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1.
Biomaterials ; 313: 122803, 2025 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-39232334

RESUMEN

Bacteria-infected wounds pose challenges to healing due to persistent infection and associated damage to nerves and vessels. Although sonodynamic therapy can help kill bacteria, it is limited by the residual oxidative stress, resulting in prolonged inflammation. To tackle these barriers, novel 4 octyl itaconate-coated Li-doped ZnO/PLLA piezoelectric composite microfibers are developed, offering a whole-course "targeted" treatment under ultrasound therapy. The inclusion of Li atoms causes the ZnO lattice distortion and increases the band gap, enhancing the piezoelectric and sonocatalytic properties of the composite microfibers, collaborated by an aligned PLLA conformation design. During the infection and inflammation stages, the piezoelectric microfibers exhibit spatiotemporal-dependent therapeutic effects, swiftly eliminating over 94.2 % of S. aureus within 15 min under sonodynamic therapy. Following this phase, the microfibers capture reactive oxygen species and aid macrophage reprogramming, restoring mitochondrial function, achieving homeostasis, and shortening inflammation cycles. As the wound progresses through the healing stages, bioactive Zn2+ and Li + ions are continuously released, improving cell recruitment, and the piezoelectrical stimulation enhances wound recovery with neuro-vascularization. Compared to commercially available dressings, our microfibers accelerate the closure of rat wounds (Φ = 15 mm) without scarring in 12 days. Overall, this "one stone, four birds" wound management strategy presents a promising avenue for infected wound therapy.


Asunto(s)
Terapia por Ultrasonido , Cicatrización de Heridas , Animales , Cicatrización de Heridas/efectos de los fármacos , Terapia por Ultrasonido/métodos , Ratas Sprague-Dawley , Ratas , Staphylococcus aureus/efectos de los fármacos , Óxido de Zinc/química , Ratones , Estimulación Eléctrica , Masculino , Infecciones Estafilocócicas/terapia , Poliésteres/química , Especies Reactivas de Oxígeno/metabolismo , Terapia por Estimulación Eléctrica/métodos , Neovascularización Fisiológica/efectos de los fármacos
2.
Sci Rep ; 14(1): 20804, 2024 09 06.
Artículo en Inglés | MEDLINE | ID: mdl-39242729

RESUMEN

In a randomized, controlled study, whole-body electromyostimulation (WB-EMS) was investigated as a promising alternative treatment technique compared to conventional strength training for the management of knee osteoarthritis (OA). Seventy-two overweight participants with symptomatic knee OA were randomly assigned to WB-EMS (n = 36) or a usual care group (UCG, n = 36). For seven months, the WB-EMS group received three times per fortnight a WB-EMS training, while the UCG was prescribed six-times physiotherapeutic treatments. We observed significant effects for the primary outcome "pain", as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS), with more favourable changes in the WB-EMS group vs UCG (between-group difference 9.0 points, 95%CI 2.9-15.1, p = 0.004). Secondary outcomes, including the other KOOS subscales (symptoms, function in daily living, function in sports/recreational activities and quality of life), 7 day pain diary, hip/leg extensor strength and lower limb function (30s sit-to-stand test), were also statistically significant in favour of the WB-EMS group. Overall, WB-EMS was found to be effective in relieving knee pain symptoms and improving physical function in individuals with symptomatic knee OA compared to usual care treatment. WB-EMS could be used as an alternative therapy in the management of knee OA; particularly for patients that cannot be motivated for conventional training.


Asunto(s)
Terapia por Estimulación Eléctrica , Osteoartritis de la Rodilla , Humanos , Osteoartritis de la Rodilla/terapia , Osteoartritis de la Rodilla/fisiopatología , Osteoartritis de la Rodilla/rehabilitación , Femenino , Masculino , Persona de Mediana Edad , Terapia por Estimulación Eléctrica/métodos , Anciano , Resultado del Tratamiento , Calidad de Vida , Articulación de la Rodilla/fisiopatología , Manejo del Dolor/métodos , Dolor/fisiopatología , Dolor/etiología
3.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 41(4): 650-655, 2024 Aug 25.
Artículo en Chino | MEDLINE | ID: mdl-39218589

RESUMEN

Individuals with motor dysfunction caused by damage to the central nervous system are unable to transmit voluntary movement commands to their muscles, resulting in a reduced ability to control their limbs. However, traditional rehabilitation methods have problems such as long treatment cycles and high labor costs. Functional electrical stimulation (FES) based on brain-computer interface (BCI) connects the patient's intentions with muscle contraction, and helps to promote the reconstruction of nerve function by recognizing nerve signals and stimulating the moving muscle group with electrical impulses to produce muscle convulsions or limb movements. It is an effective treatment for sequelae of neurological diseases such as stroke and spinal cord injury. This article reviewed the current research status of BCI-based FES from three aspects: BCI paradigms, FES parameters and rehabilitation efficacy, and looked forward to the future development trend of this technology, in order to improve the understanding of BCI-based FES.


