.The safety indicator will be the incidence of adverse events.This trial will collect data regarding the therapeutic effects of EMG-induced rehabilitation in patients with SCI receiving epidural electrical stimulation for 6 months after rehabilitation treatment.Findings from this trial will help develop rehabilitation methods in patients with SCI after epidural electrical stimulation.This study protocol was approved by Ethics Committee of Shanghai Ruijin Rehabilitation Hospital(Approval No.RKIRB2022-12)on February 15,2022 and was registered with Chinese Clinical Trial Registry(registration number:ChiCTR2200061674;date:June 30,2022).Study protocol version:1.0.

Effect of low-frequency pulse percutaneous electric stimulation on peripheral nerve injuries at different sites

BACKGROUND： The postoperative recovery of nerve function in patients with peripheral nerve injury is always an important problem to solve after treatment. The electric stimulation induced electromagnetic field can nourish nerve, postpone muscular atrophy, and help the postoperative neuromuscular function. OBJECTIVE： To observe the effects of low-frequency pulse percutaneous electric stimulation on the functional recovery of postoperative patients with peripheral nerve injury, and quantitatively evaluate the results of electromyogram （EMG） examination before and after treatment. DESIGN ： A retrospective case analysis SETTING： The Sixth People＇s Hospital affiliated to Shanghai Jiaotong University PARTICIPANTS： Nineteen postoperative inpatients with peripheral nerve injury were selected from the De- partment of Orthopaedics, the Sixth People＇s Hospital affiliated to Shanghai Jiaotong University from June 2005 to January 2006, including 13 males and 6 females aged 24-62 years with an average of 36 years old. There were 3 cases of brachial plexus nerve injury, 3 of median nerve injury, 7 of radial nerve injury, 3 of ul- nar nerve injury and 3 of common peroneal nerve injury, and all the patients received probing nerve fiber restoration. Their main preoperative manifestations were dennervation, pain in limbs, motor and sensory disturbances. All the 19 patients were informed with the therapeutic program and items for evaluation. METHODS： ① Low-frequency pulse percutaneous electric stimulation apparatus： The patients were given electric stimulation with the TERESA cantata instrument （TERESA-0, Shanghai Teresa Health Technology, Co., Ltd.）. The patients were stimulated with symmetric square waves of 1-111 Hz, and the intensity was 1.2-5.0 mA, and it was gradually adjusted according to the recovered conditions of neural regeneration following the principle that the intensity was strong enough and the patients felt no obvious upset. They were treated for 4- 24 weeks, 10-30 minutes for each time, 1-3 times a day, and 6 weeks as a course. ② EMG examination was applied to evaluate the recoveries of recruitment, motor conduction velocity （MCV） and sensory conduction velocity （SCV） before and after treatment. The patients were examined with the EMG apparatus （DIS- A2000C, Danmark） before and after the treatment of percutaneous electric stimulation. ③Standards for evaluating the effects included cured （complete recovery of motor functions, muscle strength of grade 5, no abnormality in EMG examination）, obviously effective [general recovery of motor function, muscle strength of grade 4, no or a few denervation potentials, motor conduction velocity （MCV） and sensory conduction velocity （SCV）], improved （partial recovery of motor function, muscle strength of grade 3, denervation potentials and reinneration potentials, slowed MCV and SCV, invalid （no obvious changes of motor function）. MAIN OUTCOME MEASURES： ① Ameliorated degree of the nerve function of the postoperative patients with peripheral nerve injury treated with percutaneous electric stimulation; ② Changes of EMG examination before and after treatment. RESULTS： All the 19 postoperative patients with peripheral nerve injury were involved in the analysis of results. ① Comparison of nerve function before and after treatment in 19 patients with peripheral nerve injury of different sites： For the patients with radial nerve injury （n=7）, the nerve functions all completely recovered after 8-week treatment, and the cured and obvious rate was 100% （7/7）; For the patients with brachial plexus nerve injury （n=3）, 1 case had no obvious improvement, and the cured and obvious rate was 67% （2/3）; For the patients with common peroneal nerve injury （n=3）, the extension of foot dorsum generally recovered in 1 case of nerve contusion after 4-week treatment, and the cured and obvious rate was 67% （2/3）; For the patients with median nerve injury （n=3）, muscle strength was obviously recovered, and the cured and obvious rate was 100% （3/3）; For the patients with ulnar nerve injury （n=3）, 1 case only had recovery of partial senses, and the cured and obvious rate was 67% （2/3）. Totally 9 cases were cured, 7 were obviously effective, 1 was improved, and only 2 were invalid. After 4 courses, the cured rate of damaged nerve function after four courses was 47% （9/19）, and effective rate was 89% （17/19）.② Comparison of EMG examination before and after treatment： Before and after percutaneous electric stimulation, he effective rates of recruitment, MCV and SCV were 89% （17/19）, 58% （11/19）, 47% （9/19） respectively, and there were extremely obvious differences （P〈 0.01）. CONCLUSION： ①Low-frequency pulse percutaneous electric stimulation can improve the nerve function of postoperative patients with peripheral nerve injury of different sites, especially that the injuries of radial nerve and median nerve recover more obviously. ②Percutaneous electric stimulation can ameliorate the indexes of EMG examination, especially the recruitment, in postoperative patients with peripheral nerve injury.

