Intensive care units’ acquired muscle weakness is present in approximately 50% of the patients. Although active muscle training can attenuate weakness, a large proportion of critical patients cannot participate in an...Intensive care units’ acquired muscle weakness is present in approximately 50% of the patients. Although active muscle training can attenuate weakness, a large proportion of critical patients cannot participate in any active mobilization. Neuromuscular electrical stimulation may be an alternative strategy to reverse muscle weakness. The objective of the study was to review the scientific publications on the use of neuromuscular electrical stimulation and its parameters and the main results in patients hospitalized in intensive care units. This is an integrative review surveying studies in online databases. The studies were selected from the following descriptors: neuromuscular electrical stimulation AND parameters AND intensive care units AND muscle weakness. The inclusion criteria included articles that addressed the topic of neuromuscular electrical stimulation and the parameters used in patients admitted to intensive care units, aged 18 years or older. Exclusion criteria were studies involving animals, case reports, letters to the editor and book chapters. The search comprised articles in the Portuguese, English and Spanish languages from January 2013 to March 2019. Of the 185 articles identified, nine met the eligibility criteria. The studies were evaluated assessing the level of evidence, and the relevant information was presented in the table and discussed. The parameters of the neuromuscular electrical stimulation employed in the studies showed positive results for the maintenance of strength and muscle mass. There was evidence of benefits in the local and systemic microcirculation, potentially mobilizing endothelial stem cells, to prevent atrophy, to reduce mechanical ventilation time and stay in intensive care unit;and when incorporated into the usual physiotherapy care, proved to be more effective than usual care. Its use is safe and viable in critically ill patients.展开更多
This review focuses on the available evidence regarding the molecular mechanisms and treatment potential of several non-surgical physical therapies for managing flap ischemia to propose a non-invasive,economical,and s...This review focuses on the available evidence regarding the molecular mechanisms and treatment potential of several non-surgical physical therapies for managing flap ischemia to propose a non-invasive,economical,and simple treatment to improve flap survival.A review of the literature was conducted on the topics of various non-invasive methods for the treatment of ischemic necrosis of the distal end of the flap between 1988 and 2019.A total of 52 published studies were reviewed on the applications of hyperbaric oxygen therapy,electrical stimulation therapy,heat stress pretreatment,phototherapy,and vibration therapy to manage skin flap necrosis.The underlying molecular mechanisms of these physical therapies on revitalizing the dying skin flaps were discussed and preliminary clinical uses of these therapies to salvage the necrotic skin flaps were pooled and summarized for clarifying the safety and feasibility of these methods.Various physical therapy regimens have been ushered to manage necrotic development in cutaneous flaps.With the refinement of these new technologies and enhancement of related basic science research on vascular revitalization,the prevention and treatment of flap ischemia will enter a new era.展开更多
Background:Electrical stimulation has been recommended as an effective therapy to prevent muscle atrophy after nerve injury.However,the effect of electrical stimulation on the proliferation of satellite cells in dener...Background:Electrical stimulation has been recommended as an effective therapy to prevent muscle atrophy after nerve injury.However,the effect of electrical stimulation on the proliferation of satellite cells in denervated muscles has not yet been fully elucidated.This study was aimed to evaluate the changes in satellite cell proliferation after electrical stimulation in nerve injury and to determine whether these changes are related to the restoration of myofiber cross-section area(CSA).Methods:Sciatic nerve crush injury was performed in 48 male Sprague-Dawley rats.In half(24/48)of the rats,the gastrocnemius was electrically stimulated transcutaneously on a daily basis after injury,while the other half were not stimulated.Another group of 24 male Sprague-Dawley rats were used as sham operation controls without injury or stimulation.The rats were euthanized 2,4,and 6 weeks later.After 5-bromo-2’-deoxyuridine(BrdU)labeling,the gastrocnemia were harvested for the detection of paired box protein 7(Pax7),BrdU,myofiber CSA,and myonuclei number per fiber.All data were analyzed using two-way analysis of variance and Bonferroni post-hoc test.Results:The percentages of Pax7-positive nuclei(10.81±0.56%)and BrdU-positive nuclei(34.29±3.87%)in stimulated muscles were significantly higher compared to those in non-stimulated muscles(2.58±0.33%and 1.30±0.09%,respectively,Bonferroni t=15.91 and 18.14,P<0.05).The numbers of myonuclei per fiber(2.19±0.24)and myofiber CSA(1906.86±116.51 mm2)were also increased in the stimulated muscles(Bonferroni t=3.57 and 2.73,P<0.05),and both were positively correlated with the Pax7-positive satellite cell content(R2=0.52 and 0.60,P<0.01).There was no significant difference in the ratio of myofiber CSA/myonuclei number per fiber among the three groups.Conclusions:Our results indicate that satellite cell proliferation is promoted by electrical stimulation after nerve injury,which may be correlated with an increase in myonuclei number and myofiber CSA.展开更多