Asunto(s)
Interfaces Cerebro-Computador , Humanos , Estimulación Eléctrica/métodos , Rehabilitación de Accidente Cerebrovascular/métodos , Traumatismos de la Médula Espinal/rehabilitación , Terapia por Estimulación Eléctrica/métodos
4.
J Neuroeng Rehabil ; 21(1): 153, 2024 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-39232831

RESUMEN

BACKGROUND: To overcome the application limitations of functional electrical stimulation (FES), such as fatigue or nonlinear muscle response, the combination of neuroprosthetic systems with robotic devices has been evaluated, resulting in hybrid systems that have promising potential. However, current technology shows a lack of flexibility to adapt to the needs of any application, context or individual. The main objective of this study is the development of a new modular neuroprosthetic system suitable for hybrid FES-robot applications to meet these needs. METHODS: In this study, we conducted an analysis of the requirements for developing hybrid FES-robot systems and reviewed existing literature on similar systems. Building upon these insights, we developed a novel modular neuroprosthetic system tailored for hybrid applications. The system was specifically adapted for gait assistance, and a technological personalization process based on clinical criteria was devised. This process was used to generate different system configurations adjusted to four individuals with spinal cord injury or stroke. The effect of each system configuration on gait kinematic metrics was analyzed by using repeated measures ANOVA or Friedman's test. RESULTS: A modular NP system has been developed that is distinguished by its flexibility, scalability and personalization capabilities. With excellent connection characteristics, it can be effectively integrated with robotic devices. Its 3D design facilitates fitting both as a stand-alone system and in combination with other robotic devices. In addition, it meets rigorous requirements for safe use by incorporating appropriate safety protocols, and features appropriate battery autonomy, weight and dimensions. Different technological configurations adapted to the needs of each patient were obtained, which demonstrated an impact on the kinematic gait pattern comparable to that of other devices reported in the literature. CONCLUSIONS: The system met the identified technical requirements, showcasing advancements compared to systems reported in the literature. In addition, it demonstrated its versatility and capacity to be combined with robotic devices forming hybrids, adapting well to the gait application. Moreover, the personalization procedure proved to be useful in obtaining various system configurations tailored to the diverse needs of individuals.


Asunto(s)
Robótica , Traumatismos de la Médula Espinal , Humanos , Robótica/instrumentación , Robótica/métodos , Traumatismos de la Médula Espinal/rehabilitación , Masculino , Rehabilitación de Accidente Cerebrovascular/instrumentación , Rehabilitación de Accidente Cerebrovascular/métodos , Fenómenos Biomecánicos , Terapia por Estimulación Eléctrica/instrumentación , Terapia por Estimulación Eléctrica/métodos , Marcha/fisiología , Persona de Mediana Edad , Femenino , Adulto , Prótesis Neurales , Diseño de Prótesis/métodos
5.
Neurosurg Rev ; 47(1): 618, 2024 Sep 16.
Artículo en Inglés | MEDLINE | ID: mdl-39278993

RESUMEN

Electrical stimulation is an important adjuvant therapy for spinal surgery, but whether receiving electrical stimulation can improve the fusion rate after spinal surgery is still controversial. The purpose of this study was to analyse and evaluate the effect of electrical stimulation on the fusion rate after spinal surgery. We systematically searched for related articles published in the PubMed, Embase and Cochrane Library databases on or before September 30, 2023. The odds ratio (OR) with 95% confidence interval (CI) and the fusion rates of the experimental group and the control group were calculated by a random-effects meta-analysis model. The analysis showed that receiving electrical stimulation significantly increased the probability of successful spinal fusion (OR 2.66 [95% CI 1.79-3.97]), and the average fusion rate of the electrical stimulation group (86.8%) was significantly greater than that of the control group (73.7%). The fusion rate in the direct current (DC) stimulation group was 2.33 times greater than that in the control group (OR 2.33 [95% CI 1.37-3.96]), and that in the pulsed electromagnetic field (PEMF) group was 2.60 times greater than that in the control group (OR 2.60 [95% CI 1.29-5.27]). Similarly, the fusion rate in the capacitive coupling (CC) electrical stimulation group was 3.44 times greater than that in the control group (OR 3.44 [95% CI 1.75-6.75]), indicating that regardless of the type of electrical stimulation, the fusion rate after spinal surgery improved to a certain extent. Electrical stimulation as an adjuvant therapy seems to improve the fusion rate after spinal surgery to a certain extent, but the specific effectiveness of this therapy needs to be further studied.