GDNF to the rescue:GDNF delivery effects on motor neurons and nerves,and muscle re-innervation after peripheral nerve injuries

Peripheral nerve injuries commonly occur due to trauma,like a traffic accident.Peripheral nerves get severed,causing motor neuron death and potential muscle atrophy.The current golden standard to treat peripheral nerve lesions,especially lesions with large(≥3 cm)nerve gaps,is the use of a nerve autograft or reimplantation in cases where nerve root avulsions occur.If not tended early,degeneration of motor neurons and loss of axon regeneration can occur,leading to loss of function.Although surgical procedures exist,patients often do not fully recover,and quality of life deteriorates.Peripheral nerves have limited regeneration,and it is usually mediated by Schwann cells and neurotrophic factors,like glial cell line-derived neurotrophic factor,as seen in Wallerian degeneration.Glial cell line-derived neurotrophic factor is a neurotrophic factor known to promote motor neuron survival and neurite outgrowth.Glial cell line-derived neurotrophic factor is upregulated in different forms of nerve injuries like axotomy,sciatic nerve crush,and compression,thus creating great interest to explore this protein as a potential treatment for peripheral nerve injuries.Exogenous glial cell line-derived neurotrophic factor has shown positive effects in regeneration and functional recovery when applied in experimental models of peripheral nerve injuries.In this review,we discuss the mechanism of repair provided by Schwann cells and upregulation of glial cell line-derived neurotrophic factor,the latest findings on the effects of glial cell line-derived neurotrophic factor in different types of peripheral nerve injuries,delivery systems,and complementary treatments(electrical muscle stimulation and exercise).Understanding and overcoming the challenges of proper timing and glial cell line-derived neurotrophic factor delivery is paramount to creating novel treatments to tend to peripheral nerve injuries to improve patients'quality of life.

Early electrical field stimulation prevents the loss of spinal cord anterior horn motoneurons and muscle atrophy following spinal cord injury

Our previous study revealed that early application of electrical field stimulation（EFS） with the anode at the lesion and the cathode distal to the lesion reduced injury potential, inhibited secondary injury and was neuroprotective in the dorsal corticospinal tract after spinal cord injury（SCI）. The objective of this study was to further evaluate the effect of EFS on protection of anterior horn motoneurons and their target musculature after SCI and its mechanism. Rats were randomized into three equal groups. The EFS group received EFS for 30 minutes immediately after injury at T_（10）. SCI group rats were only subjected to SCI and sham group rats were only subjected to laminectomy. Luxol fast blue staining demonstrated that spinal cord tissue in the injury center was better protected; cross-sectional area and perimeter of injured tissue were significantly smaller in the EFS group than in the SCI group. Immunofluorescence and transmission electron microscopy showed that the number of spinal cord anterior horn motoneurons was greater and the number of abnormal neurons reduced in the EFS group compared with the SCI group. Wet weight and cross-sectional area of vastus lateralis muscles were smaller in the SCI group to in the sham group. However, EFS improved muscle atrophy and behavioral examination showed that EFS significantly increased the angle in the inclined plane test and Tarlov＇s motor grading score. The above results confirm that early EFS can effectively impede spinal cord anterior horn motoneuron loss, promote motor function recovery and reduce muscle atrophy in rats after SCI.

