Electrical Nerve Stimulation (electrical + nerve_stimulation)

Distribution by Scientific Domains

Kinds of Electrical Nerve Stimulation

  • transcutaneou electrical nerve stimulation


  • Selected Abstracts


    Use of Percutaneous Electrical Nerve Stimulation (PENS) in the Short-term Management of Headache

    HEADACHE, Issue 4 2000
    Hesham E. Ahmed MD
    Objective.,To evaluate the short-term effects of percutaneous electrical nerve stimulation (PENS) in the management of three types of chronic headache. Background.,Traditional electroanalgesic therapies have been reported to be effective in the management of acute headache symptoms. However, no controlled studies have been performed in patients with chronic headache. Methods.,Thirty patients with either tension headache, migraine, or posttraumatic headache symptoms of at least 6 months' duration were randomized to receive PENS (needles with electricity) or "needles alone" according to a crossover study design. All treatments were administered for 30 minutes, three times a week for 2 consecutive weeks with 1 week off between the two different treatments. For the PENS treatments, an alternating electrical stimulation frequency of 15 and 30 Hz was used. Pain, activity, and sleep scores were assessed using a 10-cm visual analog scale, with 0 corresponding to the best and 10 to the worst, during the 48-hour period prior to the beginning of the two treatments, immediately before and after each treatment session, and 48 hours after completing each treatment modality. Results.,Compared with the needles alone, PENS therapy was significantly more effective in decreasing the overall VAS pain scores for tension-type headache, migraine and posttraumatic headache (58%, 59%, and 52% versus 20%, 15%, and 20%, respectively). Similarly, PENS therapy produced greater improvement in the patients' physical activity (41% to 58% for PENS versus 11% to 21% for needles only) and quality of sleep (41% to 48% for PENS versus 12% to 20% for needles only). However, there were no differences in the pattern of the response to PENS therapy among the three headache groups. Conclusions.,Percutaneous electrical nerve stimulation appears to be a useful complementary therapy to analgesic and antimigraine drugs for the short-term management of headache. Interestingly, the analgesic response to PENS therapy appears to be independent of the origin of the headache symptoms. [source]


    Effect of Transcutaneous Electrical Nerve Stimulation on Primary Dysmenorrhea

    NEUROMODULATION, Issue 4 2009
    Shwu-Fen Wang PT
    ABSTRACT Objectives.,Dysmenorrhea is a disturbing problem among women of childbearing age. The purpose of this study is to investigate the effect of high-frequency transcutaneous electrical nerve stimulation (TENS) on primary dysmenorrhea and to compare the placebo effect by sham TENS in a randomized controlled study. Materials and Methods.,Twenty-two women participated in the two-month experiment by using TENS or sham TENS in a random order for their dysmenorrhea. Outcome measures included self-reported pain intensity, symptom and function questionnaire related to dysmenorrhea, quality of life, satisfaction after TENS application, and other pain management agents adapted by the participants. Two-way repeated measures analysis of variance (two-way ANOVA) was conducted to compare pain intensity between pre-post values and groups (TENS vs. placebo). One-way repeated measures analysis of variance (one-way ANOVA) was conducted to compare scores from questionnaire of symptoms and quality of life at baseline, and after placebo or TENS stimulation. Results.,Pain intensity in TENS is significantly decreased than in the placebo group (p= 0.018). The decrease of pain intensity after TENS and placebo TENS were both significant, with p < 0.00005 and p < 0.00005 respectively. Furthermore, TENS significantly changed the degree of autonomic symptoms (p= 0.048); but not after placebo TENS. Conclusion.,This result supports that women in our country who suffer from primary dysmenorrhea could benefit by using TENS, which is consistent with the previous studies. In addition to pain-relieving effects, relief of the autonomic symptoms associated with dysmenorrhea also indicated that the mechanism of TENS might be different from the placebo effect of the sham TENS stimulation. These findings indicate the immediate effects of TENS in women with primary dysmenorrheal. [source]