Asunto(s)
Fusión Vertebral , Humanos , Fusión Vertebral/métodos , Terapia por Estimulación Eléctrica/métodos , Estimulación Eléctrica/métodos , Resultado del Tratamiento , Enfermedades de la Columna Vertebral/cirugía
7.
Artículo en Inglés | MEDLINE | ID: mdl-39222447

RESUMEN

Parkinson's disease (PD) and essential tremor are two major causes of pathological tremor among people over 60 years old. Due to the side effects and complications of traditional tremor management methods such as medication and deep brain surgery, non invasive tremor suppression methods have become more popular in recent years. Functional electrical stimulation (FES) is one of the methods used to reduce tremor in several studies. However, the effect of different FES parameters on tremor suppression and discomfort level, including amplitude, the number of pulses in each stimulation burst, frequency, and pulse width is yet to be studied for longer stimulation durations. Therefore, in this work, experiments were performed on 14 participants with PD to evaluate the effect of thirty seconds of out-of-phase electrical stimulation on wrist tremor at rest. Trials were conducted by varying the stimulation amplitude and the number of pulses while keeping the frequency and pulse width constant. Each test was repeated three times for each participant. The results showed an overall tremor suppression for 11 out of 14 participants and no average positive effects for three participants. It is concluded that despite the effectiveness of FES in tremor suppression, each set of FES parameters showed different suppression levels among participants due to the variability of tremor over time. Thus, for this method to be effective, an adaptive control system would be required to tune FES parameters in real time according to changes in tremor during extended stimulation periods.


Asunto(s)
Terapia por Estimulación Eléctrica , Enfermedad de Parkinson , Temblor , Humanos , Masculino , Femenino , Persona de Mediana Edad , Temblor/terapia , Temblor/fisiopatología , Anciano , Enfermedad de Parkinson/terapia , Enfermedad de Parkinson/fisiopatología , Terapia por Estimulación Eléctrica/métodos , Temblor Esencial/terapia , Temblor Esencial/fisiopatología , Muñeca , Resultado del Tratamiento
8.
Artículo en Ruso | MEDLINE | ID: mdl-39248585

RESUMEN

An intratissual electrical stimulation, accompanied by irritation of their central neurons, is used to recover the function of damaged peripheral nerves. Treatment results exceeded those with the use of cutaneous electrical stimulation, which is confirmed by comparative results of trial animal experiments. The time and quality of peripheral nerves' function recovery in comparison of intratissual and cutaneous electrical stimulation methods remain unknown. OBJECTIVE: To evaluate the time and quality of peripheral nerves' functions recovery after their suturing and conducting two different methods of electrical stimulation, namely intratissual and cutaneous, in projection of central neurons of damaged spinal nerves in the postoperative period. MATERIAL AND METHODS: The basic technical parameters of the method of peripheral nerves' functions recovery in the postoperative period were ptacticed. Postoperative rehabilitation treatment was performed in 77 patients with traumatic peripheral nerves' injuries at the level of the forearm: in 42 with intratissual electrical stimulation, in 35 - using cutaneous one with similar characteristics of electrical current and concomitant pharmacological therapy. The follow-up duration was 2 years. RESULTS: A significant (in 4-6 times) reduction in time of treatment and a greater improvement in qualitative indicators when using intratissual electrical stimulation compared to the use of cutaneous stimulation were obtained. The effectiveness of the restorative therapy was dependent on the number of procedures, and a complete recovery of the damaged peripheral nerves' functions was observed after three courses of intratissual electrical stimulation. CONCLUSION: The time and degree of recovery of peripheral nerves' functions depends on the functional activity of their central neurons at the level of the spinal cord. The activation of these neurons by low-frequency electrical current allows to activate their trophic function. Thus, the cutaneous electrical stimulation does not cause the necessary level of irritation of the neurons due to the fact that the skin is a barrier to electrical current, which reduces its impact in 200-500 times. The intratissual electrical stimulation allows to solve the problem by supplying the needle-electrode much closer to the «target¼. The proposed method of intratissual electrical stimulation has shown its advantage over cutaneous electrical stimulation, significantly reducing the duration of the restorative treatment and increasing its qualitative indicators.


