Objective To systematically evaluate the orthotic effect of functional electrical stimulation (FES) on the improvement of walking in stroke patients with foot drop. Methods The randomized controlled trials (RCTs) that investigated the orthotic effect of FES on walking in stroke patients with foot drop were electronically searched in the databases such as PubMed, Web of Science, The Cochrane Library (Issue 1, 2013), EMbase, CBM, CNKI, VIP and WanFang Data from January 2000 to January 2013, and the relevant references of included papers were also manually searched. Two reviewers independently screened the trials according to the inclusion and exclusion criteria, extracted the data, and assessed the methodology quality. The meta-analyses were performed using RevMan 5.1 software. Results A total of 8 RCTs involving 255 patients were included. The results of meta-analyses on 4 RCTs showed that, compared with the conventional rehabilitation intervention, the functional electrical stimulation could significantly improve the walking speed, with significant difference (MD=0.09, 95%CI 0.00 to 0.18, P=0.04). The other indicators were only descriptively analyzed due to the incomplete data. Conclusions Functional electrical stimulation is effective in improving walking speed, but it is uncertain of other therapeutic indicators. So it should be further proved by conducting more high quality, large sample and multi-center RCTs.
Objective To review researches of treatment of peripheral nerve injury with neuromuscular electrical stimulation (NMES) regarding mechanism, parameters, and cl inical appl ication at home and abroad. Methods The latest original l iterature concerning treatment of peri pheral nerve injury with NMES was extensively reviewed. Results NMES should be used under individual parameters and proper mode of stimulation at early stage of injury. It could promote nerve regeneration and prevent muscle atrophy. Conclusion NMES plays an important role in cl inical appl ication of treating peripheral nerve injury, and implantable stimulation will be the future.
The rectus femoris muscles of rabbits were used as muscle model. The electrical stimulation which resembled the normal motor-unit activity was used to observe its effects on free transferred muscle. After three months, the moist muscle weight (MW), its maximum cross-section area, its contractility and its histochemical characteristics were examined. The results showed that the function and morphology of the muscles were well preserved. These findings might encourage its clinical application.
A realizaton project of electrical stimulator aimed at motor dysfunction of stroke is proposed in this paper. Based on neurophysiological biofeedback, this system, using an ARM9 S3C2440 as the core processor, integrates collection and display of surface electromyography (sEMG) signal, as well as neuromuscular electrical stimulation (NMES) into one system. By embedding Linux system, the project is able to use Qt/Embedded as a graphical interface design tool to accomplish the design of stroke rehabilitation apparatus. Experiments showed that this system worked well.
An automatic control system was designed to suppress pathological tremor on wrist joint with two degrees of freedom (DoF) using functional electrical stimulation (FES). The tremor occurring in the wrist flexion-extension and adduction-abduction was expected to be suppressed. A musculoskeletal model of wrist joint was developed to serve as the control plant, which covered four main muscles (extensor carpi radialis longus, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris). A second-order mechanical impedance model was used to describe the wrist skeletal dynamics. The core work was to design the controller and a hybrid control strategy was proposed, which combined inverse model based on feed forward control and linear quadratic regulator (LQR) optimal control. Performance of the system was tested under different input conditions (step signal, sinusoidal signal, and real data of a patient). The results indicated that the proposed hybrid controller could attenuate over 94% of the tremor amplitude on multi-DoF wrist joint.
In order to investigate the effect of deep brain stimulation on diseases such as epilepsy, we developed a closed-loop electrical stimulation system using LabVIEW virtual instrument environment and NI data acquisition card. The system was used to detect electrical signals of epileptic seizures automatically and to generate electrical stimuli. We designed a novel automatic detection algorithm of epileptic seizures by combining three features of field potentials: the amplitude, slope and coastline index. Experimental results of rat epileptic model in the hippocampal region showed that the system was able to detect epileptic seizures with an accuracy rate 91.3% and false rate 8.0%. Furthermore, the on-line high frequency electrical stimuli showed a suppression effect on seizures. In addition, the system was adaptive and flexible with multiple work modes, such as automatic and manual modes. Moreover, the simple time-domain algorithm of seizure detection guaranteed the real-time feature of the system and provided an easy-to-use equipment for the experiment researches of epilepsy control by electrical stimulation.