电针联合功能性电刺激在促进不完全性脊髓损伤患者下肢运动功能中的应用

目的:观察电针联合功能性电刺激在不完全性脊髓损伤中的应用效果。方法:将90例不完全性脊髓损伤患者随机分为对照组(n=45)与观察组(n=45),对照组采用功能性电刺激治疗,观察组联合电针治疗。观察2组肌力、下肢运动评分、下肢感觉评分、脊髓损伤步行指数Ⅱ(WISCIⅡ)、改良Ashworth量表(MAS)等级、步态参数、临床疗效及治疗安全性。结果:观察组总有效率高于对照组(P<0.05);治疗后,观察组肌力、下肢运动评分、下肢感觉评分、WISCIⅡ、MAS等级、步态参数均优于对照组(均P<0.05)。2组均未发生严重不良事件。结论:电针联合功能性电刺激治疗不完全性脊髓损伤疗效显著,能够促进下肢运动功能恢复。

盆底肌肉锻炼联合仿生物电刺激用于阴道分娩产妇产后盆底功能康复效果

目的:探讨盆底肌肉锻炼(PFME)联合仿生物电刺激(BES)对阴道分娩产妇产后盆底肌功能康复效果。方法:回顾性分析2021年12月-2023年12月本院阴道分娩产后盆底功能障碍患者102例临床资料。根据治疗方案的不同分组,采用PFME治疗者纳入对照组(n=53),采用PFME联合BES治疗者纳入观察组(n=49)。两组均于产后42~50d开始治疗,持续治疗1个月。比较两组治疗前后盆底肌肌力(Oxford压力手测法)、肌电波幅、疲乏程度(盆底肌电变异系数)、超声参数(膀胱颈活动度、尿道旋转角度)。结果:治疗后,两组盆底肌各参数指标均得到改善,且观察组盆底肌肌力(3.37±1.02)和电位活动值均高于对照组(2.98±0.88),盆底肌疲乏度、膀胱颈活动度(12.47±3.34 mm)、尿道旋转角度(25.65±6.90)°均低于对照组[14.39±3.70 mm、(29.26±7.21)°](均P<0.05)。结论:PFME联合BES可更有效恢复阴道分明产妇产后盆底肌收缩功能,增强盆底肌张力并改善疲乏度,纠正膀胱颈及尿道结构,从而减轻盆底肌障碍。