Asunto(s)
Nervios Periféricos , Humanos , Masculino , Femenino , Nervios Periféricos/fisiología , Adulto , Traumatismos de los Nervios Periféricos/rehabilitación , Traumatismos de los Nervios Periféricos/terapia , Traumatismos de los Nervios Periféricos/fisiopatología , Terapia por Estimulación Eléctrica/métodos , Recuperación de la Función/fisiología , Persona de Mediana Edad
9.
Int Wound J ; 21(9): e70040, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39223104

RESUMEN

The standard treatment for patients with confirmed Venous Leg Ulcers (VLUs) is compression therapy to improve the function of the calf muscle pump. There is a significant cohort of patients who are unable to tolerate optimal compression therapy or indeed any level of compression therapy. In addition, there is a cohort of patients who can tolerate compression whose ulcers show little or no evidence of healing. There is a need for ways to further improve calf muscle pump function and to improve venous ulcer healing in these patients. Published data were reviewed on the use of Muscle Pump Activation (MPA) using common peroneal nerve neuromuscular electrical stimulation (NMES) to improve calf muscle pump function. There is physiological evidence that MPA can improve calf muscle pump function and venous return in both control subjects and in patients with venous disease. The use of MPA has also been shown to improve venous flow volume and venous flow velocity on ultrasound scanning in patients with venous disease. MPA has been shown to improve microcirculation in the skin using Laser Doppler and laser Doppler Speckle Contrast Imaging, in both normal subjects as well as in patients with venous disease and VLU. A recent randomized controlled trial of MPA plus compression therapy compared with compression therapy alone, found significantly faster rates of healing with the use of MPA in addition to compression therapy. There are indications for the use of MPA as an adjunctive treatment to enhance calf muscle pump function in patients with VLU: who cannot tolerate compression therapy who can only tolerate suboptimal, low-level compression whose ulcer healing remains slow or stalled with optimal compression.


Asunto(s)
Terapia por Estimulación Eléctrica , Músculo Esquelético , Nervio Peroneo , Úlcera Varicosa , Cicatrización de Heridas , Humanos , Úlcera Varicosa/terapia , Úlcera Varicosa/fisiopatología , Terapia por Estimulación Eléctrica/métodos , Nervio Peroneo/fisiopatología , Cicatrización de Heridas/fisiología , Músculo Esquelético/fisiopatología , Masculino , Femenino , Resultado del Tratamiento
10.
Can J Urol ; 31(4): 11943-11949, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39217518

RESUMEN

INTRODUCTION: Despite the growing body of literature on sacral neuromodulation (SNM) outcomes, research focusing on male patients remains limited and often represented by small cohorts nested within a larger study of mostly women. Herein, we evaluated the outcomes of SNM in a male-only cohort with overactive bladder (OAB), fecal incontinence (FI), chronic bladder pain, and neurogenic lower urinary tract dysfunction (NLUTD). MATERIALS AND METHODS: This retrospective cohort study included 64 male patients who underwent SNM insertion between 2013 and 2021 at a high-volume tertiary center. Indications for SNM therapy included OAB, FI, chronic pelvic pain, and NLUTD. Descriptive statistics, Fisher's and t-test were used in analysis. RESULTS: The mean age was 57.7 ± 13.4 years, and the most frequent reason for SNM insertion was idiopathic OAB (72%), FI (16%), pelvic pain (11%), and NLUTD (11%). A majority (84%) of men received treatment prior to SNM insertion. 84% reported satisfaction and 92% symptom improvement within the first year, and these improvements persisted beyond 1 year in 73% of patients. Mean follow up was 52.7 ± 21.0 months. The complication rate was 23%, and the need for adjunct treatments was significantly reduced (73% to 27%, p < 0.001). Treatment outcomes did not differ significantly between various indications for SNM therapy or the presence of benign prostatic hyperplasia (BPH). CONCLUSION: SNM is an effective and safe procedure for male patients with neurogenic and non-neurogenic OAB, pelvic pain, and FI. Over 70% of patients experienced symptomatic improvement and remained satisfied in the mid to long term follow up. BPH does not seem to hinder treatment outcomes.