    Transcutaneous Electrical Nerve Stimulation as Prehospital Emergency Interventional Care: Treating Acute Pelvic Pain in Young Women

    NEUROMODULATION, Issue 2 2006
    Renate Barker MD
    Abstract Objectives., In Europe, patients with acute pelvic pain are transported to the hospital in an ambulance without an emergency physician. We hypothesized that transcutaneous electrical nerve stimulation (TENS) would be an effective noninvasive procedure for pain treatment. Methods., We conducted a prospective, randomized, blinded study where 100 women were randomly assigned into a real- or a sham-TENS group. TENS began before the transport to the ambulance and was left in place until the arrival at the hospital. Each patient rated her pain on paper using a visual analog scale. Results., Compared to sham TENS, patients with active TENS felt that their pain was reduced by half after treatment (p < 0.01), anxiety scores significantly decreased (p < 0.01), heart rate and arteriolar vasoconstriction decreased significantly (p < 0.01), and nausea (p < 0.01) was lessened. Overall satisfaction with the received care was significantly higher (p < 0.01). Conclusion., TENS is a safe, rapid, and effective analgesic treatment for acute pelvic pain. [source]


    No relationship between enzyme activity and structure of nucleotide binding site in sarcoplasmic reticulum Ca2+ -ATPase from short-term stimulated rat muscle

    ACTA PHYSIOLOGICA, Issue 4 2009
    T. Mishima
    Abstract Aim:, We examined whether structural alterations to the adenine nucleotide binding site (ANBS) within sarcoplasmic (endo) reticulum Ca2+ -ATPase (SERCA) would account for contraction-induced changes in the catalytic activity of the enzyme as assessed in vitro. Methods:, Repetitive contractions were induced in rat gastrocnemius by electrical nerve stimulation. Measurements of sarcoplasmic reticulum properties were performed on control and stimulated muscles immediately after or at 30 min after the cessation of 5-min stimulation. In order to examine the properties at the ANBS, the binding capacity of SERCA to fluorescence isothiocyanate (FITC), a competitive inhibitor at the ANBS, was analysed in microsomes. Results:, Short-term electrical stimulation evoked a 23.9% and 32.6% decrease (P < 0.05) in SERCA activity and in the FITC binding capacity, respectively, in the superficial region of the muscle. Whereas SERCA activity reverted to normal levels during 30-min recovery, a restoration of the FITC binding capacity did not occur. Conclusion:, The discordant changes between the enzyme activity and the FITC binding suggest that, at least during recovery after exercise, changes in SERCA activity may not correlate closely with structural alterations to the ANBS within the enzyme. [source]


    The effect of number of lengthening contractions on rat isometric force production at different frequencies of nerve stimulation

    ACTA PHYSIOLOGICA, Issue 3 2009
    M. E. T. Willems
    Abstract Aim:, To test the effect of 3, 10, 60 and 240 lengthening contractions (LC) on maximal isometric force of rat plantar flexor muscles at different stimulation frequencies. Methods:, Using a dynamometer and electrical nerve stimulation, maximally active skeletal muscles were stretched by ankle rotation to produce LC of the plantar flexor muscles in intact female rats. After the lengthening contraction protocols, maximal isometric force was measured at different frequencies of nerve activation to obtain frequency-dependent force deficits (weakness). Results:, The magnitude of the force deficit, measured 1 h after the protocols at 80 Hz, increased as a function of repetition number (three LC, 33.3 ± 1.7%; 10 LC, 37.2 ± 2.3%; 60 LC, 67.6 ± 1.5%; 240 LC, 77.7 ± 1.2%). Force deficits were also measured at each stimulation frequency tested (5:120 Hz). Using a ratio of isometric force at 20:100 Hz stimulation, the relative depression of force at low frequency was determined. The relative depression of isometric force at low frequency was most prominent during the early repetitions. Conclusion:, As low-frequency force depression appears to result primarily from excitation,contraction (E,C) coupling failure, the early LC in a series of repeated contractions probably contribute most to damage of the cellular components involved in E,C coupling. [source]