电针八髎穴联合盆底肌电刺激对脊髓损伤后尿失禁病人排尿情况、尿流动力学及生活质量的影响

目的探讨电针八髎穴联合盆底肌电刺激对脊髓损伤后尿失禁病人排尿情况、尿流动力学及生活质量的影响。方法选择2020年2月至2022年5月在河北省沧州中西医结合医院治疗的94例脊髓损伤后尿失禁病人,按其入院时间列出1~94个号码,通过电子计算机自动逐一摇出两组号码:电刺激组(n=47,盆底肌电刺激治疗)、联合组(n=47,在电刺激组基础上实施电针八髎穴治疗),均进行6周治疗。比较两组排尿情况、尿流动力学指标及生活质量。结果治疗6周后,两组日排尿次数、日尿失禁次数均少于治疗前(P<0.05),联合组日排尿次数、日尿失禁次数分别为(5.72±1.81)次、(3.85±1.23)次,均明显少于电刺激组的(8.21±2.75)次、(5.23±1.87)次(P<0.05);两组最大逼尿肌压力(MDP)、残余尿量均小于治疗前(P<0.05),联合组MDP、残余尿量分别为(6.75±5.29)cmH_(2)O、(66.52±22.40)mL,均明显小于电刺激组的(54.80±6.13)cmH_(2)O、(87.56±26.71)mL(P<0.05);两组单次排尿量、最大尿流率(Q_(max))均大于治疗前(P<0.05),联合组单次排尿量、Q_(max)分别为(257.49±48.60)mL、(17.82±4.11)mL/s,均明显大于电刺激组的(207.33±46.85)mL、(14.56±3.89)mL/s(P<0.05);两组尿失禁生活质量问卷(I-QOL)各维度评分及总分均高于治疗前(P<0.05),且联合组均明显较电刺激组高(P<0.05)。结论对脊髓损伤后尿失禁病人实施电针八髎穴联合盆底肌电刺激治疗,可有效改善尿流动力学及排尿情况,显著提高生活质量。

低频经颅电刺激联合肌力训练对脑卒中后偏瘫患者临床疗效的影响

目的:分析低频经颅电刺激联合肌力训练对脑卒中后偏瘫患者临床疗效的影响.方法:选取2020年1月至2022年7月在本院就诊的88例脑卒中后偏瘫患者作为研究对象.按治疗方法不同将其分为观察组(n=45,低频经颅电刺激+肌力训练)和对照组组(n=43,肌力训练).比较两组临床疗效、肢体功能及脑血流.结果:治疗后,观察组总有效率为97.78%(44/45),高于对照组的总有效率86.05%(37/43),差异有统计学意义(P<0.05);观察组上、下肢Fugl-Meyer运动评分高于对照组,差异有统计学意义(P<0.05);观察组大脑前动脉、中动脉、后动脉平均血流速度均高于对照组,差异均有统计学意义(P<0.05).结论:低频经颅电刺激联合肌力训练治疗脑卒中后偏瘫患者疗效更佳,值得推广应用.

Satellite cell proliferation and myofiber cross-section area increase after electrical stimulation following sciatic nerve crush injury in rats

Background:Electrical stimulation has been recommended as an effective therapy to prevent muscle atrophy after nerve injury.However,the effect of electrical stimulation on the proliferation of satellite cells in denervated muscles has not yet been fully elucidated.This study was aimed to evaluate the changes in satellite cell proliferation after electrical stimulation in nerve injury and to determine whether these changes are related to the restoration of myofiber cross-section area(CSA).Methods:Sciatic nerve crush injury was performed in 48 male Sprague-Dawley rats.In half(24/48)of the rats,the gastrocnemius was electrically stimulated transcutaneously on a daily basis after injury,while the other half were not stimulated.Another group of 24 male Sprague-Dawley rats were used as sham operation controls without injury or stimulation.The rats were euthanized 2,4,and 6 weeks later.After 5-bromo-2’-deoxyuridine(BrdU)labeling,the gastrocnemia were harvested for the detection of paired box protein 7(Pax7),BrdU,myofiber CSA,and myonuclei number per fiber.All data were analyzed using two-way analysis of variance and Bonferroni post-hoc test.Results:The percentages of Pax7-positive nuclei(10.81±0.56%)and BrdU-positive nuclei(34.29±3.87%)in stimulated muscles were significantly higher compared to those in non-stimulated muscles(2.58±0.33%and 1.30±0.09%,respectively,Bonferroni t=15.91 and 18.14,P<0.05).The numbers of myonuclei per fiber(2.19±0.24)and myofiber CSA(1906.86±116.51 mm2)were also increased in the stimulated muscles(Bonferroni t=3.57 and 2.73,P<0.05),and both were positively correlated with the Pax7-positive satellite cell content(R2=0.52 and 0.60,P<0.01).There was no significant difference in the ratio of myofiber CSA/myonuclei number per fiber among the three groups.Conclusions:Our results indicate that satellite cell proliferation is promoted by electrical stimulation after nerve injury,which may be correlated with an increase in myonuclei number and myofiber CSA.

