COMPARISON OF PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION AND NEUROMUSCULAR RE-EDUCATION WITH CONVENTIONAL TREATMENT AND HOME BASED EXERCISE PLAN ALONG WITH FACIAL NERVE STIMULATION FOR REDUCING FACIAL DISABILITY IN PATIENTS WITH BELL’S PALSY

The purpose of the present study was to compare the proprioceptive neuromuscular facilitation and neuromuscular re-education with conventional treatment and home based exercise plan along with facial nerve stimulation for reducing facial disability in patients with Bell’s Palsy. In the present study, purposively selected 20 patients (both male and female) with Bell’s palsy with age group 20-70 years were considered. Further, the patients were allocated equally into two treatment groups. In Group-A, patients were treated with Proprioceptive Neuromuscular Facilitation (PNF) and Neuromuscular Re-Education (NRE) along with interrupted galvanic stimulation, facial massage and home based exercises. In Group-B, patients received the treatment of interrupted galvanic stimulation and manual facial massage along with home based facial exercises program in front of mirror. The outcome measures included Facial Disability Index-Physical Function (FDI-PF), Facial Disability Index-Social Function (FDI-SF), Synkinesis Assessment Questionnaire (SAQ) and Sunnybrook Facial Grading Scale (SFGS). In results. it was found that in pre-intervention condition, no significant differences were noted in FDI-PF, FDI-SF, SAQ and SFGS between these two groups. However, significant differences (p<0.001) were observed in FDI-PF, FDI-SF and SFGS in post intervention condition between the patients treated in Group-A and Group-B. Statistically significant increase (p<0.001) was found in FDI-PF and SFGS and significant decrease (p<0.013-0.001) was found in FDI-SF and SAQ between pre- and post-intervention in Group-A. Statistically significant decrease (p<0.003-0.001) was found in FDI-PF, FDI-SF, SAQ and SFGS between pre- and post-intervention in patients treated in Group-B. From the findings of the study it could be concluded the treatment protocol comprised of PNF and NRE along with interrupted galvanic stimulation, facial massage and home based exercises was more effective than only interrupted galvanic stimulation, facial massage and home based exercises in improving facial symmetry and reducing facial disability in patients with Bell’s palsy. Keywords: Proprioceptive neuromuscular technique, Neuromuscular re-education technique, Interrupted galvanic stimulation, Facial massage, Home based exercises, Bell’s palsy, Facial disability, Synkinesis.

Intraoperative neurophysiological mapping: the effect of general anaesthetic impact on brain cortex affectability

Neuron irritation lies at the heart of intraoperative motor mapping and varies with the general anaesthetic type and dose. Basing on the analysis of 63 cases (male/female 25/38, aged 21–69) of brain tumors (glial tumors, metastasis, cavernous angiomas) the study explores the role of propofol and sevoflurane in the affectability of cortex neurons during the intraoperative neurophysiological mapping. The study has clearly demonstrated that the liminal current strength is notably higher when inhalation anaesthesia (sevoflurane) is used, than in the case of TIVA (propofol). The propofol activity in the doses causing brain activity depression results in a sharp increase in the excitability threshold. In contrast, sevoflurane causes a steady dose-related rise in the liminal current strength during the motor area galvanic stimulation due to the suppression of affectability and conduction in the nervous system.

Use of vestibular galvanic stimulation for correction of the position and of the gaze in a flight simulator

SummaryGalvanic Vestibular Stimulation(GVS) induce the sensation of movement in subjects in flight simulators and in cosmonauts, creating a cognitive simulation of movement. The system consists of a control unit, a function generator, and a power amplifier. GVS is capable of activating the neurons of the vestibular system and inducing the sensation of movement. When applied in coordination with a flight simulation program GVS modifies the eye movement control responses, electrically activating the vestibular-ocular, vestibule-colic, and vestibule-spinal reflexes. The ultimate goal of this type of stimulation is to generate augmented reality in the pilots during training or potentially also during a flight in microgravity.

Efficacy of Trans-Mastoidal Vestibular Galvanic Stimulation in Improvement of Gait Performance and Upright Postural Stability in Hemiplegic C.P. Children

Objectives: This work was carried out to investigate the efficacy of galvanic vestibular stimulation in improving of gait performance and upright postural stability in hemiplegic cerebral palsy children. Method: Thirty children were enrolled in this study and randomly assigned into two groups; group A (galvanic vestibular stimulation plus vestibular training program), and group B (vestibular training program only). Stride length and time, walking speed tests and modified Ashworth, pediatric balance scales were used to detect and follow the walking performance and upright postural stability. This measurement was taken before initial treatment and after 12 weeks of treatment. The children parents in both groups A and B were instructed to complete 3 hours of the home routine program. Results: Data analysis was available on the 30 hemiplegic cerebral palsied children participated in the study. The difference between pre and post-treatment results was significant representative in stride length , time and walking velocity, spasticity changes and pediatric balance scores in study groups while insignificant improvement in control groups. Conclusion: The combined vestibular training program and trans-mastoidal vestibular galvanic stimulation are suggested in improving walking performance and upright postural stability in a static and dynamic situation. So this selective physiotherapy approach may be used as a strong choice for improving walking and balance abilities in hemiplegic C.P children.