Sedac electrotherapy III. A ten year study of therapeutic efficiency and indications.
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Adjustment Disorders↗
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[Value of electrotherapy within the scope of conservative treatment of anorectal incontinence].
The following study reports on transanal electric stimulation as a conservative method of treatment in anal incontinence. In the centre of interest are clinical examinations on 45 patients that underwent a combined treatment with the IT-system 100 from Reha-Medi and pelvic floor training. A collective of 29 patients only treated with pelvic floor training was used as a control group. The results were based on a thorough medical history ascertainment and the corresponding clinical examinations at the beginning and end of the treatment. Our findings were classified according to the modified score of incontinence of Holschneider [16]. After therapy 42.2% of patients with electric stimulation therapy and 27.6% of the control group showed continence. 40 respectively 62.1% were non responder without relevant benefit. In the electric stimulation group the median score before and after therapy amounted to 6.57 versus 9.24 points. The control group achieved 6.72 respectively 8.58 points. The differences are statistically significant (p < 0.05, Student t-test). Concerning the results in relation to the cause of the incontinence, no significant differences between idiopathic and traumatic origin of the insufficiency of the sphincter mechanism are found in both groups. Therefore all variations of anorectal incontinence are seen as indication for treatment. The international literature as well as our own results confirm that electric stimulation is effective and may be in special cases a major factor in the conservative treatment of anorectal incontinence.
Adult↗
Future directions of electrotherapy for atrial fibrillation.
Suboptimal treatment of atrial fibrillation (AF) by pharmacotherapy alone has given rise to multiple novel electrotherapeutic modalities including pacing, ablation, and atrial defibrillation. These treatment approaches offer physicians the opportunity to evaluate their patients more extensively to better optimize therapy. AV junctional node ablation followed by full-time pacing improves quality of life and reduces the incidence of tachycardia-induced cardiomyopathy. Physicians who are reluctant to ablate the AV node may opt for either an AV nodal modification procedure or therapeutic modalities that attempt to maintain sinus rhythm. Both biatrial and dual site pacing have met with some success in preventing AF in a limited patient population. Studies also have evaluated the extent to which pacing may be used to terminate AF. These initial studies showed that, in general, pacing was ineffective. Radiofrequency catheter ablation is another therapeutic modality receiving considerable interest. The creation of multiple lesions mimicking the maze procedure, isthmus ablation to prevent the onset of atrial flutter that may degrade into AF, and ablation of tachycardia foci are all potential treatment alternatives to consider either as the primary therapy or as a synergistic procedure designed to augment another electrical therapy. Internal atrial defibrillation is being shown to be both safe and efficacious. This therapy appears uniquely able to repeatedly restore sinus rhythm in a segment of the AF population. Any of these therapies, either alone or more likely in some form of combined therapy, is likely to significantly influence and improve the care of patients with AF in the future.
Atrial Fibrillation↗
[The use of transcranial electrotherapy in the rehabilitation of osteoarthrosis patients].
Rehabilitation of 39 patients with osteoarthrosis deformans (OD) consisted of transcranial electrostimulation (TCES) which was performed by means of Transair unit generating impulse current (77 Hz, frontal-retroauricular electrodes position). There was a positive trend in clinical indices, pain intensity, skin temperature. TCES mechanism of action involves stimulation of endorphine brain structures which elevates blood levels of beta-endorphines.
Adult↗
Transcutaneous electrostimulation: emerging treatment for diabetic neuropathic pain.
Three independent studies utilizing transcutaneous electrical nerve stimulation to relieve diabetic peripheral neuropathic pain were reviewed. The proprietary equipment, an H-wave machine, administered all electrotherapy. The first two studies assessed the efficacy of electrotherapy alone and electrotherapy with amitriptyline. The treated electrotherapy group reported an overall greater reduction of symptoms, 52% with 2-3 weeks of active treatment. Amitriptyline alone produced a 26% reduction of pain after 4 weeks. The addition of active electrotherapy to amitriptyline produced a 66% reduction of pain. The final study looked at patients who have utilized electrotherapy for over one year. A reported 44% improvement of symptoms was attained with continuous electrotherapy treatment. The data also suggested that a maintenance treatment protocol for long-term pain relief would have to be developed.