脑循环电刺激结合口肌训练治疗语言发育迟缓患儿的临床效果

目的分析脑循环电刺激结合口肌训练治疗语言发育迟缓患儿的临床效果。方法90例语言发育迟缓患儿根据治疗方式的不同分为两组各45例,对照组行口肌训练治疗,观察组行脑循环电刺激结合口肌训练治疗,比较两组的临床疗效及语言发育水平。结果观察组的治疗总有效率为97.78%,显著高于对照组的80.00%(P<0.05)。治疗后,两组的Gese Ⅱ量表各维度评分均显著高于治疗前,且观察组的GeseⅡ量表各维度评分均显著高于对照组(P<0.05)。结论脑循环电刺激结合口肌训练治疗语言发育迟缓患儿效果显著,能有效提升患儿的语言发育水平。

盆底肌康复训练联合电刺激生物反馈治疗产后压力性尿失禁的效果

目的探讨盆底肌康复训练联合电刺激生物反馈治疗产后压力性尿失禁的效果。方法选择2021年10月至2022年10月鱼台县妇幼保健计划生育服务中心收治的78例产后压力性尿失禁患者为研究对象,按照随机数字表法分为观察组、对照组,每组各39例。对照组给予盆底肌康复训练,观察组给予盆底肌康复训练联合电刺激生物反馈,比较两组盆底肌功能、排尿情况、性生活质量。结果观察组治疗4周、8周后盆底肌功能优于对照组(P<0.05)。观察组排尿情况优于对照组(P<0.05)。观察组性交痛评分低于对照组,其他指标评分高于对照组(P<0.05)。结论盆底肌康复训练联合电刺激生物反馈治疗产后压力性尿失禁,能有效恢复盆底肌功能,改善排尿情况及性生活质量。

脉冲电联合康复器对脑卒中吞咽障碍的影响

目的:探讨脉冲电刺激联合舌肌康复器对脑卒中吞咽障碍患者的影响。方法:选取2019年5月—2022年5月收治的脑卒中后吞咽障碍患者90例,按入院先后顺序分为观察组和对照组,每组45例。对照组使用常规康复训练,观察组在对照组的基础上给予脉冲电刺激联合舌肌康复器治疗。比较两组患者治疗前后吞咽功能、表面肌电图(sEMG)、舌骨喉活动度及临床疗效。结果:治疗后,观察组吞咽造影检查(VFSS)总分、表面肌电图的最大波幅值、舌骨上移和前移距离及甲状软骨上移和前移距离均显著高于对照组;观察组洼田饮水试验分数、吞咽时程均明显低于对照组,差异均有统计学意义(P<0.05)。结论:脉冲电刺激联合舌肌康复器可升高脑卒中吞咽障碍患者sEMG的最大波幅值,缩短吞咽时程,改善舌骨喉活动度,促进吞咽功能的恢复。

