Neuromodulation : journal of the International Neuromodulation Society
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The aim of this article is to introduce the robotic orthosis Lokomat, developed to automate treadmill training rehabilitation of locomotion for spinal cord injured and stroke patients, to the Functional Electrical Stimulation (FES) and Neuromodulation research communities, and to report on our newly conducted research. We first illustrate the primary use of Lokomat in rehabilitation and focus on control aspects and algorithms associated with robotic rehabilitation of locomotion. ⋯ The first application is closed-loop control of the FES-induced shank movement and the second is the development of a neural network model of the spinal locomotor centers. This model was used to derive a neural locomotion controller for the Lokomat.
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This study was aimed to test whether the administration of transcutaneous electrical neural stimulation (TENS), heat or cold alone, or the coadministration of TENS in combination with heat or with cold may alter the thresholds of the sensory (algosity) and the affective (unpleasantness) dimensions of experimental pain. Mechanical pain induced by a pressure algometer was applied to the tibial shaft of 180 healthy volunteers before and after random application of one of the six following modalities: sham-stimulation, cold, heat, TENS, combination of TENS + cold, or combination of TENS + heat. ⋯ Only the combination of TENS + heat significantly elevated the thresholds of algosity (from 221 mmHg to 262 mmHg, p < 0.01) and of unpleasantness (from 134 ± 9 to 197 ± 9 mmHg; p < 0.001). These findings suggest that the coadministration of several physical modalities can be more efficacious in the treatment of pain than each modality alone.
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We investigated the effects of one somatosensory stimulation technique, the cyclic pressure application (CPA), and compared them with the effects of left transcutaneous electrical stimulation (TENS) on the expression of left visuospatial exploration deficits in 13 stroke patients, as assessed by four visuospatial exploration tasks. Four treatment conditions were given: TENS, CPA, TENS + CPA, as well as a placebo condition. For each patient, the intensity of the TENS was determined, based on his/her perception threshold of paresthesia for the electrical impulses. ⋯ Unilateral disturbances in visuospatial exploration, often associated with the neurologic syndrome of hemispatial neglect and more frequently observed after right hemisphere damage, refers to the defective ability of patients with unilateral cerebral lesions to explore the side of space contralateral to the lesion. Many quantifiable tests have been developed to assess the expression of visuomotor exploration. These tests differ substantially in their sensitivity, but the Star Cancellation and Line Bisection tasks are cited as the most sensitive measurements of visuospatial exploration.