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1

Graciloplasty, electrostimulation, electromyography. Clinical implications of electrophysiological phenomena in the neo-sphincter created from the gracilis mus

100%

Romaniszyn M., Wałęga P.

Polish Journal of Surgery

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2016

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vol. 88(2)

68-76

EN

The aim of the study was to compare the electrophysiological phenomena occurring in the gracilis muscle, transposed into the pelvic floor during the graciloplasty procedure, subjected to continuous electrical stimulation by means of implanted stimulator, or regular stimulation by means of an external device, as well as the long-term functional results of the graciloplasty procedure. Material and methods. A total of 27 patients were included in the analysis. The study group consisted of 7 patients after dynamic graciloplasty, 11 patients after graciloplasty followed by transrectal stimulation, 4 patients after graciloplasty with transcutaneous stimulation, and 5 patients after graciloplasty without any stimulation. All patients had a surface electromyographic examination of the transposed gracilis muscle performed, the signal for each patient was compared to the signal acquisited from a non-transposed gracilis in the same patient. In addition, each subject underwent a clinical operation results assessment, as well as an anorectal manometry examination. Results. In the electromiographic examination, the mean frequency of motor units action potentials of the gracilis muscle in the thigh was 64 Hz, and in the muscle after transposition and stimulation period mean frequency was 62 Hz. There was no statistically significant difference in the frequency of action potentials before and after treatment in any of the analyzed groups, or between groups with different methods of stimulation (p> 0.05). We found a significant correlation between the clinical outcome of the procedure, and the average amplitude of the EMG signal from the transposed muscle, as well as between the amplitude of the EMG signal and the basal pressure in the anal canal in manometric examination. There were no significant correlations in the remaining manometric parameters. Conclusions. Despite the different methods of postoperative stimulation, including expensive implantable stimulators, there was no difference in the electrical activity between the transposed gracilis muscle, and the gracilis muscle left in situ. There was no signoficant advantage of the dynamic graciloplasty procedure over the graciloplasty with transanal or transcutaneous stimulation.

2

Potentiation Increases Peak Twitch Torque by Enhancing Rates of Torque Development and Relaxation

88%

Froyd C., Beltrami F. G., Jensen J., Noakes T. D.

Journal of Human Kinetics

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2013

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vol. 38

83-94

EN

The aim of this study was to measure the extent to which potentiation changes in response to an isometric maximal voluntary contraction. Eleven physically active subjects participated in two separate studies. Single stimulus of electrical stimulation of the femoral nerve was used to measure torque at rest in unpotentiated quadriceps muscles (study 1 and 2), and potentiated quadriceps muscles torque in a 10 min period after a 5 s isometric maximal voluntary contraction of the quadriceps muscles (study 1). Additionally, potentiated quadriceps muscles torque was measured every min after a further 10 maximal voluntary contractions repeated every min (study 2). Electrical stimulation repeated several times without previous maximal voluntary contraction showed similar peak twitch torque. Peak twitch torque 4 s after a 5 s maximal voluntary contraction increased by 45±13% (study 1) and by 56±10% (study 2), the rate of torque development by 53±13% and 82±29%, and the rate of relaxation by 50±17% and 59±22%, respectively, but potentiation was lost already two min after a 5 s maximal voluntary contraction. There was a tendency for peak twitch torque to increase for the first five repeated maximal voluntary contractions, suggesting increased potentiation with additional maximal voluntary contractions. Correlations for peak twitch torque vs the rate of torque development and for the rate of relaxation were r2= 0.94 and r2=0.97. The correlation between peak twitch torque, the rate of torque development and the rate of relaxation suggests that potentiation is due to instantaneous changes in skeletal muscle contractility and relaxation.

3

The Effect of Return Electrode Position on Induced Electric Fields for Electrical Stimulation of Retinal Ganglion Cells

75%

Celik M.

Acta Physica Polonica A

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2017

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vol. 132

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issue 3

493-495

EN

Age-related macular degeneration and retinitis pigmentosa are the most countered eye diseases that damage photoreceptors and cause to lose the visual sense. To regain the visual sense, studies are focused on the electrical stimulation of nerve cells remain intact. The electrical stimulation is carried out with the electrode arrays that include a certain number of stimulation electrodes and a common return electrode. In this study, the retinal stimulation is modelled using a computational model to investigate stimulation performance depending on the return electrode position and its geometrical properties. Stimulation induced electric field, current density and temperature over the retinal tissue are examined. It is seen that closer placement of return electrode and stimulation electrodes causes high electric field intensity and current density between electrodes, which is quite risky for long term chronic implementation by the reason of the increase in the temperature beyond the safe limits. It is concluded that there is an indispensability for the distances, three to five times of the electrode diameter, between electrodes to avoid electrode corrosion and tissue damage.

