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PubMed1978

Hazards of succinylcholine administration during electrotherapy.

We describe prolonged apnea following electrotherapy in a patient who was also being treated with a topical organophosphate anticholinesterase, ecothiophate iodide (phospholine iodide), for glaucoma. The increased duration of action of succinylcholine resulted from low levels of serum cholinesterase that had been caused by the organophosphate. Attention is called to other drugs that directly or indirectly (by lowering serum cholinesterase) interact with succinylcholine chloride resulting in prolonged apnea. Other potential hazards of succinylcholine administration, such as hyperkalemia and cardiac arrhythmias, are also discussed.

Aged↗
PubMed1992

Electrotherapy and the management of minimally displaced fracture of the neck of the humerus.

A poor outcome arising from a minimally displaced fracture of the neck of the humerus may be the result of a contracture of the capsule of the glenohumoral joint. Pulsed high frequency electromagnetic energy (PHFE) is an electrotherapy to reduce pain and swelling and to enhance healing. If PHFE is effective, early mobilization of the injured shoulder will be possible, reducing the risk of joint capsule contracture. We therefore conducted a double-blind trial of PHFE in minimally displaced fractures of the neck of the humerus. Early physiotherapy produced an excellent outcome in all cases. The functional outcome depended on age rather than time of starting treatment, although a relationship was found between the time of starting treatment and the duration of therapy required. The use of PHFE did not improve the result further.

Adolescent↗
PubMed1989

Electrotherapy and hyperbaric oxygen: promising treatments for postradiation complications.

Electrotherapy and hyperbaric oxygen therapy have been added to physical therapy to treat patients with postsurgery and radiation sequelae. Problems of reduced oral opening and range of head movement, soft tissue necrosis, osteoradionecrosis, and delayed wound healing were addressed in 37 patients over a 3-year period. Of this group, 16 irradiated maxillary resection patients were specifically followed up to determine the effectiveness of the new modalities on improving reduced oral opening. Although healing and the quality of the soft tissues showed marked improvement there was no significant improvement in oral opening.

Acupuncture Therapy↗
PubMed1981

Effect of transcutaneous electrotherapy on CSF beta-endorphin content in patients without pain problems.

To test the hypothesis of opiate-like peptide release after transcutaneous electrotherapy we measured beta-endorphin cerebrospinal fluid (CSF) content in 13 patients without pain problems. The results indicate a time dependent increase of CSF beta-endorphin in the group of patients studied. This fact suggests that the analgesic properties of the treatment may be ascribed to an involvement of the endogenous opiates system, independently from the basal clinical conditions of the patients.

Adult↗
PubMed2001

Quantitative analysis of the electroencephalogram during cranial electrotherapy stimulation.

OBJECTIVE: Normal individuals were used to quantitate electroencephalographic (EEG) changes during concurrent administration of 0.5 and 100 Hz cranial electrotherapy stimulation (CES). METHODS: Twelve normal, right-handed males were used in a randomized, double-blind crossover design study. A 3 amplifier system incorporating noise-cancellation was used to collect one channel of EEG (O1-Cz configuration) for 30 min. Either 0.5, 100 Hz, or sham CES treatment was administered for 20 min of each session. Statistical analyses were applied to time- and frequency-domain EEG variables. RESULTS: Relative to sham control, 0.5 and 100 Hz CES caused the alpha band mean frequency to shift downward. Additionally, 100 Hz CES also caused a decrease of the alpha band median frequency and beta band power fraction. CONCLUSIONS: Both 0.5 and 100 Hz CES provide frequency distribution shifts that suggest beneficial changes in mental state. However, compared to 0.5 Hz CES, 100 Hz CES effected a greater overall change. It is suggested that similar tests be performed on individuals with various behavioral and neurological disorders to determine if comparable EEG changes can be realized and correlated with beneficial effects of CES therapy.

Adult↗
PubMed2001

The treatment of fibromyalgia with cranial electrotherapy stimulation.