    CLINICAL STUDY: Suppression of cue-induced heroin craving and cue-reactivity by single-trial transcutaneous electrical nerve stimulation at 2 Hz

    ADDICTION BIOLOGY, Issue 2 2006
    Fei Zhong
    ABSTRACT The purpose of the present study was to investigate the efficacy of 2 Hz transcutaneous electrical nerve stimulation (TENS) to reduce cue-induced heroin craving and the corresponding cardiovascular responses. Seventy heroin addicts with at least 1 month of abstinence were enrolled and randomly divided into two groups of 35, to receive single-trial 2 Hz TENS (TENS group) or mock TENS (mock group) during experimental procedure, respectively. They were required to express their degree of craving by visual analog scale before and after the presentation of a video-cue, and after TENS treatment, which lasted for 30 minutes. Heart rate and arterial blood pressure were simultaneously monitored in 56 cases, with 28 in each group. Results show that in mock group, video-cue induced a dramatic increase of craving score, which did not return to baseline in 150 minutes, whereas in the TENS group, 2 Hz TENS treatment produced a significant decrease of craving, reaching baseline in 90 minutes. Video-cue induced a significant increase of heart rate and systolic and diastolic blood pressure, which remained elevated for at least 60 minutes in the mock group; whereas in the TENS group, they returned to baseline immediately after the termination of TENS. These results indicate that the craving induced by a heroin-related cue can be immediately and significantly suppressed, and the cardiovascular activation totally abolished by a single-trial 2 Hz TENS for 30 minutes [source]


    TENS and optokinetic stimulation in neglect therapy after cerebrovascular accident: a randomized controlled study

    EUROPEAN JOURNAL OF NEUROLOGY, Issue 9 2008
    A. Schröder
    Background:, In a randomized controlled type Ib study, the effectiveness of three different forms of therapy for the treatment of visual neglect was assessed by comparing therapy outcomes in three groups of patients after cerebrovascular accidents. Methods:, A control group received only standard exploration training, whilst the second and third group received exploration training combined with either contralateral transcutaneous electrical nerve stimulation (TENS) or optokinetic stimulation (OKS) respectively. Results:, It was found that exploration training alone resulted in no improvement on both standard neglect tests (NTs) and everyday-relevant measures of reading and writing performance. In contrast, the groups receiving TENS or OKS showed significant improvements in both sets of measures with the difference that for the TENS group the improvement in NT scores at the end of therapy had disappeared 1-week later. However, both treatments resulted in significant improvements in reading and writing which were still present upon retesting 1-week after the end of therapy. Conclusion:, Both methods can be recommended for neglect therapy and are superior to exploration therapy alone. [source]


    EFNS guidelines on neurostimulation therapy for neuropathic pain

    EUROPEAN JOURNAL OF NEUROLOGY, Issue 9 2007
    G. Cruccu
    Pharmacological relief of neuropathic pain is often insufficient. Electrical neurostimulation is efficacious in chronic neuropathic pain and other neurological diseases. European Federation of Neurological Societies (EFNS) launched a Task Force to evaluate the evidence for these techniques and to produce relevant recommendations. We searched the literature from 1968 to 2006, looking for neurostimulation in neuropathic pain conditions, and classified the trials according to the EFNS scheme of evidence for therapeutic interventions. Spinal cord stimulation (SCS) is efficacious in failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS) type I (level B recommendation). High-frequency transcutaneous electrical nerve stimulation (TENS) may be better than placebo (level C) although worse than electro-acupuncture (level B). One kind of repetitive transcranial magnetic stimulation (rTMS) has transient efficacy in central and peripheral neuropathic pains (level B). Motor cortex stimulation (MCS) is efficacious in central post-stroke and facial pain (level C). Deep brain stimulation (DBS) should only be performed in experienced centres. Evidence for implanted peripheral stimulations is inadequate. TENS and r-TMS are non-invasive and suitable as preliminary or add-on therapies. Further controlled trials are warranted for SCS in conditions other than failed back surgery syndrome and CRPS and for MCS and DBS in general. These chronically implanted techniques provide satisfactory pain relief in many patients, including those resistant to medication or other means. [source]