Asunto(s)
Dolor Crónico , Terapia por Estimulación Eléctrica , Incontinencia Fecal , Plexo Lumbosacro , Dolor Pélvico , Vejiga Urinaria Hiperactiva , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Vejiga Urinaria Hiperactiva/terapia , Incontinencia Fecal/terapia , Resultado del Tratamiento , Dolor Pélvico/terapia , Anciano , Terapia por Estimulación Eléctrica/métodos , Dolor Crónico/terapia , Estudios de Cohortes , Adulto
11.
PLoS One ; 19(8): e0296613, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39213293

RESUMEN

BACKGROUND: Transcutaneous spinal stimulation (TSS) and neuromuscular electrical stimulation (NMES) can facilitate self-assisted standing in individuals with paralysis. However, individual variability in responses to each modality may limit their effectiveness in generating the necessary leg extension force for full body weight standing. To address this challenge, we proposed combining TSS and NMES to enhance leg extensor muscle activation, with optimizing timing adjustment to maximize the interaction between the two modalities. METHODS: To assess the effects of TSS and NMES on knee extension and plantarflexion force, ten neurologically intact participants underwent three conditions: (1) TSS control, (2) NMES control, and (3) TSS + NMES. TSS was delivered between the T10 and L2 vertebrae, while NMES was delivered to the skin over the right knee extensors and plantarflexors. TSS and NMES were administered using a 15 Hz train of three 0.5 ms biphasic pulses. During the TSS + NMES condition, the timing between modalities was adjusted in increments of » the interval within a 15 Hz frequency, i.e., 66, 49.5, 33, 16.5, and 1 ms. RESULTS: NMES combined with TSS, produced synergistic effects even on non-targeted muscle groups, thereby promoting leg extension across multiple joints in the kinematic chain. The sequence of NMES or TSS trains relative to each other did not significantly impact motor output. Notably, a delay of 16.5 to 49.5 ms between interleaved TSS and NMES pulses, each delivered at 15 Hz, results in more robust and synergistic responses in knee extensors and plantarflexors. CONCLUSIONS: By adjusting the timing between TSS and NMES, we can optimize the combined use of these modalities for functional restoration. Our findings highlight the potential of integrated TSS and NMES protocols to enhance motor function, suggesting promising avenues for therapeutic applications, particularly in the rehabilitation of individuals with SCI.


Asunto(s)
Extremidad Inferior , Estimulación Eléctrica Transcutánea del Nervio , Humanos , Masculino , Femenino , Adulto , Extremidad Inferior/fisiología , Estimulación Eléctrica Transcutánea del Nervio/métodos , Músculo Esquelético/fisiología , Adulto Joven , Terapia por Estimulación Eléctrica/métodos , Electromiografía , Estimulación de la Médula Espinal/métodos
12.
Int J Mol Sci ; 25(16)2024 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-39201729

RESUMEN

Traumatic spinal cord injury is a major cause of disability for which there are currently no fully effective treatments. Recent studies using epidural electrical stimulation have shown significant advances in motor rehabilitation, even when applied during chronic phases of the disease. The present study aimed to investigate the effectiveness of epidural electric stimulation in the motor recovery of rats with spinal cord injury. Furthermore, we aimed to elucidate the neurophysiological mechanisms underlying motor recovery. First, we improved upon the impact spinal cord injury model to cause severe and permanent motor deficits lasting up to 2 months. Next, we developed and tested an implantable epidural spinal cord stimulator device for rats containing an electrode and an implantable generator. Finally, we evaluated the efficacy of epidural electrical stimulation on motor recovery after spinal cord injury in Wistar rats. A total of 60 animals were divided into the following groups: (i) severe injury with epidural electrical stimulation (injury + stim, n = 15), (ii) severe injury without stimulation (group injury, n = 15), (iii) sham implantation without battery (sham, n = 15), and (iv) a control group, without surgical intervention (control, n = 15). All animals underwent weekly evaluations using the Basso, Beattie, Bresnahan (BBB) locomotor rating scale index, inclined plane, and OpenField test starting one week before the lesion and continuing for eight weeks. After this period, the animals were sacrificed and their spinal cords were explanted and prepared for histological analysis (hematoxylin-eosin) and immunohistochemistry for NeuN, ß-III-tubulin, synaptophysin, and Caspase 3. Finally, NeuN-positive neuronal nuclei were quantified through stereology; fluorescence signal intensities for ß-tubulin, synaptophyin, and Caspase 3 were quantified using an epifluorescence microscope. The injury + stim group showed significant improvement on the BBB scale compared with the injured group after the 5th week (p < 0.05). Stereological analysis showed a significantly higher average count of neural cells in the injury + stim group in relation to the injury group (1783 ± 2 vs. 897 ± 3, p < 0.001). Additionally, fluorescence signal intensity for synaptophysin was significantly higher in the injury + stim group in relation to the injury group (1294 ± 46 vs. 1198 ± 23, p < 0.01); no statistically significant difference was found in ß-III-tubulin signal intensity. Finally, Caspase 3 signal intensity was significantly lower in the stim group (727 ± 123) compared with the injury group (1225 ± 87 p < 0.05), approaching levels observed in the sham and control groups. Our data suggest a regenerative and protective effect of epidural electrical stimulation in rats subjected to impact-induced traumatic spinal cord injury.