OBJECTIVE:To evaluate the effects of electric acupoint stimulation on gastrointestinal hormones and motility among geriatric postoperative patients with gastrointestinal tumors,and to explore an efficient and noninvas...OBJECTIVE:To evaluate the effects of electric acupoint stimulation on gastrointestinal hormones and motility among geriatric postoperative patients with gastrointestinal tumors,and to explore an efficient and noninvasive method for postoperative recovery of bowel functions.METHODS:Forty patients were randomly and evenly assigned into a regular nursing care group(RNC) and an acupoint electric stimulation group(AES).Patients in the RNC group received regular nursing care and patients in the AES group received regular nursing care plus electric stimulation of acupoints.The serum levels of gastrin(GAS),motilin(MOT),and cholecystokinin(CCK),and an electrogastrogram(EGG) of all the patients were evaluated on the first,third,and fifth day after surgery.The time to first flatus after surgery and the number of patients with side effects such as abdominal pain,abdominal distention,and diarrhea were recorded.RESULTS:There were significant differences between the two groups in GAS,MOT,EGG,time to first flatus,abdominal pain,abdominal distention,and diarrhea(P < 0.05).CONCLUSION:Electric stimulation on acupoints could increase levels of GAS and MOT,promote the recovery of gastrointestinal functions,and decrease complications among postoperative senile patients with gastrointestinal tumors.展开更多
Objective The purpose of this study is to evaluate and compare the two different treatments by researching 135 cases with stress urinary incontinence.Methods From June 2006 to June 2010,135 patients with stress urinar...Objective The purpose of this study is to evaluate and compare the two different treatments by researching 135 cases with stress urinary incontinence.Methods From June 2006 to June 2010,135 patients with stress urinary incontinence were treated in Department of Gynecology and Obstetrics of Peking University Shenzhen Hospital.91 cases of them were treated with low frequency electric stimulation and biofeedback therapy (Group A),and the other 44 cases were treated by improved transobturaor tension-free vaginal tape(TVT-O) and TVT-O (Group B).Then,we compared these two groups by whole recovery rate,recovery rate of patients with urge incontinence,charge of treatment and complication,respectively.Results Group B's recovery rate for stress urinary incontinence was 100%.Ⅰ degree stress urinary incontinence in Group A's recovery rate was higher;Ⅱ degree patients' recovery rate for stress urinary incontinence was lower;Ⅲ degree patients' recovery rate was 0%.Only 1 case showed abnormal urine stream;2 cases showed urinary retention,but the symptoms disappeared after the treatment.No significant complication in Group A.There were huge differences of the expense between the two groups.The effect in Group A for patients with urge incontinence was good,but there was no effect shown in Group B.Conclusions The two treatments are safe and effective for stress urinary incontinence,but there are existed prominent differences of the therapeutic efficacy between the two groups.展开更多
基金funded in part by the Coordination of Improvement of Higher Level Personnel—Brazil(CAPES)—Finance Code 001by the National Council of Scientific and Technological Development—Brazil(CNPq)—Doctorate GD
文摘Intensive care units’ acquired muscle weakness is present in approximately 50% of the patients. Although active muscle training can attenuate weakness, a large proportion of critical patients cannot participate in any active mobilization. Neuromuscular electrical stimulation may be an alternative strategy to reverse muscle weakness. The objective of the study was to review the scientific publications on the use of neuromuscular electrical stimulation and its parameters and the main results in patients hospitalized in intensive care units. This is an integrative review surveying studies in online databases. The studies were selected from the following descriptors: neuromuscular electrical stimulation AND parameters AND intensive care units AND muscle weakness. The inclusion criteria included articles that addressed the topic of neuromuscular electrical stimulation and the parameters used in patients admitted to intensive care units, aged 18 years or older. Exclusion criteria were studies involving animals, case reports, letters to the editor and book chapters. The search comprised articles in the Portuguese, English and Spanish languages from January 2013 to March 2019. Of the 185 articles identified, nine met the eligibility criteria. The studies were evaluated assessing the level of evidence, and the relevant information was presented in the table and discussed. The parameters of the neuromuscular electrical stimulation employed in the studies showed positive results for the maintenance of strength and muscle mass. There was evidence of benefits in the local and systemic microcirculation, potentially mobilizing endothelial stem cells, to prevent atrophy, to reduce mechanical ventilation time and stay in intensive care unit;and when incorporated into the usual physiotherapy care, proved to be more effective than usual care. Its use is safe and viable in critically ill patients.
文摘This review focuses on the available evidence regarding the molecular mechanisms and treatment potential of several non-surgical physical therapies for managing flap ischemia to propose a non-invasive,economical,and simple treatment to improve flap survival.A review of the literature was conducted on the topics of various non-invasive methods for the treatment of ischemic necrosis of the distal end of the flap between 1988 and 2019.A total of 52 published studies were reviewed on the applications of hyperbaric oxygen therapy,electrical stimulation therapy,heat stress pretreatment,phototherapy,and vibration therapy to manage skin flap necrosis.The underlying molecular mechanisms of these physical therapies on revitalizing the dying skin flaps were discussed and preliminary clinical uses of these therapies to salvage the necrotic skin flaps were pooled and summarized for clarifying the safety and feasibility of these methods.Various physical therapy regimens have been ushered to manage necrotic development in cutaneous flaps.With the refinement of these new technologies and enhancement of related basic science research on vascular revitalization,the prevention and treatment of flap ischemia will enter a new era.