    Axon-glia communication evokes calcium signaling in olfactory ensheathing cells of the developing olfactory bulb

    GLIA, Issue 4 2007
    Anne Rieger
    Abstract Olfactory ensheathing cells (OECs) accompany receptor axons in the olfactory nerve and promote axonal growth into the central nervous system. The mechanisms underlying the communication between axons and OECs, however, have not been studied in detail yet. We investigated the effect of activity-dependent neuronal transmitter release on Ca2+ signaling of OECs in acute mouse olfactory bulb slices using confocal Ca2+ imaging. TTX-sensitive axonal activity upon electrical nerve stimulation triggers a rise in cytosolic Ca2+ in OECs, which can be mimicked by application of DHPG, an agonist of metabotropic glutamate receptors (mGluRs). Both stimulation- and DHPG-induced Ca2+ transients in OECs were abolished by depletion of intracellular Ca2+ stores with cyclopiazonic acid (CPA). The mGluR1 -specific antagonist CPCCOEt completely inhibited DHPG-evoked Ca2+ transients, but reduced stimulation-induced Ca2+ transients only partly, suggesting the involvement of another neurotransmitter. Application of ATP evoked CPA-sensitive Ca2+ transients in OECs, which were inhibited by the P2Y1 -specific antagonist MRS2179. Co-application of CPCCOEt and MRS2179 almost completely blocked the stimulation-induced Ca2+ transients, indicating that they were mediated by mGluR1 and P2Y1 receptors. Our results show that OECs are able to respond to olfactory nerve activity with an increase in cytosolic Ca2+ due to glutamate and ATP release. © 2006 Wiley-Liss, Inc. [source]


    Investigation of optimal intensity and safety of electrical nerve stimulation during intraoperative neuromonitoring of the recurrent laryngeal nerve: A prospective porcine model,

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 10 2010
    Che-Wei Wu MD
    Abstract Background Intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) has recently been more frequently applied in thyroid surgery. However, concerns have been raised regarding the safety and optimal intensity of electrical nerve stimulation. Methods Eight piglets were enrolled, and electrically evoked electromyography (EMG) was recorded from the vocalis muscles via endotracheal surface electrodes. The baseline EMG was measured and continuous pulsatile stimulations were performed on the vagus nerve and RLN for 10 minutes. Changes of EMG waveform and cardiopulmonary status were analyzed. Results A dose,response curve existed with increasing EMG amplitude as stimulating current was increased, with maximum amplitude elicited on vagal and RLN stimulation at <1 mA. No obvious EMG changes and untoward cardiopulmonary effects were observed after the stimulation. Conclusions Electrical stimulation is safe during IONM in this porcine model. Minimal current that required generating the maximal evoked EMG, approximately 1 mA in this study, can be selected to minimize the risk of nerve damage and cardiopulmonary effects. © 2010 Wiley Periodicals, Inc. Head Neck, 2010 [source]


    Use of Percutaneous Electrical Nerve Stimulation (PENS) in the Short-term Management of Headache