In cranial electrotherapy stimulation (CES), micro-current levels of electrical stimulation are passed across the head via electrodes clipped to the ear lobes. After successful clinical use of CES with fibromyalgia patients in our clinic, it was decided to test these results with a double-blind, placebo-controlled study in which 60 randomly assigned patients were given 3 weeks of 1-hour-daily CES treatments, sham CES treatments, or were held as wait-in-line controls for any placebo effect in the sham-treated patients. Treated patients showed a 28% improvement in tender point scores, and a 27% improvement in self-rated scores of general pain level. The number of subjects rating their quality of sleep as poor dropped from 60% at the beginning of the study to 5%. In addition, there were significant gains in the self-rated feelings of well-being and quality of life, plus gains in six stress-related psychological test measures. No placebo effect was found among the sham-treated controls. A theoretical role of CES in affecting the brain's pain message mechanisms and/or neurohormonal control systems is discussed. It is concluded that CES is as effective as the drug therapies in several trials, with no negative side effects, and deserves further consideration as an additional agent for the treatment of fibromyalgia.

Journal Article↗
PubMedDate not supplied

Electrotherapy reverses inframalleolar ischemia: a retrospective, observational study.

OBJECTIVE: To determine if high-voltage pulsed current (HVPC) augments ischemic wound healing and increases periwound perfusion. DESIGN: A 5-year, retrospective, observational study was conducted on successive patients with ischemic wounds who were poor candidates for revascularization. INTERVENTION: HVPC was applied directly to wounds at greater than 100 volts, 100 pulses per second, 1 hour per day. In addition to HVPC, patients received standard care for ischemic wounds at the study facility. Ischemic wounds for which HVPC was not clinically indicated or not available received standard care alone. MAIN OUTCOME MEASURES: Wound area measured by planimetry, wound appearance observed by digital imaging techniques, and microcirculation monitored by transcutaneous oxygen (TcPo(2)) levels. RESULTS: The group that received HVPC plus standard care showed smaller wound areas from weeks 20 though 52 after the start of treatment compared with the group that received standard care alone (P <.05; Mann-Whitney test). One year after the start of treatment, 90% of HVPC-treated wounds were healed, compared with 29% of the wounds that received only standard care (P <.05; Fisher exact test). For the HVPC group, maximum periwound TcPo(2) improved during electrotherapy (6 +/- 8 mm Hg [standard deviation; SD] at baseline improved to 26 +/- 20 SD, during HVPC, P <.05; Wilcoxon signed rank test). CONCLUSION: The results of this retrospective trial demonstrate that HVPC plus standard care improved the healing rate of high-risk ischemic wounds. A direct relationship was shown between improved healing rates and increased periwound perfusion. A prospective randomized controlled trial is needed to further support these observational, preliminary findings.

Adult↗
PubMed1996

Potential and current density distributions of cranial electrotherapy stimulation (CES) in a four-concentric-spheres model.

Cranial electrotherapy stimulation (CES) has been successfully used for treatment of many psychiatric diseases. Its noninvasive nature is its major advantage over other forms of treatments such as drugs. It is postulated that the low electric current of CES causes the release of neurotransmitters. However, the current pathways have not been extensively investigated. In the following paper, analytical and numerical methods are used to determine the distribution of potential and current density in a four zone concentric spheres model of the human head when excited by two electrodes diametrically opposite to each other. Because of the azimuthal symmetry, which is assumed in this study, a two-dimensional (2-D) finite difference approximation is derived in the spherical grid. The current density distribution is projected around the center of the model, where the thalamus is modeled as a concentric sphere. All dimensions and electrical properties of the model are adapted from clinical data. Results of this simulation indicate that, in contrast to previous beliefs, a small fraction of the CES current does reaches the thalamic area and may facilitate the release of neurotransmitters.

Adult↗
PubMedDate not supplied

Cranial electrotherapy stimulation as a treatment for anxiety in chemically dependent persons.