Asunto(s)
Modelos Animales de Enfermedad , Plasticidad Neuronal , Ratas Wistar , Traumatismos de la Médula Espinal , Animales , Traumatismos de la Médula Espinal/terapia , Traumatismos de la Médula Espinal/fisiopatología , Traumatismos de la Médula Espinal/patología , Ratas , Recuperación de la Función , Terapia por Estimulación Eléctrica/métodos , Sinaptofisina/metabolismo , Tubulina (Proteína)/metabolismo , Espacio Epidural/patología , Médula Espinal/metabolismo , Médula Espinal/patología , Médula Espinal/fisiopatología , Masculino , Caspasa 3/metabolismo , Regeneración Nerviosa , Femenino , Proteínas del Tejido Nervioso , Antígenos Nucleares
13.
Medicine (Baltimore) ; 103(34): e39321, 2024 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-39183430

RESUMEN

To investigate the effects of health education combined with biofeedback electrical stimulation on maternal postpartum pelvic floor function and psychology. The clinical data of 80 patients with postpartum pelvic floor dysfunction (PFD) from May 2020 to May 2022 were selected as retrospective study subjects, and 40 cases were divided into the comparison group and the observation group according to the different intervention methods. Among them, the comparison group implemented biofeedback electrical stimulation and guidance, and the observation group implemented Greene health education and Kegel pelvic floor rehabilitation training intervention based on the comparison group. The differences in pelvic floor muscle strength, sexual quality of life, anxiety, and depression in the 2 groups with postpartum PFD were compared. Comparison of pelvic floor muscle strength: before the intervention (P > .05) and after the intervention, the anterior resting mean electromyography (EMG), slow muscle mean EMG, fast muscle maximum EMG, and mixed muscle mean EMG values of patients in the observation group were higher than those in the comparison group, and the posterior resting mean EMG values were lower than those in the comparison group (P < .05). There was no statistically significant difference in the Hospital Anxiety and Depression Scale (HADS) scores and anxiety and depression subscale scores between the 2 groups of patients before intervention (P > .05). After the intervention, the HADS scores and anxiety and depression subscale scores were lower than those before the intervention in both groups, and the differences were statistically significant in the intervention group than in the comparison group (P < .05). There was no statistically significant difference between The Chinese Female Sexual Life Quality Questionnaire scores of both groups before the intervention (P > .05). Sexual desire, vaginal lubrication, sexual arousal, sexual satisfaction, orgasm, and painful intercourse improved in both groups after the intervention, and the scores in the intervention group were higher than those in the comparison group (P < .05). Health education combined with biofeedback electrical stimulation can effectively improve the quality of patients' sexual life, improve the pelvic floor muscle strength of patients with postpartum PFD, enhance patients' confidence, reduce patients' anxiety and depression, and effectively improve patients' psychological status.


Asunto(s)
Biorretroalimentación Psicológica , Fuerza Muscular , Trastornos del Suelo Pélvico , Diafragma Pélvico , Calidad de Vida , Humanos , Femenino , Estudios Retrospectivos , Adulto , Biorretroalimentación Psicológica/métodos , Diafragma Pélvico/fisiopatología , Fuerza Muscular/fisiología , Trastornos del Suelo Pélvico/terapia , Trastornos del Suelo Pélvico/psicología , Trastornos del Suelo Pélvico/rehabilitación , Ansiedad/terapia , Educación en Salud/métodos , Depresión/terapia , Electromiografía , Terapia por Estimulación Eléctrica/métodos , Periodo Posparto/psicología
14.
Clin Auton Res ; 34(4): 395-411, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39133345

RESUMEN

Direct current stimulation (DCS) is a non-invasive approach to stimulate the nervous system that is now considered a powerful tool for treating neurological diseases such as those affecting cognitive or locomotor functions. DCS, as applied clinically today, is an approach built on early uses in antiquity and knowledge gained over time. Its current use makes use of specific devices and takes into account knowledge of the mechanisms by which this approach modulates functioning of the nervous system at the cellular level. Over the last 20 years, although there are few studies, it has been shown that DCS can also modulate the breathing autonomic function. In this narrative review, after briefly providing the historical perspective and describing the principles and the main cellular and molecular effects, we summarize the currently available data regarding the modulation of ventilation, and propose that DCS could be used to treat autonomic or non-autonomic neurological disorders affecting breathing.