    HEADACHE, Issue 4 2000
    Hesham E. Ahmed MD
    Objective.,To evaluate the short-term effects of percutaneous electrical nerve stimulation (PENS) in the management of three types of chronic headache. Background.,Traditional electroanalgesic therapies have been reported to be effective in the management of acute headache symptoms. However, no controlled studies have been performed in patients with chronic headache. Methods.,Thirty patients with either tension headache, migraine, or posttraumatic headache symptoms of at least 6 months' duration were randomized to receive PENS (needles with electricity) or "needles alone" according to a crossover study design. All treatments were administered for 30 minutes, three times a week for 2 consecutive weeks with 1 week off between the two different treatments. For the PENS treatments, an alternating electrical stimulation frequency of 15 and 30 Hz was used. Pain, activity, and sleep scores were assessed using a 10-cm visual analog scale, with 0 corresponding to the best and 10 to the worst, during the 48-hour period prior to the beginning of the two treatments, immediately before and after each treatment session, and 48 hours after completing each treatment modality. Results.,Compared with the needles alone, PENS therapy was significantly more effective in decreasing the overall VAS pain scores for tension-type headache, migraine and posttraumatic headache (58%, 59%, and 52% versus 20%, 15%, and 20%, respectively). Similarly, PENS therapy produced greater improvement in the patients' physical activity (41% to 58% for PENS versus 11% to 21% for needles only) and quality of sleep (41% to 48% for PENS versus 12% to 20% for needles only). However, there were no differences in the pattern of the response to PENS therapy among the three headache groups. Conclusions.,Percutaneous electrical nerve stimulation appears to be a useful complementary therapy to analgesic and antimigraine drugs for the short-term management of headache. Interestingly, the analgesic response to PENS therapy appears to be independent of the origin of the headache symptoms. [source]


    Paramedical treatment in primary dystonia: A systematic review,

    MOVEMENT DISORDERS, Issue 15 2009
    Cathérine C.S. Delnooz MD
    Abstract Dystonia is a disabling movement disorder with a significant impact on quality of life. The current therapeutic armamentarium includes various drugs, botulinum toxin injections, and occasionally (neuro)surgery. In addition, many patients are referred for paramedical (including allied health care) interventions. An enormous variation in the paramedical treatment is provided, largely because evidence-based, accepted treatment regimes are not available. We have conducted a systematic review of studies that explored the effect of various paramedical interventions in primary dystonia. Only studies that have used clinical outcome measures were included. There were no class A1 or A2 studies and therefore, level 1 or 2 practice recommendations for a specific intervention could not be deducted. Many papers were case reports, mostly with a very limited number of patients and a clear publication bias for beneficial effects of a particular paramedical intervention. Some potentially interesting interventions come from class B studies, which include physical therapy in addition to botulinum toxin injections (BoNT-A) in cervical dystonia; sensorimotor training and transcutaneous electrical nerve stimulation (TENS) in writer's cramp; and speech therapy added to BoNT-A injections in laryngeal dystonia. Good quality clinical studies are therefore warranted, which should have the aim to be generally applicable. A design in which the paramedical intervention is added to a current gold standard, for example, BoNT-A injections in cervical dystonia, is recommended. © 2009 Movement Disorder Society [source]


    Acute effect of transcutaneous electrical nerve stimulation on tremor

    MOVEMENT DISORDERS, Issue 2 2003
    Renato P. Munhoz MD
    Abstract Based on the claims that transcutaneous electrical nerve stimulation is effective in myoclonic dystonia and essential tremor, we evaluated its acute effects in 5 patients with essential tremor and 2 patients with tremor attributed to peripheral neuropathy using as parameters the Washington Heights-Inwood Genetic Study of Essential Tremor rating scale, self-reported impression, and recording of electromyographic activity. We found no significant improvement in any of the parameters tested. © 2002 Movement Disorder Society [source]