4

Elektrostymulacja serca – nowoczesna metoda leczenia zaburzeń rytmu i przewodzenia. Postępowanie u chorego z wszczepionym układem stymulującym serce lub kardiowerterem‑defibrylatorem

63%

Jaguś‑Jamioła A., Cissowska M., Kowal J., Kaźmierczak‑Dziuk A.

Pediatria i Medycyna Rodzinna

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2012

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vol. 8

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issue 2

137-147

EN

Electrical stimulation is an undisputable, effective and wide‑spreading method of treating heart rhythm disorders. Currently there are 5 millions people living with implantable heart pacemakers. Electrical stimulation initializes electric activity in case of the absence of heart’s own activity. Basic pacemakers are single or dual chamber and also it is possible to program very specific parameters of stimulation. The number of people living with implanted cardioverter‑defibrillator (ICD) increases recently, in cases of primary or secondary prevention of sudden cardiac death. ICD recognizes brady‑ and tachyarrhythmias, terminates ventricular arrhythmias by means of cardioversion or defibrillation, ICD is able to stimulate cardiac rhythm and also enables the ECG recording during arrhythmia. The main clinical problems associated with pacemaker or ICD are function disorders of the device, infective complications, damage caused by the electromagnetic field and anxiety disorders. The patient qualified to implantation pacemaker or ICD should gain detailed information about indications for electrical stimulation, benefits but also restrictions connected with the therapy. It is very important to stay under the care of specialized medical unit, undergo necessary controls and be aware of basic rules in daily life, such as avoiding exposure on electromagnetic interferences, because they may influence the pacemaker or ICD. There is no doubt in effectiveness and legitimacy of implanted cardioverters‑defibrillators, but still exists the problem of the patient’s intolerance for hurtful, unpleasant interventions witch may achieve high energy. The patient’s anxiety should be reduced by precise and reliable information and permanent cooperation between doctor and patient.

PL

Elektrostymulacja jest niekwestionowaną skuteczną i coraz bardziej powszechną metodą leczenia zaburzeń rytmu i przewodzenia. W tej chwili na świecie żyje około 5 milionów ludzi z wszczepionym kardiostymulatorem. Ta forma terapii inicjuje czynność elektryczną serca w razie braku właściwej aktywności własnego rozrusznika. Podstawowe układy stymulujące są jedno‑ lub dwujamowe, istnieje także możliwość bardzo precyzyjnego dobrania parametrów pracy urządzenia. W ostatnich latach rośnie liczba pacjentów z wszczepionym kardiowerterem‑defibrylatorem (implantable cardioverter‑defibrillator, ICD – wszczepialny kardiowerter‑defibrylator) w prewencji pierwotnej i wtórnej nagłej śmierci sercowej. ICD rozpoznaje tachy‑ i bradyarytmie, przerywa tachyarytmie komorowe kardiowersją lub defibrylacją, posiada funkcję stymulacji, a także umożliwia odtworzenie EKG w czasie incydentu arytmii. Problemy kliniczne związane z kardiostymulatorem lub ICD to zaburzenia pracy urządzenia, powikłania infekcyjne, uszkodzenia związane z narażeniem na pole elektromagnetyczne, a także zaburzenia lękowe u pacjenta. W przypadku ustalenia u chorego wskazań do implantacji układu stymulującego serce lub ICD należy udzielić mu wyczerpujących informacji na temat wskazań, korzyści, ale i ograniczeń, z jakimi się zetknie. Po wszczepieniu kardiostymulatora lub kardiowertera‑defibrylatora konieczne są stała opieka poradni specjalistycznej, regularne kontrole pracy urządzenia i przestrzeganie najważniejszych zasad w życiu codziennym, m.in. unikanie narażenia na interferencje elektromagnetyczne, które mogą wpływać na pracę stymulatora lub ICD. Skuteczność i zasadność wszczepiania kardiowerterów‑defibrylatorów nie budzi wątpliwości, nie eliminuje to jednak problemu, jakim jest dla chorego ograniczona tolerancja odczuwania wyładowań osiągających energię do kilkudziesięciu dżuli. Obawy chorego należy eliminować poprzez dokładną i rzetelną informację oraz stałą współpracę pomiędzy pacjentem a lekarzem.

5

Pressure injury treatment with anodal and cathodal electrical stimulation in persons with nervous system injuries. A prospective, randomized, clinical study. Preliminary report.

63%

Polak A., Nawrat-Szołtysik A., Ickowicz T., Kucio E., Kasprzak K., Chlebek A., Etfer B., Pniowska M., Rajca J., Łagodzic S., Kania W.