Amitriptyline↗
Diabetic peripheral neuropathy: amelioration of pain with transcutaneous electrostimulation.
OBJECTIVE: To evaluate the efficacy of transcutaneous electrotherapy for chronic painful peripheral neuropathy in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: Thirty-one patients with symptoms and signs of peripheral neuropathy were randomized to the electrotherapy or sham treatment (control) group. The electrostimulation was given by a portable unit (H-Wave machine) than generated a biphasic, exponentially decaying waveform (pulse width 4 ms, 25-35 V, > or = 2 Hz). Patients treated each of their lower extremities for 30 min daily for 4 weeks at home. Nine patients from the sham-treatment group participated for a second period, during which all of them received the active electrotherapy. Patient's degree of pain and discomfort was graded on a scale of 0 to 5. RESULTS: In the sham-treated group (n = 13), the neuropathic symptoms improved in five (38%) patients, and the pain score declined from 2.92 +/- 0.13 to 2.38 +/- 0.26 (P < 0.04), suggesting a procedure-related placebo effect. In the electrotherapy group (n = 18), symptomatic improvement was seen in 15 (83%) cases, 3 of which were completely asymptomatic; the pain score declined from 3.17 +/- 0.12 to 1.44 +/- 0.25 (P < 0.01) and the posttreatment pain scores were considerably lower (P < 0.03), indicating a substantial treatment effect over and above any placebo influence. Patients in the electrotherapy group reported greater reduction in symptoms (52 +/- 7% vs. 27 +/- 10% in control subjects, P < 0.05) on an analog scale. Moreover, the electrotherapy decreased pain scores (from 3.0 +/- 0.62 to 1.56 +/- 0.32, P < 0.02) in nine patients who had received sham treatment earlier. CONCLUSIONS: A form of transcutaneous electrotherapy ameliorated the pain and discomfort associated with peripheral neuropathy. This novel modality offers a potential non-pharmacological treatment option.
Adult↗
[The preventing and treating effects of electro-acupuncture on cholelithiasis in golden hamster].
In this study, the 38 golden hamsters, male and female each half, were divided into four groups: the control and control treating groups to feed normal foods; cholelithiasis model and model treating groups to feed special diet, which made high fat, high cholesterol and high carbohydrates to cause the cholelithiasis model of hamsters. After 30 day, the natural formation rate of gallstone rose to 50% (contral group), while model group, the formation rate was 100%. On the 30th day, the treatment was carried out. The control treating group and model treating group were acupunctured at Yanglingquan(G 34) and Qimen(Liv 14) through Riyue(G 24) on the right side of body respectively by electrotherapy. The period of treatment was total 7 days, once everyday and 10 min every once. The results showed: (1) In control treating group, the natural formation rate of gallstone of normal hamsters was dropped from 50% to 10%, the number of gall-tones was reduced markedly(P < 0.05) and number of huge gallstones was dropped to zero(P < 0.01). (2) In the cholelithiasis model treating group, the treatment of electrotherapy could significantly reduced the formation rate of cholelithiasis, the number of gallstones and the huge gall-stones(P < 0.05 or P < 0.01). Also, content of the cholesterol in plasma and bile were reduced, but the contents of the cholic acid secreted from the liver were obviously increased in the model hamsters. It was significant difference to compared with model group(P all < 0.05). (3) The electrotherapy increased the rhythmic actions and frequency of Oddi's sphincter electromyogram markedly(P < 0.05, P < 0.01) as well as secretion of hepatic bile(P < 0.05, P < 0.01). The effects of electrotherapy could continued 30 to 40 minutes. The results suggest that some points to acupuncture with electrotherapy can reduce the contents of cholesterol in plasma and bile, and increase the volumes of secretion of cholic acid, thus inhibit the crystallization of cholesterol from bile. At the sometime, the electrotherapy causes the rhythmic contractions of Oddi's sphincter and increase the secretion of bile, so the gallstones are discharged on its own initiative. Therefore the cholelithiasis is cured by acupuncture.
Animals↗
Rehabilitation of atrophied muscle in the rheumatoid arthritic hand: a comparison of two methods of electrical stimulation.
