A double-masked, randomized, placebo-controlled trial of temporary endoscopic mucosal gastric electrical stimulation for gastroparesis

Given the rising rate of opioid-related adverse drug events during postsurgical pain management, a nonpharmacologic therapy that could decrease analgesic medication requirements would be of immense value. We designed a prospective, placebo-and-randomized controlled trial to assess the clinical effect of transcutaneous acupoint electrical stimulation (TEAS) on the postoperative patient-controlled analgesia (PCA) requirement for morphine, as well as side effects and recovery profile after inguinal hernia repair. Seventy-one subjects undergoing inguinal hernia repair with a standardized anesthetic technique were randomly assigned to one of three analgesic treatment regimens: PCA + TEAS (n = 24); PCA + sham-TEAS (no electrical stimulation) (n = 24), and PCA only (n = 23). The postoperative PCA requirement, pain scores, opioid-related side effects, and blood cortisol levels were recorded. TEAS treatment resulted in a twofold decrease in the analgesic requirement and decreased pain level reported by the patients. In addition, a significant reduction of cortisol level was reported in the TEAS group at 24 h postoperatively compared to the sham and control groups. We conclude that TEAS is a safe and effective option for reducing analgesic consumption and postoperative pain following inguinal hernia repair.

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Functional electrical stimulation‐assisted cycle ergometry-based progressive mobility programme for mechanically ventilated patients: randomised controlled trial with 6 months follow-up

Thorax ◽

10.1136/thoraxjnl-2020-215755 ◽

2021 ◽

pp. thoraxjnl-2020-215755

Author(s):

Petr Waldauf ◽

Natália Hrušková ◽

Barbora Blahutova ◽

Jan Gojda ◽

Tomáš Urban ◽

...

Keyword(s):

Electrical Stimulation ◽

Randomised Controlled Trial ◽

Functional Electrical Stimulation ◽

Controlled Trial ◽

Cycle Ergometry ◽

Control Group ◽

Mechanically Ventilated ◽

Icu Discharge ◽

Randomised Controlled

PurposeFunctional electrical stimulation-assisted cycle ergometry (FESCE) enables in-bed leg exercise independently of patients’ volition. We hypothesised that early use of FESCE-based progressive mobility programme improves physical function in survivors of critical care after 6 months.MethodsWe enrolled mechanically ventilated adults estimated to need >7 days of intensive care unit (ICU) stay into an assessor-blinded single centre randomised controlled trial to receive either FESCE-based protocolised or standard rehabilitation that continued up to day 28 or ICU discharge.ResultsWe randomised in 1:1 ratio 150 patients (age 61±15 years, Acute Physiology and Chronic Health Evaluation II 21±7) at a median of 21 (IQR 19–43) hours after admission to ICU. Mean rehabilitation duration of rehabilitation delivered to intervention versus control group was 82 (IQR 66–97) versus 53 (IQR 50–57) min per treatment day, p<0.001. At 6 months 42 (56%) and 46 (61%) patients in interventional and control groups, respectively, were alive and available to follow-up (81.5% of prespecified sample size). Their Physical Component Summary of SF-36 (primary outcome) was not different at 6 months (50 (IQR 21–69) vs 49 (IQR 26–77); p=0.26). At ICU discharge, there were no differences in the ICU length of stay, functional performance, rectus femoris cross-sectional diameter or muscle power despite the daily nitrogen balance was being 0.6 (95% CI 0.2 to 1.0; p=0.004) gN/m2 less negative in the intervention group.ConclusionEarly delivery of FESCE-based protocolised rehabilitation to ICU patients does not improve physical functioning at 6 months in survivors.Trial registration numberNCT02864745.

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Training-induced changes in muscle contraction patterns enhance exercise performance after short-term neuromuscular electrical stimulation

Isokinetics and Exercise Science ◽

10.3233/ies-202111 ◽

2020 ◽

Vol 28 (4) ◽

pp. 339-350

Author(s):

Gökhan Umutlu ◽

Nevzat Demirci ◽

Nasuh Evrim Acar

Keyword(s):