Cranial electrotherapy stimulation (CES) is reported to be an effective treatment for anxiety, a major presenting symptom among chemically dependent patients. In this study, 40 inpatient alcohol and/or polydrug users were given CES or sham CES in a double blind design. An additional 20 patients served as normal hospital routine controls. Dependent measures of anxiety were the Profile of Mood States, the Institute for Personality and Ability Testing Anxiety Scale, and the State/Trait Anxiety Index. CES-treated patients showed significantly greater improvement on all anxiety measures than did either control group. There were no differences in response between older and younger patients, or between the primarily drug or alcohol abusers. No placebo effect was found on any of our measures. It is concluded tht CES is a clinically significant addition to the treatment regimen for this patient population.

Adult↗
PubMed1999

No effect of bipolar interferential electrotherapy and pulsed ultrasound for soft tissue shoulder disorders: a randomised controlled trial.

OBJECTIVE: To assess the efficacy of bipolar interferential electrotherapy (ET) and pulsed ultrasound (US) as adjuvants to exercise therapy for soft tissue shoulder disorders (SD). METHODS: Randomised placebo controlled trial with a two by two factorial design plus an additional control group in 17 primary care physiotherapy practices in the south of the Netherlands. Patients with shoulder pain and/or restricted shoulder mobility, because of a soft tissue impairment without underlying specific or generalised condition, were enrolled if they had not recovered after six sessions of exercise therapy in two weeks. They were randomised to receive (1) active ET plus active US; (2) active ET plus dummy US; (3) dummy ET plus active US; (4) dummy ET plus dummy US; or (5) no adjuvants. Additionally, they received a maximum of 12 sessions of exercise therapy in six weeks. Measurements at baseline, 6 weeks and 3, 6, 9, and 12 months later were blinded for treatment. OUTCOME MEASURES: recovery, functional status, chief complaint, pain, clinical status, and range of motion. RESULTS: After written informed consent 180 patients were randomised: both the active treatments were given to 73 patients, both the dummy treatments to 72 patients, and 35 patients received no adjuvants. Prognosis of groups appeared similar at baseline. Blinding was successfully maintained. At six weeks seven patients (20%) without adjuvants reported very large improvement (including complete recovery), 17 (23%) and 16 (22%) with active and dummy ET, and 19 (26%) and 14 (19%) with active and dummy US. These proportions increased to about 40% at three months, but remained virtually stable thereafter. Up to 12 months follow up the 95% CI for differences between groups for all outcomes include zero. CONCLUSION: Neither ET nor US prove to be effective as adjuvants to exercise therapy for soft tissue SD.

Adult↗
PubMed1980

A critical appraisal of neuromuscular stimulation and electrotherapy in neurorehabilitation.

The problems of neuromuscular electrostimulation in patients affected by central or peripheral nervous system chronic lesions have been analysed during an interdisciplinary meeting held in Pavia on Dec. 9, 1978 and evolved to the discussion of two previous workshops concerning the same topic. The effective value of functional electrical stimulation, especially for the lower limbs, seems to be proved in some patients with upper motor neuron lesions. However, a clear definition of patient selection criteria has not been given yet, while a comparison with the results with vibratory techniques is still be carried out. With regard to the so-called electrotherapy of denervated muscles. it has been stressed that the trophic state can also be promoted by vibratory mechanical stimulation while the electrical stimulation could partly reduce the diffuse type of membrane excitability present in the devervated muscle fibres; this effect might interfere negatively with the process of collateral nerve sprouting.

Electric Stimulation Therapy↗
PubMed1979

Treatment of methadone withdrawal with cerebral electrotherapy (electrosleep).

The use of cerebral electrotherapy (CET) in methadone detoxification was studied in 28 patients. Fourteen patients received active CET; the other 14 acted as controls and received either stimulated CET or only methadone detoxification therapy. One patient dropped out of the study. The Taylor Manifest Anxiety Scale and the Hamilton Anxiety Scale were administered before and after the study period. Nine of the patients receiving active CET were drug-free by the end of 8 to 10 days, and all experienced a marked reduction of their symptoms; the control group did not show significant changes. CET was clearly beneficial in the treatment of patients undergoing methadone withdrawal.

Adolescent↗
PubMed1980

Cortical evoked responses and transcutaneous electrotherapy.