This study compares the effectiveness of two therapeutic electrotherapies which result in plastic adaptation in the atrophied muscle of rheumatoid arthritic hands. The natural discharge pattern of a fatigue-resistant motor unit (eutrophic electrotherapy) was more effective than a uniform 10 Hz electrotherapy. It was concluded that uniform 10 Hz electrotherapy ignored the information carried in the motor unit action potential spike train, which was the signal inducing rapid and behaviourally effective plastic adaptation.
Adult↗
The parasiticidal effect of electricity on Leishmania major, both in vitro and in vivo.
The effects of low electrical potentials on Leishmania major (MRHO/IR/75/ER) were investigated both in culture (in terms of promastigote viability) and in experimentally infected BALB/c and NMRI mice (in terms of the cure of pre-existing skin lesions). Exposure to direct-current potentials of 3, 6, 9 and 12 V (at 0.2-10.7 mA) killed all promastigotes in <15, <10, <10 and <10 min, respectively. When electrodes were used to pass similar direct currents across skin lesions on the tails of infected mice, all but the lowest voltage (3 V) caused unwanted ulceration. At 3 V, however, 3 weeks of electrotherapy, for 10 min twice weekly, initially appeared to cure all the lesions and the therapy was then halted. If given no electrotherapy, the BALB/c mice showed much greater Leishmania-attributable morbidity and mortality than the NMRI mice, and it was only in the treated BALB/c mice that relapses were observed, about 3 weeks after electrotherapy had ceased. The possible clinical use of electrotherapy in the treatment of human cutaneous leishmaniasis is discussed.
Animals↗
An investigation into the analgesic effects of interferential currents and transcutaneous electrical nerve stimulation on experimentally induced ischemic pain in otherwise pain-free volunteers.
BACKGROUND AND PURPOSE: Interferential currents (IFC) and transcutaneous electrical nerve stimulation (TENS) are used for pain management. This study compared the analgesic effects of IFC and TENS on experimentally induced ischemic pain in otherwise pain-free subjects using a modified version of the submaximal-effort tourniquet technique. SUBJECTS: The subjects were 30 volunteers (18 male, 12 female) without known pathology that could cause pain. Their mean age was 33.5 years (SD=9.9, range=21-54). METHOD: A single-blind, sham-controlled, parallel-group method was used. The primary outcome measure was the change in the self-report of pain intensity during 1 of 3 possible interventions: (1) IFC, (2) TENS, or (3) sham electrotherapy. The IFC and TENS were administered on the forearm, and the sham electrotherapy group received no current output via a dummy stimulator. RESULTS: A 2-way repeated-measures analysis of variance revealed that there was no change in pain intensity during treatment when all 3 groups were considered together. Further analysis revealed that IFC reduced pain intensity when compared with sham electrotherapy but not when compared only with TENS. DISCUSSION AND CONCLUSION: There were no differences in the magnitude of analgesia between IFC and TENS. Interferential currents reduced pain intensity to a greater extent than sham electrotherapy.
Adult↗
Treatment of nasal valve collapse with transcutaneous and intranasal electric stimulation.
We conducted a prospective, randomized, double-blind pilot study of patients presenting with symptoms of obstructed nasal breathing to determine whether electrotherapy could provide nonsurgical symptom relief. Forty patients were divided into an electrotherapy group (n = 20) and a placebo group (n = 20). All selected patients demonstrated nasal valve stenosis with a positive Cottle maneuver and clinically evident nasal valve collapse. Treatment consisted of high-frequency transcutaneous and intranasal electric stimulation of nasal muscles for 15 minutes, 3 times a week for 10 weeks. Treated patients were followed for 10 to 12 months. Twelve patients in the electrotherapy group (60%) exhibited subjective improvement; in 8 cases (40%), the improvement was proved objectively. In the placebo group, 7 patients (35%) indicated subjective improvement; and in one case (50%), the improvement was proved objectively. Follow-up visits showed a rapid decline of positive results when treatment was discontinued. Therefore, we concluded that sure relief of nasal valve stenosis and collapse cannot be achieved with treatment by electric stimulation alone, and this method appears to have limited application. However, further studies are needed to determine whether electrotherapy used in combination with other treatments (e.g., biofeedback training or nasal springs) may provide more lasting relief for patients who want to avoid endonasal surgical intervention.
