RESUMEN
Robot-assisted gait training (RAGT) has been proven effective in improving gait function in not only patients with central nervous system damage, but also in patients who have undergone musculoskeletal surgery. Nevertheless, evidence supporting the efficacy of such training in burn patients remains insufficient. This report aimed to evaluate the effect of RAGT in burn patients with spinal cord injuries (SCI) caused by electrical trauma. We reported a case of two patients. The total duration of each session was about 1 h 30 min. This included 10 min to put on the exoskeleton, 30 min of robot-assisted training using SUBAR®, 10 min to remove the exoskeleton, 10 min to observe whether complications such as skin abrasion, ulcer, or pain occur in the scar area after RAGT, and 30 min of conventional physiotherapy, at a rate of 5 days a week for 12 weeks. All measurements were assessed before training (0 week) and after training (12 weeks). The American Spinal Cord Injury Association (ASIA) lower extremity motor score (LEMS), passive range of motions (ROMs) of different joints (hip, knee, and ankle), ambulatory motor index (AMI), functional ambulation categories (FAC), and 6 min walking (6 MWT) distances were evaluated to measure the degree of gait function through training. In both patients, manual muscle test measurement and joint ROM in the lower extremities improved after 12 weeks training. The first patient scored 0 in the FAC before training. After 12 weeks of training, he could walk independently indoors, improving to an FAC score of 4. He also reached 92.16 m in the 6 MWT. LEMS improved from 22 before training to 30 after training, and AMI score improved from 12 before training to 16 after training. In the second patient, an independent walking function was not acquired. LEMS improved from 10 before training to 26 after training. AMI scores were the same at 10 points before and after training. The results suggested the possibility of achieving clinical effects in terms of improving lower extremity muscle strength, joint ROMs, and gait performance in patients with SCI caused by electrical trauma.
RESUMEN
In a case of thalamencephalic and mesencephalic injury secondary to electrical trauma, a 29-year-old patient has been receiving manual acupuncture for 17 months in National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion. As a result of treatment, the patient's self-care ability and quality of life have greatly improved. In order to fully understand how acupuncture can benefit neurological sequelae resulting from electrical trauma, further research is needed. Additionally, there should be consideration given to the promotion of acupuncture therapy in the neurological sequelae of electric shock.
RESUMEN
Electrical stun devices (ESDs) serve a basic role in law enforcement and provide an alternative to lethal options for target control by causing electromuscular incapacitation (EMI). A fundamental concern is the adverse health consequences associated with their use. The capability of EMI electric field pulses to disrupt skeletal muscle cells (i.e. rhabdomyolysis) was investigated over the operational range commonly used in commercial EMI devices. Functional and structural alteration and recovery of muscle and nerve tissue were assessed. In an anesthetized swine model, the left thigh was exposed to 2 min of electrical pulses, using a commercially available ESD or a custom-made EMI signal power amplifier. Serum creatinine phosphokinase (CPK), troponin, aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) levels were monitored intermittently for 6 h post-EMI exposure. A standard external cardiac defibrillator served as a positive control. Muscle and nerve tissue histology adjacent to the EMI contacts were examined. Post-EMI shock skeletal muscle function was evaluated by analyzing the compound muscle action potentials (CMAPs) of the rectus femoris muscle. Maximal energy cardiac defibrillator pulses resulted in rhabdomyolysis and marked elevation of CPK, LDH, and AST 6 h post-shock. EMI field pulses resulted in the animals developing transient acidosis. CMAP amplitudes decreased approximately 50% after EMI and recovered to near-normal levels within 6 h. Within 6 h post-EMI exposure, blood CPK was mildly increased, LDH was normal, and no arrhythmia was observed. Minimal rhabdomyolysis was produced by the EMI pulses. These results suggest that EMI exposure is unlikely to cause extremity rhabdomyolysis in normal individuals. Bioelectromagnetics. © 2020 Bioelectromagnetics Society.
Asunto(s)
Conductividad Eléctrica/efectos adversos , Músculo Esquelético/lesiones , Músculo Esquelético/patología , Potenciales de Acción , Animales , Regulación de la Expresión Génica , Músculo Esquelético/inervación , Rabdomiólisis/sangre , Rabdomiólisis/etiología , Rabdomiólisis/metabolismo , Rabdomiólisis/patología , PorcinosRESUMEN
El trauma eléctrico es poco frecuente en la consulta pediátrica. Sólo corresponde al 1% de la lesiones por quemaduras, siendo más frecuente en niños menores de 6 años, varones, con capacidad de deambulación y exploración autónoma del entorno. El órgano blanco por excelencia de la corriente eléctrica son los nervios, por su baja resistencia. Esto condiciona las múltiples manifestaciones clínicas, en diversos tiempos, pudiendo ser causa de mortalidad, gran morbilidad y secuelas que ocasionan discapacidades con impacto sobre la calidad de la vida del individuo. Se reporta el caso de un lactante menor masculino con trauma por electrocución con neuropatía craneal y periférica, haciendo énfasis en los aspectos fisiopatogénicos, clínicos y paraclínicos de la lesión neurológica. Conclusión: La corriente eléctrica tiene como órgano blanco el sistema nervioso central. El trauma eléctrico tiene expresión clínica neurológica variable y puede dejar secuelas que modifican la calidad de vida del niño. Las estrategias de educación en prevención pueden disminuir la ocurrencia de estas lesiones.
Electrical trauma is rare in the pediatric clinic. Only 1% of injuries correspond to burns, these being more common in male infants and preschool children with sufficient mobility and autonomy to explore their environment. Nerves are the target organ of electric current , due to their low resistance. This determines multiple clinical manifestations and may be the cause of mortality, high morbidity and sequels that may cause disabilities which impact negatively the childs quality of life. The case of a male infant with trauma by electrocution with cranial and peripheral neuropathy is reported, with particular emphasis on pathophysiological, clinical and paraclinical aspects of the neurological injury. Conclusion: Electric trauma has variable clinical neurological expressions and may cause severe sequels that affect the childs quality of life. Educational strategies on prevention can reduce the occurrence of these external injuries.
RESUMEN
Individuals who have experienced an electrical injury have been reported to demonstrate both acute and delayed cognitive and psychiatric symptoms. The present study assessed 20 electrically injured patients who underwent neuropsychological evaluations twice following their injury. Time since injury, time between assessments, and longitudinal mood changes were evaluated for their potential impact on simple and complex attention outcomes. As an overall group, there was little change over time from low average to average baseline attention/concentration performance. However, results indicated that longitudinal increases in depressive symptoms were consistently associated with poorer performance on a measure of simple and complex attention. Loss of consciousness, litigation status, baseline injury status (acute vs. post-acute), and time between evaluations were not significant predictors of changes in cognitive performance. Implications for the treatment of comorbid psychiatric issues and for future research on victims of electrical trauma are discussed.