Asunto(s)
Enfermedades del Sistema Nervioso Autónomo , Humanos , Enfermedades del Sistema Nervioso Autónomo/terapia , Enfermedades del Sistema Nervioso Autónomo/fisiopatología , Terapia por Estimulación Eléctrica/métodos , Trastornos Respiratorios/terapia , Trastornos Respiratorios/fisiopatología , Enfermedades del Sistema Nervioso/terapia , Animales , Respiración , Sistema Nervioso Autónomo/fisiopatología
15.
Sci Adv ; 10(32): eado7538, 2024 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-39110791

RESUMEN

Chronic wounds affect ~2% of the U.S. population and increase risks of amputation and mortality. Unfortunately, treatments for such wounds are often expensive, complex, and only moderately effective. Electrotherapy represents a cost-effective treatment; however, its reliance on bulky equipment limits its clinical use. Here, we introduce water-powered, electronics-free dressings (WPEDs) that offer a unique solution to this issue. The WPED performs even under harsh conditions-situations wherein many present treatments fail. It uses a flexible, biocompatible magnesium-silver/silver chloride battery and a pair of stimulation electrodes; upon the addition of water, the battery creates a radial electric field. Experiments in diabetic mice confirm the WPED's ability to accelerate wound closure and promote healing by increasing epidermal thickness, modulating inflammation, and promoting angiogenesis. Across preclinical wound models, the WPED-treated group heals faster than the control with wound closure rates comparable to treatments requiring expensive biologics and/or complex electronics. The results demonstrate the WPED's potential as an effective and more practical wound treatment dressing.


Asunto(s)
Vendajes , Cicatrización de Heridas , Animales , Ratones , Agua/química , Electrónica , Diabetes Mellitus Experimental/terapia , Humanos , Modelos Animales de Enfermedad , Terapia por Estimulación Eléctrica/métodos
16.
Sci Rep ; 14(1): 17939, 2024 08 02.
Artículo en Inglés | MEDLINE | ID: mdl-39095520

RESUMEN

Post-Acute sequelae of SARS-CoV-2 (PASC) is a multisystem disorder causing persistent musculoskeletal deconditioning and reduced lower extremity strength. Electrical stimulation (E-Stim) to the gastrocnemius muscle can enhance strength outcomes by increasing the frequency of muscle fiber activation. We investigated its effect on individuals with PASC. Participants were randomized into intervention (IG) or control (CG) groups. The IG self-administered daily one-hour E-Stim to both their gastrocnemius muscles using a functional device over 4-week, while the CG used a sham device. Primary outcomes were ankle dorsiflexion strength assessed via dynamometry during maximum voluntary contractions, and gastrocnemius voluntary activation (GVA) via surface electromyography. The secondary outcome assessed activities of daily living (ADL), instrumental ADL, and mobility queries. Percentage improvement was calculated. Eighteen patients were analyzed (IG = 10; CG = 8). After 4 week, the IG showed a significantly higher improvement in ankle dorsiflexion strength (222.64%) compared to the CG (51.27%, p = 0.002). Additionally, the IG's ankle dorsiflexion strength improvement significantly correlated with GVA improvement (rho = 0.782) at 4 week. The secondary outcomes did not reveal significant changes in neither group. Self-administered gastrocnemius E-Stim improves ankle dorsiflexion strength in individuals with PASC. However, larger sample sizes and longer interventions are needed to validate these findings.


Asunto(s)
COVID-19 , Terapia por Estimulación Eléctrica , Fuerza Muscular , Músculo Esquelético , Humanos , Masculino , Músculo Esquelético/fisiopatología , Femenino , Persona de Mediana Edad , COVID-19/fisiopatología , COVID-19/terapia , Fuerza Muscular/fisiología , Terapia por Estimulación Eléctrica/métodos , Método Doble Ciego , SARS-CoV-2 , Anciano , Síndrome Post Agudo de COVID-19 , Actividades Cotidianas , Electromiografía , Adulto , Tobillo/fisiopatología , Articulación del Tobillo/fisiopatología , Resultado del Tratamiento
17.
Support Care Cancer ; 32(9): 569, 2024 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-39102127