Percutaneous electrostimulation, acupuncture, and direct stimulation of the central nervous system are supposed to be capable of reducing painful sensation by releasing enkephalins and endorphins. We treated six volunteers with electrotherapy, obtaining in all cases a clear reduction of the pain induced by electric stimulation of the median nerve at the wrist. During the treatment, the administration of naloxone, an antagonist of morphine, in four subjects provoked a short but clear and immediate return of pain. In the other two cases, the drug provoked a further decrease of the painful sensation. During electro-stimulation in all patients, the somatosensory evoked potentials showed a statistically significant decrease. In the four "naloxone-responsive" subjects, the cortical evoked responses returned to basal amplitude after naloxone. In the two patients with a clinically paradoxic response, nonsignificant modification in the cortical evoked potentials was noted.

Adult↗
PubMedDate not supplied

Using cranial electrotherapy stimulation to treat pain associated with spinal cord injury.

Treatments for chronic pain in persons with spinal cord injury (SCI) have been less than effective. Cranial electrotherapy stimulation (CES), a noninvasive technique that delivers a microcurrent to the brain via ear clip electrodes, has been shown to effectively treat several neurological and psychiatric disorders. The present study examined the effects of daily 1-hour active CES or sham CES treatment (randomly assigned) for 21 days on pain intensity and interference with activities in 38 males with SCI. The active CES group (n = 18) reported significantly decreased daily pain intensity compared with the sham CES group (n = 20) (mean change: active CES = -0.73, sham CES = -0.08; p = 0.03). Additionally, the active CES group reported significantly decreased pain interference (-14.6 pre- vs postintervention, p = 0.004) in contrast to the nonsignificant decrease in the sham CES group (-4.7 pre- vs postintervention, p = 0.24). These results suggest that CES can effectively treat chronic pain in persons with SCI.

Adult↗
PubMedDate not supplied

The use of cranial electrotherapy stimulation in the treatment of closed-head-injured patients.

This double-blind study sought to discover if cranial electrotherapy stimulation (CES), which is a known treatment of depression, anxiety and insomnia in non-head-injured patients, could be an effective, drug-free treatment of stress-related symptoms in the closed-head-injured (CHI) patient. In this study 10 CHI patients treated for 45 min daily, 4 days a week for 3 weeks, responded significantly on all negative mood factors of the Profile Of Mood States, while five sham-treated and six placebo controls did not. While the majority of the patients were known seizure cases, no patient suffered a seizure during CES therapy. No placebo effects were found, nor were any negative effects from CES treatment seen.

Adult↗
PubMed1995

Electrotherapy usage trends in private physiotherapy practice in Alberta.

Electrotherapy is a common treatment intervention administered by physiotherapists. Owing to a lack of scientific reporting of modality usage, particularly within Canada, it was the purpose of this study to survey all private practitioners registered within the Province of Alberta. A total of 208 clinicians representing 41% of the population sample, responded to the survey. Results indicated hot packs followed by ultrasound, ice, transcutaneous electrical nerve stimulation (TENS) and interferential were the most frequently used modalities. With the exception of ultrasound, these findings differed considerably from previous reports of modality usage. Statistical comparisons, using Fisher's exact test of independence, revealed frequent use of TENS was greater amongst older clinicians and clinic owners (p < 0.05) while male therapists used biofeedback more often than female colleagues (p < 0.05). No significant differences were found between therapists trained at the University of Alberta and those educated elsewhere. Peer influence within the geographically and politically defined sample population may explain the relatively few between-group differences. Future research should target additional population samples plus continue to monitor trends within previously studied groups.

Alberta↗
PubMedDate not supplied

Cranial electrotherapy stimulation (CES): a safe and effective low cost means of anxiety control in a dental practice.

A double-blind placebo-controlled study was performed on 33 randomly selected dental patients to evaluate whether cranial electrotherapy stimulation (CES) is a viable procedure for reducing anxiety during routine dental procedures. The active CES treatment group was significantly less anxious than the placebo group at the conclusion of various dental procedures.

Adult↗