Bone marrow-derived mesenchymal stem cells (BMSCs) for repairing damaged heart tissue are a new kind of important treatment options because of their potential to differentiate into cardiomyocytes. We in this experiment investigated the effect of different electrical stimulation time on the expression of myocardial specificity gene and protein in rat bone marrow mesenchymal stem cells (rBMSCs) in vitro. The rBMSCs of second or third generation were randomly divided into three groups, i.e. electrical stimulation (ES) group, 5-Azacytidine (5-Aza) group and the control group. The rBMSCs in the ES groups with complete medium were exposed to 2 V, 2 Hz, 5 ms electrical stimulation for 0.5 h, 2 h, 4 h, and 6 h respectively every day for 10 days. Those in the 5-Aza group were induced by 5-Aza (10 μmol/L) for 24 h, and then cultured with complete medium for 10 days. Those in the control group were only cultured with complete medium, without any treatment, for 10 days. The rBMSCs' morphological feature in each group was observed with inverted phase microscope. The mRNA expression of myocyte-specific enhancer factor 2C (MEF-2C) and connexin 43 (Cx43) were examined with Real-Time quantitative PCR and the protein expression of MEF-2C, Cx43 were detected with Western Blot method. The results showed that the mRNA expression level of the MEF-2C, Cx43 and the protein expression level of MEF-2C, Cx43 were significantly higher in the ES group and 5-Aza group than those in the relative control group (P < 0.05). It suggests that electrical stimulation could play a part of role in the induction of the rBMSCs to differentiate into the cariomyocyte-like cells in vitro and the effectiveness of the electrical stimulation with 2 h/d had the best in our experiement. But the mechanism how electrical stimulation promotes the differentiation of rBMSC into cardiomyocyte is still unclear.
Objective To explore the effect of short-term low-frequency electrical stimulation (SLES) during operation on nerve regeneration in delayed peripheral nerve injury with long gap. Methods Thirty female adult Sprague Dawley rats, weighing 160-180 g, were used to prepare 13-mm defect model by trimming the nerve stumps. Then all rats were randomly divided into 2 groups, 15 rats in each group. After nerve defect was bridged by the contralateral normal sciatic nerve, SLES was applied in the experimental group, but was not in the control group. The spinal cords and dorsal root ganglions (DRGs) were harvested to carry out immunofluorescence histochemistry double staining for growth-associated proteins 43 (GAP-43) and brain-derived neurotrophic factor (BDNF) at 1, 2, and 7 days after repair. Fluorogold (FG) retrograde tracing was performed at 3 months after repair. The mid-portion regenerated segments were harvested to perform Meyer’s trichrome staining, immunofluorescence double staining for neurofilament (NF) and soluble protein 100 (S-100) on the transversely or longitudinal sections at 3 months after repair. The segment of the distal sciatic nerve trunk was harvested for electron microscopy and morphometric analyses to measure the diameter of the myelinated axons, thickness of myelin sheaths, the G ratio, and the density of the myelinated nerve fibers. The gastrocnemius muscles of the operated sides were harvested to measure the relative wet weight ratios. Karnovsky-Root cholinesterase staining of the motor endplate was carried out. Results In the experimental group, the expressions of GAP-43 and BDNF were higher than those in the control group at 1 and 2 days after repair. The number of labeled neurons in the anterior horn of gray matter in the spinal cord and DRGs at the operated side from the experimental group was more than that from the control group. Meyer’s trichrome staining, immunofluorescence double staining, and the electron microscopy observation showed that the regenerated nerves were observed to develop better in the experimental group than the control group. The relative wet weight ratio of experimental group was significantly higher than that of the control group (t=4.633,P=0.000). The size and the shape of the motor endplates in the experimental group were better than those in the control group. Conclusion SLES can promote the regeneration ability of the short-term (1 month) delayed nerve injury with long gap to a certain extent.
In order to improve the accuracy and reliability of the electrodes implant location when using spinal functional electrical stimulation to rebuild hindlimb motor function, we measured the distributions of function core regions in rat spinal cord associated with hindlimb movements. In this study, we utilized three-dimensional scanning intraspinal microstimulation technology to stimulate the rat spinal cord to generate hip, knee and ankle joint movements, and acquired the coordinates of the sites in spinal cord which evoked these movements. In this article, 12 SD rats were used to overcome the individual differences in the functional region of the spinal cord. After normalized and overlaid the messages, we obtained the function core regions in spinal cord associated with ankle dorsiflexion movement, hip flexion movement, hip extension movement and hip adduction movement. It provides a reference for rebuilding the hindlimb movement function with micro-electronic neural bridge.
ObjectivesTo systematically review the efficacy of pelvic floor electrical stimulation on urinary dysfunction.MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were searched to collect randomized controlled trials (RCTs) on the efficacy of pelvic floor electrical stimulation on urinary dysfunction from inception to August 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies; then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 RCTs involving 559 patients were included. The results of meta-analysis showed that the pelvic floor electrical stimulation group was superior to the control group in bladder volume before and after treatment(MD=79.25, 95%CI 40.36 to 118.15, P<0.000 1), residual urine volume (MD=35.50, 95%CI 7.60 to 63.41, P=0.01), maximum detrusor pressure (MD=5.19, 95%CI 2.11 to 8.27, P<0.001), number of leaks (RR=1.95, 95%CI 1.39 to 2.52, P<0.000 01), daily average urination frequency (RR=2.64, 95%CI 1.97 to 3.31, P<0.000 01), and international lower urinary tract score (MD=5.07, 95%CI 2.17 to 7.96, P=0.000 6).ConclusionsCurrent evidence shows that pelvic floor electrical stimulation is an effective therapy for urinary dysfunction. Due to limited quality and quantity of the included studies, more high quality-studies are required to verify the above conclusion.