    Effect of Transcutaneous Electrical Nerve Stimulation on Primary Dysmenorrhea

    NEUROMODULATION, Issue 4 2009
    Shwu-Fen Wang PT
    ABSTRACT Objectives.,Dysmenorrhea is a disturbing problem among women of childbearing age. The purpose of this study is to investigate the effect of high-frequency transcutaneous electrical nerve stimulation (TENS) on primary dysmenorrhea and to compare the placebo effect by sham TENS in a randomized controlled study. Materials and Methods.,Twenty-two women participated in the two-month experiment by using TENS or sham TENS in a random order for their dysmenorrhea. Outcome measures included self-reported pain intensity, symptom and function questionnaire related to dysmenorrhea, quality of life, satisfaction after TENS application, and other pain management agents adapted by the participants. Two-way repeated measures analysis of variance (two-way ANOVA) was conducted to compare pain intensity between pre-post values and groups (TENS vs. placebo). One-way repeated measures analysis of variance (one-way ANOVA) was conducted to compare scores from questionnaire of symptoms and quality of life at baseline, and after placebo or TENS stimulation. Results.,Pain intensity in TENS is significantly decreased than in the placebo group (p= 0.018). The decrease of pain intensity after TENS and placebo TENS were both significant, with p < 0.00005 and p < 0.00005 respectively. Furthermore, TENS significantly changed the degree of autonomic symptoms (p= 0.048); but not after placebo TENS. Conclusion.,This result supports that women in our country who suffer from primary dysmenorrhea could benefit by using TENS, which is consistent with the previous studies. In addition to pain-relieving effects, relief of the autonomic symptoms associated with dysmenorrhea also indicated that the mechanism of TENS might be different from the placebo effect of the sham TENS stimulation. These findings indicate the immediate effects of TENS in women with primary dysmenorrheal. [source]


    Transcutaneous Electrical Nerve Stimulation as Prehospital Emergency Interventional Care: Treating Acute Pelvic Pain in Young Women

    NEUROMODULATION, Issue 2 2006
    Renate Barker MD
    Abstract Objectives., In Europe, patients with acute pelvic pain are transported to the hospital in an ambulance without an emergency physician. We hypothesized that transcutaneous electrical nerve stimulation (TENS) would be an effective noninvasive procedure for pain treatment. Methods., We conducted a prospective, randomized, blinded study where 100 women were randomly assigned into a real- or a sham-TENS group. TENS began before the transport to the ambulance and was left in place until the arrival at the hospital. Each patient rated her pain on paper using a visual analog scale. Results., Compared to sham TENS, patients with active TENS felt that their pain was reduced by half after treatment (p < 0.01), anxiety scores significantly decreased (p < 0.01), heart rate and arteriolar vasoconstriction decreased significantly (p < 0.01), and nausea (p < 0.01) was lessened. Overall satisfaction with the received care was significantly higher (p < 0.01). Conclusion., TENS is a safe, rapid, and effective analgesic treatment for acute pelvic pain. [source]


    The Diagnostic Dilemma of "Pseudopacemaker Spikes"

    PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 2 2000
    ANDREW J.M. BROADLEY
    In a patient who sustained sudden collapse, later attributed to pulmonary embolization, an ECG during her evaluation demonstrated sinus tachycardia and stimulus artefacts at a rate of 250 per minute which did not capture the heart. Implanted pacemaker malfunction was considered the cause until a chest X ray showed a transcutaneous electrical nerve stimulation (TENS) device, which was the source of the artefacts. In instances of rapid stimulus artefacts on the ECG that do not capture the heart, the presence of a TENS device should be considered. [source]


    An Integrative Approach for Treating Postherpetic Neuralgia,A Case Report

    PAIN PRACTICE, Issue 3 2007
    Shu-Ming Wang MD
    Abstract: This report describes the successful treatment of a patient with postherpetic neuralgia using traditional pharmacology in combination with acupuncture. Case Report: A 13-year-old girl developed postherpetic neuralgia following a severe attack of varicella zoster. Despite a 1-week course of intravenous acyclovir initiated at the onset of symptoms, the patient developed persistent left facial pain and constant nausea after lesions were healed. A comprehensive pain treatment regimen, consisting of a stellate ganglia block, medications, transcutaneous electrical nerve stimulation and hypnosis, was administered, but the patient did not gain any incremental pain relief. The acupuncture service was consulted to provide assistance with this patient's pain management. A combination of body and auricular acupuncture as well as related techniques, including acupressure and transcutaneous acupoint electrical stimulation, was added to the pain treatment regimen. After 10 complementary acupuncture treatments over a 2-month period, the patient's nausea disappeared. Her left facial pain continued to decline from a maximum of 10 to 0 as assessed by a visual analog scale over a period of 4 months following self-administered treatments of acupressure and transcutaneous acupoint electrical stimulation. The patient was then gradually weaned off all her medications and the complementary acupuncture treatment. She was discharged from the pediatric pain clinic after 5 months of the combined therapy. Conclusions: Acupuncture and its related techniques may be an effective adjunctive treatment for symptoms associated with postherpetic neuralgia and deserve further study. [source]