Adult↗
Blood perfusion of subcutaneous tumours in mice following the application of low-level direct electric current.
Electrotherapy with low-level direct electric current has been proved to be an effective local treatment of solid tumours. In the presented study an attempt was made to evaluate the effect of a single treatment with electrotherapy on blood perfusion of solid subcutaneous fibrosarcoma Sa-1 tumours in A/J mice. The tissue-staining method with Patent blue-violet dye, the rubidium extraction technique, and the noninvasive near-infrared spectroscopy method were used for this purpose. Results of all methods indicate that perfusion and subsequently oxygenation of tumours were reduced due to application of electrotherapy.
Animals↗
Beneficial effects of electrical stimulation on neuropathic symptoms in diabetes patients.
Transcutaneous electrical nerve stimulation is utilized for relieving pain in the diabetes peripheral neuropathy. Previous studies were short-term and did not document sustained beneficial effects. In this study, the authors evaluated long-term effectiveness of electrotherapy administered by proprietary equipment, an H-wave machine. A detailed questionnaire concerning patients' symptoms prior to and following electrotherapy was mailed to the users of H-wave machine. The responses of 34 individuals who had diabetes mellitus were analyzed (age 74.1 +/- 1.6 SEM years, body mass index 28.5 +/- 0.8 kg/m2, duration of diabetes 15.8 +/- 2.0 years and duration of neuropathic symptoms 8.0 +/- 1.8 years). Telephone interviews were conducted with 20 additional diabetes patients selected randomly from the persons who did not return the questionnaire. Forty-one (76%) patients reported a 44.0 +/- 4.0% subjective improvement in their neuropathic pain. The overall improvement in pain was also significant on an analog scale of 10 (p < .01), and correlated well with the percent amelioration data (r2 = .65). These data suggest an effectiveness of electrotherapy in managing neuropathic pain as an adjunct to the analgesics. It appears to provide continued benefit as the responders have used this nonpharmacological treatment modality for an average period of 1.7 +/- 0.3 years.
Aged↗
Applying electric and electromagnetic energy as adjuvant treatment for pressure ulcers: a critical review.
Chronic pressure ulcers are a significant health problem especially in the aging population. National estimated annual treatment costs are in the billions of dollars. Only two treatment-related recommendations receive high ratings for reported experimental evidence of validity: Use of moist wound dressings and adjunctive electrotherapy for unresponsive Stage III and IV and recalcitrant Stage II ulcers. A critical literature review pertaining to electrotherapy reveals a myriad of electrical treatment modalities varying greatly in electric current type, strength, direction, frequency, waveform, and underlying voltage. However, few clinical trials pertaining to electrotherapy exist with almost all of them characterized by a small sample size leading to a biased group assignment with no possibility for stratification by ulcer stage, site, and other important factors. Power analysis shows that a sample size of at least 164 subjects is needed to permit cost-effectiveness evaluation with attention to critical variables. "Time to healing" is recommended as the treatment outcome measure to permit proper efficiency comparisons between the various treatment modalities and controls. These comparisons are crucial in a cost-conscious environment.
Bandages↗
[Conservative treatment of peripheral nerve lesions].
Conservative treatment for cases of peripheral nerve damage may be subdivided into electrotherapy, positioning on splints and active as well as passive physiotherapy. Electrotherapy is generally carried out with exponential current which makes selective stimulation of the paralyzed muscles possible without stimulation of sensory fibres. The adjustment of the stimulation parameters, duration of stimulus and pause, gradient and stimulus intensity to the conditions of stimulation for each case is possible by determining the most favorable pulse duration. Successful electrotherapy depends upon an early beginning, the selective stimulation of the paralyzed muscles with exponential current at a sufficiently high intensity under isometric conditions and by avoiding overstretching of the muscles. Positioning of the extremities on splints in a functional position of the joints prevents overstretching of paralyzed muscles and thus contractures. Passive physiotherapy is indicated for the prevention or mobilisation of joint contractures. Active physiotherapy stimulates the regeneration of motor nerve fibres. The aim is a reintegration of the paralyzed muscles with the mobile muscles. Here the training of intact synergists, the innervation of antagonists and the activation of symmetrical healthy muscles of the contralateral extremity should be considered. The treatment of single nerve lesions with vitamin B does not appear reasonable.