Medical Rehabilitation

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2017

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vol. 21(3)

23-34

PL

Wstęp: Elektrostymulacja (ES) jest zabiegiem rekomendowanym w leczeniu odleżyn ale metodyka zabiegów zapewniających najlepsze skutki lecznicze wymaga jeszcze ustalenia. Cel: Porównanie skuteczności ES katodowej i anodowej w leczeniu odleżyn II-IV stopnia. Projekt badawczy: Badanie eksperymentalne z randomizacją. Materiał i metody: 38 osób z odleżynami leczonych w Centrum Rehabilitacji na terenie Górnego Śląska zostało losowo podzielonych do grupy elektrostymulacji anodowej (AG/12 osób; średni wiek 52,83 lata), elektrostymulacji katodowej (KG/13 osób; średni wiek 52,00 lata) i elektrostymulacji placebo (PG/13 osób; średni wiek 54,46 lata). U wszystkich chorych stosowano standardowe leczenie odleżyn. Dodatkowo w AG i KG zastosowano elektrostymulację wysokonapięciową prądem pulsującym (high-voltage monophasic pulsed current − HVMPC) (impulsy podwójne szpiczaste, 154 μs; 100 Hz; 0,36 A; 360 μC/s) przez 50 minut dziennie, pięć dni w tygodniu, przez 8 tygodni. W AG elektrodą leczniczą była anoda, a w KG – katoda. W PG wykonywano symulowaną elektrostymulację. Obie elektrody były układane na wilgotnej gazie. Elektrodę leczniczą układano na powierzchni rany a zamykającą obwód na zdrowej skórze w odległości przynajmniej 15 cm od rany. Pole powierzchni odleżyn było mierzone przed leczeniem oraz po zakończeniu każdego kolejnego tygodnia terapii. Wyniki: W grupach AG i KG powierzchnia odleżyn zmniejszyła się odpowiednio o 73,68% (SD 28,03) i 76,02% (SD 17,51). Wyniki te były znamiennie statystycznie większe niż w PG (44,20%; SD 20,86). Wyniki uzyskane w AG i KG nie różniły się znamiennie statystycznie. Wnioski: ES wysokonapięciowa anodowa i katodowa w podobnym stopniu przyczyniają się do zmniejszenia odleżyn II-IV stopnia.

EN

Introduction: Electrical stimulation (ES) is a treatment recommended for pressure injuries (PIs), but an optimal protocol methodology for wound treatment has not yet been established. Objective: Comparing the effectiveness of cathodal and anodal ES in the treatment of category II-IV pressure injuries. Research project: Experimental trial with randomization. Material and methods: 38 individuals with pressure wounds treated at the Rehabilitation Centre in the region of Upper Silesia were randomly divided into the anodal ES group (AG/12 people, mean age 52.83 years), cathodal ES group (CG/13 people, average age 52.00 years) and the ES placebo group (PG/13 people, average age 54.46 years). Standard pressure injury treatment was implemented in all patients. Additionally, in the AG and CG, ES with high-voltage monophasic pulsed current (HVMPC; twin-peak impulses; 154 μs; 100 pps; 0.36 A; 360 μC/s) was applied for 50 minutes a day, fi ve days a week, for 8 weeks. In the AG group, the healing electrode was an anode, while in the CG, cathodes were used. In the PG, sham ES was performed. Both electrodes were placed on moist gauze. The electrode for treatment was placed on the surface of the wound and the return electrode was positioned on healthy skin at least 15 cm from the PI edge. The surface area of the PIs was measured before and after each subsequent week of therapy. Results: In the AG and CG, the surface of the pressure injuries decreased by 73.68% (SD 28.03) and 76.02% (SD 17.51), respectively. These results were statistically signifi cantly higher than in the PG (44.20%, SD 20.86). The results obtained in AG and CG did not signifi cantly differ statistically. Conclusions: High-voltage anodal and cathodal ES cause a decrease in category II-IV pressure injuries to a similar extent.

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Graciloplasty, electrostimulation, electromyography. Clinical implications of electrophysiological phenomena in the neo-sphincter created from the gracilis mus

Potentiation Increases Peak Twitch Torque by Enhancing Rates of Torque Development and Relaxation

The Effect of Return Electrode Position on Induced Electric Fields for Electrical Stimulation of Retinal Ganglion Cells

Elektrostymulacja serca – nowoczesna metoda leczenia zaburzeń rytmu i przewodzenia. Postępowanie u chorego z wszczepionym układem stymulującym serce lub kardiowerterem‑defibrylatorem

Pressure injury treatment with anodal and cathodal electrical stimulation in persons with nervous system injuries. A prospective, randomized, clinical study. Preliminary report.