基金Supported by the grants from the National Natural Science Foundation of China(No.81501940,No.11472018,No.81871851).
文摘Background:Electrical stimulation has been recommended as an effective therapy to prevent muscle atrophy after nerve injury.However,the effect of electrical stimulation on the proliferation of satellite cells in denervated muscles has not yet been fully elucidated.This study was aimed to evaluate the changes in satellite cell proliferation after electrical stimulation in nerve injury and to determine whether these changes are related to the restoration of myofiber cross-section area(CSA).Methods:Sciatic nerve crush injury was performed in 48 male Sprague-Dawley rats.In half(24/48)of the rats,the gastrocnemius was electrically stimulated transcutaneously on a daily basis after injury,while the other half were not stimulated.Another group of 24 male Sprague-Dawley rats were used as sham operation controls without injury or stimulation.The rats were euthanized 2,4,and 6 weeks later.After 5-bromo-2’-deoxyuridine(BrdU)labeling,the gastrocnemia were harvested for the detection of paired box protein 7(Pax7),BrdU,myofiber CSA,and myonuclei number per fiber.All data were analyzed using two-way analysis of variance and Bonferroni post-hoc test.Results:The percentages of Pax7-positive nuclei(10.81±0.56%)and BrdU-positive nuclei(34.29±3.87%)in stimulated muscles were significantly higher compared to those in non-stimulated muscles(2.58±0.33%and 1.30±0.09%,respectively,Bonferroni t=15.91 and 18.14,P<0.05).The numbers of myonuclei per fiber(2.19±0.24)and myofiber CSA(1906.86±116.51 mm2)were also increased in the stimulated muscles(Bonferroni t=3.57 and 2.73,P<0.05),and both were positively correlated with the Pax7-positive satellite cell content(R2=0.52 and 0.60,P<0.01).There was no significant difference in the ratio of myofiber CSA/myonuclei number per fiber among the three groups.Conclusions:Our results indicate that satellite cell proliferation is promoted by electrical stimulation after nerve injury,which may be correlated with an increase in myonuclei number and myofiber CSA.
基金Supported by the National Natural Science Foundation Project of China(Transcutaneous Electrical Acupoint Stimulation Prevents the Deep Vein Thrombosis:the Role of Endothelium Modulation,No.81202750)
文摘OBJECTIVE:To evaluate the effects of electric acupoint stimulation on gastrointestinal hormones and motility among geriatric postoperative patients with gastrointestinal tumors,and to explore an efficient and noninvasive method for postoperative recovery of bowel functions.METHODS:Forty patients were randomly and evenly assigned into a regular nursing care group(RNC) and an acupoint electric stimulation group(AES).Patients in the RNC group received regular nursing care and patients in the AES group received regular nursing care plus electric stimulation of acupoints.The serum levels of gastrin(GAS),motilin(MOT),and cholecystokinin(CCK),and an electrogastrogram(EGG) of all the patients were evaluated on the first,third,and fifth day after surgery.The time to first flatus after surgery and the number of patients with side effects such as abdominal pain,abdominal distention,and diarrhea were recorded.RESULTS:There were significant differences between the two groups in GAS,MOT,EGG,time to first flatus,abdominal pain,abdominal distention,and diarrhea(P < 0.05).CONCLUSION:Electric stimulation on acupoints could increase levels of GAS and MOT,promote the recovery of gastrointestinal functions,and decrease complications among postoperative senile patients with gastrointestinal tumors.
文摘Objective The purpose of this study is to evaluate and compare the two different treatments by researching 135 cases with stress urinary incontinence.Methods From June 2006 to June 2010,135 patients with stress urinary incontinence were treated in Department of Gynecology and Obstetrics of Peking University Shenzhen Hospital.91 cases of them were treated with low frequency electric stimulation and biofeedback therapy (Group A),and the other 44 cases were treated by improved transobturaor tension-free vaginal tape(TVT-O) and TVT-O (Group B).Then,we compared these two groups by whole recovery rate,recovery rate of patients with urge incontinence,charge of treatment and complication,respectively.Results Group B's recovery rate for stress urinary incontinence was 100%.Ⅰ degree stress urinary incontinence in Group A's recovery rate was higher;Ⅱ degree patients' recovery rate for stress urinary incontinence was lower;Ⅲ degree patients' recovery rate was 0%.Only 1 case showed abnormal urine stream;2 cases showed urinary retention,but the symptoms disappeared after the treatment.No significant complication in Group A.There were huge differences of the expense between the two groups.The effect in Group A for patients with urge incontinence was good,but there was no effect shown in Group B.Conclusions The two treatments are safe and effective for stress urinary incontinence,but there are existed prominent differences of the therapeutic efficacy between the two groups.