Electric Stimulation Therapy↗
[Medical treatment abroad. Why Bjørnstjerne Bjørnson died in Paris 1910].
The Norwegian poet and playwright Bjørnstjerne Bjørnson (1832-1910), Nobel prize laureate in literature 1903, died in Paris. He had suffered from angina pectoris for a few years and had difficulties in walking because of thrombophlebitis in his right leg. In 1909, he had received electrotherapy from a French physiologist, Dr. d'Arsonval, in Paris and felt rejuvenated after the treatment. In May 1909, while undergoing spa treatment in Larvik, he had an apoplexy which left him with a left hemiparesis, presumably due to a thrombosis of the right internal carotid artery. He became bedridden, developed focal epilepsy and was unable to participate in the national cultural activities that used to be part of his life. He then decided to return to Paris for another series of electrotherapy. He was brought to Paris in the Royal Danish railway carriage, and was received at the border as an official guest of the French republic. The electrotherapy machine was installed in his room at Hotel Wagram, where he stayed for several months while receiving treatment. However, his health deteriorated during the treatment and he died in Paris in April 1910.
Carotid Artery Thrombosis↗
The effects of weight reduction on the rehabilitation of patients with knee osteoarthritis and obesity.
OBJECTIVE: To evaluate the effect of weight reduction on the rehabilitation of patients with knee osteoarthritis and obesity. METHODS: A total of 126 patients with bilateral knee osteoarthritis and obesity were classified into 3 groups by their stages of osteoarthritis. Each group was divided into subgroups a, b, and c. The subjects in subgroup a received weight reduction treatment, those in subgroup b received weight reduction and electrotherapy modalities, and those in subgroup c received electrotherapy modalities to relieve pain. RESULTS: Pain reduction, weight reduction, ambulation speed, and changes of Lequesne's index were greater in patients in subgroups a and b than in subgroup c after treatment. Although the last pain scores in subgroup b were less than those in subgroup a, as measured by a visual analog scale (VAS), there was no significant difference between their functional status. Significant pain relief (VAS < 2) and an acceptable functional status (Lequesne's index < 7) were indicated when weight reduction was more than 15% and 12%, respectively, of the initial body weight of the individual. CONCLUSION: Weight reduction was found to be a practical adjuvant treatment in the rehabilitation of patients with knee osteoarthritis.
Acupuncture Therapy↗
A review of non-invasive electro neuromodulation as an intervention for non-neurogenic bladder dysfunction in children.
AIMS: The use of electrotherapeutics to improve filling and emptying dysfunction of the adult bladder has been well established, however the practice in children is less well known. The purpose of this review is to summarize the rationale behind the use of electro neuromodulation in children, examine the reported efficacy of the intervention for different presentations of dysfunction, and establish the current limitations to knowledge and practice. MATERIALS AND METHODS: A modified systematic review was carried out on all Medline studies identified as considering the use of electrotherapy or neuromodulation in children with bladder problems. Literature relating to use of this approach in adults was also searched in order to present current understanding of the treatment rationale and modes of application. RESULTS: A Medline search and handsearch of relevant conference proceedings revealed six studies of neuromodulation in children with non-neurogenic bladder dysfunction. There were no reports of the intervention in children with isolated pelvic floor dyssynergia, irritative symptoms, structural changes predisposing the pelvic floor to weakness, or monosymptomatic nocturnal enuresis. One report of the favorable effect of neuromodulation on gut dysmotility was identified. Study design and quality generated level 4 evidence. Positive post-intervention changes reported included: increased bladder capacity, decreased severity of urge, improved continence, and decrease frequency of urinary tract infection. Significant improvement in the urodynamic parameters of bladder compliance, number of uninhibited contractions, and bladder volume at first detrusor contraction were also reported. CONCLUSIONS: There are clear benefits from the use of electroneuromodulation in children with differing forms of voiding dysfunction. The treatment approach is independent of cognitive and pharmacological therapy, is minimally invasive, and free of side effects. To date, there are no clinical variables that reliably predict efficacy of electrotherapy in the various presentations of over and under active detrusor, sphincter dyssynergia, or irritative symptoms.
Child, Preschool↗