功能性电刺激联合神经肌肉激活技术训练对外伤性脊髓损伤肌肉和神经康复的影响

目的 探讨功能性电刺激联合神经肌肉激活技术训练对靶向肌肉神经重建术后外伤性脊髓损伤患者肌肉和神经康复的影响。方法 前瞻性选取2020年7月至2022年6月在青岛市中医医院接受靶向肌肉神经重建术治疗的76例外伤性脊髓损伤患者作为研究对象,按照随机数字表法将其分为对照组和观察组,各38例。对照组患者在术后进行功能性电刺激治疗,观察组接受功能性电刺激联合神经肌肉激活技术训练。分别在治疗前和治疗后3个月时评价患者美国脊柱损伤协会(ASIA)脊柱神经等级、肌肉功能和肌肉表面肌电信号、改良Barthel指数量表(MBI)、功能独立性量表(FIM)以及血清高迁移率族蛋白1(HMGB1)、半乳糖凝集素-3(galectin-3)和转化生长因子-β1(TGF-β1)水平。结果 治疗后,两组患者ASIA分级显著提高,ASIA评分显著增加,且观察组患者ASIA分级显著优于对照组,ASIA评分显著高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者伸肌群、屈肌群峰力矩和力矩加速能以及腘绳肌与股四头肌肌力比值均显著高于治疗前,且观察组患者伸肌群、屈肌群峰力矩和力矩加速能以及腘绳肌与股四头肌肌力比值均显著高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者腓肠肌、股二头肌、肱四头肌、胫前肌表面肌电信号均显著增强,且观察组患者显著高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组MBI和FIM量表评分显著提高,且观察组MBI和FIM量表评分均显著高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者血清HMGB1、galectin-3和TGF-β1水平均较治疗前显著降低,且观察组患者各指标均显著低于对照组,差异均有统计学意义(P<0.05)。结论 功能性电刺激联合神经肌肉激活技术训练能够显著改善外伤性脊髓损伤患者在肌肉神经重建术后的肌肉和神经功能,提高生活自理能力和运动功能。

盆底肌锻炼配合电刺激治疗对子宫脱垂患者临床疗效及性生活质量的影响

目的探讨盆底肌锻炼配合电刺激治疗对子宫脱垂患者临床疗效及性生活质量的影响。方法选取86例子宫脱垂患者,根据患者入院时间分组,2022年1~6月43例作为对照组,患者实施盆底肌锻炼干预;将2022年7~12月43例患者作为观察组,患者实施盆底肌锻炼配合电刺激治疗。比较两组患者临床疗效、性生活质量。结果观察组患者总有效率为97.7%,对照组患者总有效率为86.0%,观察组患者总有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者性生活满意度和性高潮评分比较,差异无统计学意义(P>0.05);治疗后3个月、6个月后,两组患者性生活满意度和性高潮评分均高于治疗前,差异有统计学意义(P<0.05)。且治疗后3个月、6个月后,观察组患者的性生活满意度和性高潮评分均高于对照组,差异有统计学意义(P<0.05)。结论子宫脱垂患者采用盆底肌锻炼联合电刺激治疗,可提高患者临床疗效,提升性生活质量,值得临床推广与应用。

电刺激生物反馈对盆底功能障碍患者的效果评估

目的探讨电刺激生物反馈对轻中度女性盆底功能障碍(FPFD)患者的临床疗效。方法于2017年1月至2018年6月,选取在南方医科大学附属中山市博爱医院就诊的轻中度FPFD患者为病例来源,按入院先后,将86例FPFD患者作为观察组,根据盆底功能、尿失禁和子宫脱垂构成比和程度1∶1匹配另外FPFD患者86例作为对照组,观察组实施电刺激生物反馈联合盆底肌肉功能锻炼治疗,对照组进行盆底肌肉功能锻炼治疗,治疗6个月后,分析和比较两组患者盆底肌力、盆底功能指标、子宫脱垂、尿失禁、生命质量及性生活质量的改善情况。结果在盆底肌力(Ⅱ级~Ⅴ级)、盆底功能指标(最大收缩力、持续收缩力、协调能力、静息状态肌电值和最大尿流率)、子宫脱垂和尿失禁方面,观察组恢复情况均明显优于对照组,差异均有统计学意义(χ^2/t值分别为7.910、7.603、4.233、6.888、3.982、4.251、5.499、6.717、6.988、6.540、4.912,均P<0.05);在性生活及生命质量方面,观察组也较对照组有显著改善,差异均有统计学意义(t值分别为3.769、2.682,均P<0.05)。结论电刺激生物反馈联合盆底肌肉功能锻炼能有效促进轻中度FPFD患者康复,改善患者性生活及生命质量,值得临床推广应用。