Electrical Stimulation ◽

Muscle Contraction ◽

Exercise Performance ◽

Controlled Trial ◽

Dynamic Control ◽

Neuromuscular Electrical Stimulation ◽

Interval Training ◽

Time To Exhaustion ◽

Muscle Strengthening ◽

The Individual

BACKGROUND: Neuromuscular electrical stimulation (NMES) is a complementary tool for therapeutic exercise for muscle strengthening and may potentially enhance exercise performance. OBJECTIVE: To determine whether high-intensity interval training (HIIT) and continuous aerobic training (CA) coupled with NMES enhance the changes in the eccentric/concentric muscle contraction patterns of hamstring and quadriceps. METHODS: Forty-five healthy sedentary male participants performed cycling training 3 times per week for 8 weeks combined with/without NMES performed at a load equivalent to 65% and 120% of IVO2max (intensity associated with the achievement of maximal oxygen uptake). Anthropometrics, blood lactate measurements, IVO2max, TLimVO2max (time-to-exhaustion) and isokinetic strength parameters were measured at baseline and post-training using a randomized controlled trial. RESULTS: The conventional hamstring-to-quadriceps-ratio (HQR: Hcon/Qcon) at 60∘/s and the Dynamic Control Ratio (DCR: Hecc/Qcon) at 180∘/s significantly increased both in the dominant (D) and non-dominant (ND) limb in the HIIT + NMES group (p< 0.05). There was a positive significant correlation between the individual changes in D HQR at 60∘/s and IVO2max (r= 0.94, p= 0.005) and the DCR at 180∘/s and TLimVO2max (r= 0.90, p= 0.015), respectively. CONCLUSIONS: The increases in the eccentric muscle contraction and DCR following HIIT + NMES seem to improve fatigue tolerance, cause less fatigue and oxidative stress on the lower limb during pedaling at high intensities.

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Gastric Electrical Stimulation Results in Improved Metabolic Control in Diabetic Patients Suffering From Gastroparesis

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/s-2004-830525 ◽

2005 ◽

Vol 113 (01) ◽

pp. 38-42 ◽

Cited By ~ 54

Author(s):

I. van der Voort ◽

J. Becker ◽

K. Dietl ◽

J. Konturek ◽

W. Domschke ◽

...

Keyword(s):

Electrical Stimulation ◽

Metabolic Control ◽

Gastric Electrical Stimulation ◽

Diabetic Patients

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Changes in H reflex and neuromechanical properties of the trapezius muscle after 5 weeks of eccentric training: a randomized controlled trial

Journal of Applied Physiology ◽

10.1152/japplphysiol.00164.2014 ◽

2014 ◽

Vol 116 (12) ◽

pp. 1623-1631 ◽

Cited By ~ 15

Author(s):

Steffen Vangsgaard ◽

Janet L. Taylor ◽

Ernst A. Hansen ◽

Pascal Madeleine

Keyword(s):

Electrical Stimulation ◽

Strength Training ◽

Reference Group ◽

Controlled Trial ◽

Trapezius Muscle ◽

Training Group ◽

H Reflex ◽

Eccentric Training ◽

Voluntary Activity ◽

Stimulation Of

Trapezius muscle Hoffman (H) reflexes were obtained to investigate the neural adaptations induced by a 5-wk strength training regimen, based solely on eccentric contractions of the shoulder muscles. Twenty-nine healthy subjects were randomized into an eccentric training group ( n = 15) and a reference group ( n = 14). The eccentric training program consisted of nine training sessions of eccentric exercise performed over a 5-wk period. H-reflex recruitment curves, the maximal M wave (Mmax), maximal voluntary contraction (MVC) force, rate of force development (RFD), and electromyographic (EMG) voluntary activity were recorded before and after training. H reflexes were recorded from the middle part of the trapezius muscle by electrical stimulation of the C3/4 cervical nerves; Mmax was measured by electrical stimulation of the accessory nerve. Eccentric strength training resulted in significant increases in the maximal trapezius muscle H reflex (Hmax) (21.4% [5.5–37.3]; P = 0.01), MVC force (26.4% [15.0–37.7]; P < 0.01), and RFD (24.6% [3.2–46.0]; P = 0.025), while no significant changes were observed in the reference group. Mmax remained unchanged in both groups. A significant positive correlation was found between the change in MVC force and the change in EMG voluntary activity in the training group ( r = 0.57; P = 0.03). These results indicate that the net excitability of the trapezius muscle H-reflex pathway increased after 5 wk of eccentric training. This is the first study to investigate and document changes in the trapezius muscle H reflex following eccentric strength training.

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