RESUMEN

PURPOSE: To synthesise evidence evaluating non-pharmacological interventions targeting mobility among people with advanced cancer, considering the type, efficacy and contextual factors that may influence outcome. METHODS: Systematic review of studies of non-pharmacological interventions in adults (≥ 18 years) with advanced (stage III-IV) cancer, and assessing mobility using clinical or patient-reported outcome measures. Searches were conducted across three electronic databases (MEDLINE, EMBASE and CINAHL) up to June 2024. Methodological quality was assessed using Joanna Briggs Institute tools and contextual factors were evaluated through the Context and Implementation of Complex Interventions framework. A narrative synthesis was conducted due to clinical heterogeneity of included studies. RESULTS: 38 studies encompassing 2,464 participants were included. The most frequent mobility outcome measure was the 6-min walk test (26/38 studies). Exercise was the most common intervention, (33 studies: 27 aerobic and resistance, 5 aerobic, 1 resistance versus aerobic training) and improvements in mobility were found in 21/33 outcomes. Electrotherapy interventions led to significant improvements in mobility in 3/5 studies. Geographical factors (e.g. distance, transport, parking requirements) potentially limited participation in 18/38 studies. A lack of ethnic diversity among populations was evident and language proficiency was an inclusion criterion in 12 studies. CONCLUSION: Exercise and neuromuscular electrical stimulation appear to improve mobility outcomes in advanced cancer. The evaluation of other non-pharmacological interventions targeting mobility should consider access and inclusivity, and be adaptable to the needs of this population.


Asunto(s)
Limitación de la Movilidad , Neoplasias , Humanos , Neoplasias/terapia , Terapia por Ejercicio/métodos , Terapia por Estimulación Eléctrica/métodos , Medición de Resultados Informados por el Paciente , Ejercicio Físico/fisiología
18.
Nat Commun ; 15(1): 6749, 2024 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-39117667

RESUMEN

Ingestible electronics have the capacity to transform our ability to effectively diagnose and potentially treat a broad set of conditions. Current applications could be significantly enhanced by addressing poor electrode-tissue contact, lack of navigation, short dwell time, and limited battery life. Here we report the development of an ingestible, battery-free, and tissue-adhering robotic interface (IngRI) for non-invasive and chronic electrostimulation of the gut, which addresses challenges associated with contact, navigation, retention, and powering (C-N-R-P) faced by existing ingestibles. We show that near-field inductive coupling operating near 13.56 MHz was sufficient to power and modulate the IngRI to deliver therapeutically relevant electrostimulation, which can be further enhanced by a bio-inspired, hydrogel-enabled adhesive interface. In swine models, we demonstrated the electrical interaction of IngRI with the gastric mucosa by recording conductive signaling from the subcutaneous space. We further observed changes in plasma ghrelin levels, the "hunger hormone," while IngRI was activated in vivo, demonstrating its clinical potential in regulating appetite and treating other endocrine conditions. The results of this study suggest that concepts inspired by soft and wireless skin-interfacing electronic devices can be applied to ingestible electronics with potential clinical applications for evaluating and treating gastrointestinal conditions.


Asunto(s)
Ghrelina , Animales , Porcinos , Ghrelina/metabolismo , Ghrelina/sangre , Robótica/instrumentación , Mucosa Gástrica/metabolismo , Estimulación Eléctrica/instrumentación , Terapia por Estimulación Eléctrica/instrumentación , Terapia por Estimulación Eléctrica/métodos , Femenino , Humanos , Suministros de Energía Eléctrica , Tracto Gastrointestinal , Electrodos
19.
Nat Commun ; 15(1): 6774, 2024 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-39117721

RESUMEN

Without intervention, cardiac arrhythmias pose a risk of fatality. However, timely intervention can be challenging in environments where transporting a large, heavy defibrillator is impractical, or emergency surgery to implant cardiac stimulation devices is not feasible. Here, we introduce an injectable cardiac stimulator, a syringe loaded with a nanoparticle solution comprising a conductive polymer and a monomer that, upon injection, forms a conductive structure around the heart for cardiac stimulation. Following treatment, the electrode is cleared from the body, eliminating the need for surgical extraction. The mixture adheres to the beating heart in vivo without disrupting its normal rhythm. The electrofunctionalized injectable cardiac stimulator demonstrates a tissue-compatible Young's modulus of 21 kPa and a high conductivity of 55 S/cm. The injected electrode facilitates electrocardiogram measurements, regulates heartbeat in vivo, and rectifies arrhythmia. Conductive functionality is maintained for five consecutive days, and no toxicity is observed at the organism, organ, or cellular levels.


Asunto(s)
Arritmias Cardíacas , Animales , Arritmias Cardíacas/terapia , Arritmias Cardíacas/fisiopatología , Conductividad Eléctrica , Corazón/fisiología , Nanopartículas/química , Electrocardiografía , Humanos , Ratones , Frecuencia Cardíaca , Polímeros/química , Masculino , Inyecciones , Módulo de Elasticidad , Terapia por Estimulación Eléctrica/instrumentación , Terapia por Estimulación Eléctrica/métodos , Electrodos Implantados
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