电刺激盆底肌结合主动训练治疗不完全性脊髓损伤后排尿功能障碍

目的:探讨电刺激结合盆底肌训练对脊髓损伤后排尿功能障碍的影响。方法:不完全性脊髓损伤患者8例,治疗时将刺激电极置于患者直肠内,刺激频率20Hz,每次治疗30min;同时配合盆底肌主动训练,每次收缩和放松各5s,反复10遍为1次,休息3～5min,连续2次。治疗前和治疗结束后,记录24h排尿次数、溢尿次数、单次排尿量、残余尿量、对日常生活的影响及尿动力学检查。结果:连续治疗2个月后,8例患者排尿功能均有不同程度改善,单次排尿量及最大尿流率增加,残余尿减少,对日常生活的影响减小。结论:电刺激结合盆底肌主动训练可改善不完全性脊髓损伤患者的排尿功能,提高日常生活的质量。

神经肌肉电刺激辅助治疗脊髓损伤神经源性膀胱的临床探析

目的探讨神经肌肉电刺激辅助治疗脊髓损伤神经源性膀胱(NB)的临床疗效。方法将72例脊髓损伤NB患者随机分为电刺激组和常规组各36例。常规组仅接受康复治疗结合膀胱训练等常规治疗,观察组在常规组治疗基础上辅助接受神经肌肉电刺激治疗。比较两组治疗后的总有效率、24 h排尿次数、每次排尿量、残余尿量以及神经功能评分(ASIA评分)。结果治疗后观察组的总有效率、24 h排尿次数、每次排尿量、残余尿量方面均优于常规组[分别为97.2%vs.55.6%,(5.1±1.2)次vs(8.3±2.2)次,(189.9±11.4)ml vs(145.3±10.8)ml,(90.2±2.4)ml vs(110.1±3.3)ml,均为P<0.05]。两组的ASIA评分比较差异无统计学意义(P>0.05)。两组均无发生明显不良反应。结论神经肌肉电刺激辅助治疗能明显改善脊髓损伤NB患者临床症状,有利于患者康复,是一种治疗NB的好的辅助疗法。

经皮神经肌电刺激治疗周围神经损伤的探讨

目的 探讨经皮神经肌电刺激促进周围神经再生的临床价值。方法 采用丹迪Cantata型肌电图仪对 78例周围神经损伤患者 ,进行经皮神经肌电刺激治疗 ,观察受损神经功能恢复情况并做治疗前后肌电图对比分析。结果 本组 78例臂丛神经、坐骨神经不全损伤者 ,经 1- 10个疗程的治疗 ,受损神经功能恢复治愈率达6 7.9% ,有效率达 91%。结论 经皮神经肌电刺激治疗 ,可促进周围神经的再生 ,改善受损神经局部血液循环 ,缓解或消除疼痛 ,提高神经肌的兴奋性 。

电刺激方法治疗肌肉损伤的应用观察

本文采用我院研制的“T90-1型电脑电刺激肌肉力量训练仪”先后在国家举重队、女子竞走队、田径队及第四军医大学等进行了应用观察。结果表明,该方法对大强度运动过程中的肌肉疼痛,以及拉伤后的硬结具有显著效果。

平滑肌电刺激对重度盆腔子宫内膜异位症术后肠功能恢复的疗效

目的观察平滑肌电刺激对促进重度盆腔子宫内膜异位症术后肠道功能恢复的疗效。方法选择重度盆腔子宫内膜异位症术后患者150例,分为观察组及对照组各75例。2组患者均记录肠粘连的程度及部位,并于术后24 h开始腰腹部皮肤仿生物电刺激,观察组选择平滑肌电刺激模式,对照组使用传统横纹肌电刺激模式。对比两组患者术后规律肠鸣音出现、排气、排便、耐受普食的时间及腹胀情况。结果观察组术后出现规律肠鸣音的时间、首次排气时间及首次耐受普食无不适的时间均早于对照组(P<0.05),观察组腹胀持续时间短于对照组(P<0.05)。所有患者均未出现肠梗阻、电刺激不良反应及出血等不良事件。结论平滑肌电刺激对重度盆腔子宫内膜异位症患者术后肠道功能恢复治疗效果优于横纹肌电刺激模式。