    Choice of treatment modalities was not influenced by pain, severity or co-morbidity in patients with knee osteoarthritis

    PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2010
    Gro Jamtvedt
    Abstract Background and Purpose.,Patients with knee osteoarthritis (OA) are commonly treated by physiotherapists in primary care. The physiotherapists use different treatment modalities. In a previous study, we identified variation in the use of transcutaneous electrical nerve stimulation (TENS), low level laser or acupuncture, massage and weight reduction advice for patients with knee OA. The purpose of this study was to examine factors that might explain variation in treatment modalities for patients with knee OA.,Methods.,Practising physiotherapists prospectively collected data for one patient with knee osteoarthritis each through 12 treatment sessions. We chose to examine factors that might explain variation in the choice of treatment modalities supported by high or moderate quality evidence, and modalities which were frequently used but which were not supported by evidence from systematic reviews. Experienced clinicians proposed factors that they thought might explain the variation in the choice of these specific treatments. We used these factors in explanatory analyses.,Results.,Using TENS, low level laser or acupuncture was significantly associated with having searched databases to help answer clinical questions in the last six months (odds ratio [OR] = 1.93, 95% confidence interval [CI] = 1.08,3.42). Not having Internet access at work and using more than four treatment modalities were significant determinants for giving massage (OR = 0.36, 95% CI = 0.19,0.68 and OR = 8.92, 95% CI = 4.37,18.21, respectively). Being a female therapist significantly increased the odds for providing weight reduction advice (OR = 3.60, 95% CI = 1.12,11.57). No patient characteristics, such as age, pain or co-morbidity, were significantly associated with variation in practice.,Conclusions.,Factors related to patient characteristics, such as pain severity and co-morbidity, did not seem to explain variation in treatment modalities for patients with knee OA. Variation was associated with the following factors: physiotherapists having Internet access at work, physiotherapists having searched databases for the last six months and the gender of the therapist. There is a need for more studies of determinants for physiotherapy practice. Copyright © 2009 John Wiley & Sons, Ltd. [source]


    The effect of electrical and mechanical stimulation on the regenerating rodent facial nerve,

    THE LARYNGOSCOPE, Issue 6 2010
    Tessa Hadlock MD
    Abstract Objectives/Hypothesis: Investigators have long sought realistic methods to accelerate regeneration following nerve injury. Herein, we investigated the degree to which manual target muscle manipulation and brief electrical stimulation of the facial nerve, alone or in combination, affects recovery following rat facial nerve injury. Study Design: Prospective, randomized animal study. Methods: Sixty rats were randomized to three groups: brief electrical stimulation (BES), mechanical stimulation of the whisker pad (MEC), or both (COMBO). Animals underwent facial nerve transection and immediate microsurgical repair. In BES and COMBO groups, transection was preceded by 1-hour (3 V, 20 Hz square wave) electrical stimulation. Animals were tested weekly, with 5-minute recording sessions of whisker movement. In the MEC and COMBO groups, animals received 5 minutes of daily massage to the left whisker pad throughout the recovery period. Whisking behavior was analyzed for comparisons. Results: The BES and MEC groups demonstrated improved functional recovery in all whisking parameters compared with the COMBO group or historical controls at most time points between postoperative weeks 1 and 7. After 12 weeks, functional recovery remained superior in the BES and MEC groups compared with the COMBO and control groups, although the effect was no longer statistically significant. Conclusions: We observed an accelerative recovery effect of either electrical nerve stimulation or massage of the whisker pad on whisking behavior. The combination of both interventions had a negating effect on the acceleration of recovery. The potential clinical utility of these modalities bears consideration, and their negating interaction warrants further study. Laryngoscope, 2010 [source]