Neuromodulation : journal of the International Neuromodulation Society
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The objective of the study was a quantitative examination of Proprioceptive Neuromuscular Facilitation (PNF) exercise in simultaneous combination with FES of lower extremity muscles in comparison to voluntary movement, training with PNF alone, or training with FES alone. Two subjects were monitored during a one-month rehabilitation period. The PNF pattern included flexion, adduction, and external rotation of the hip, knee flexion, and dorsiflexion with inversion of the ankle, a pattern similar to the swing phase of walking. ⋯ Major changes were found in the hip angle. Improvements in goniograms were greatest during the first week, smaller during the second week, and showed only a slight positive trend in the last two weeks. The measurements made two months after the start of training showed somewhat lower values in comparison to previous sessions.
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The effect of spinal cord stimulation (SCS) on cerebral blood flow (CBF) has, in the past, been evaluated by semiquantitative techniques, but has not been used to treat CBF diseases. The aim of this study was to assess the effect of cervical SCS on regional blood flow by both semiquantitative and quantitative methods. Thirty-five patients with cervical SCS-implanted devices were enrolled. ⋯ During cervical SCS there was a significant and bilateral increase in systolic (21%) and diastolic (26%) velocity in the MCA and in CCA blood flow (50%). We conclude that cervical SCS increases blood flow in the middle cerebral artery and common carotid artery. The consistent increase supports the potential usefulness of cervical SCS as an adjuvant treatment for cerebral blood flow diseases.
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The objective of this study was to assess the usability and safety of BION injectable neuromuscular microstimulators for therapeutic electrical stimulation (TES) to treat two conditions involving disuse atrophy: poststroke shoulder subluxation in hemiplegic subjects and knee osteoarthritis. Clinicians were provided with PC-based software to track implants and to design the exercise programs. Subjects self-administered TES (3 sessions/day, 10-30 min/session) for 6 or 12 weeks. ⋯ The devices did not migrate and did not cause inflammation or pain. Thresholds were stable over time. We conclude that the use of BION implants to exercise atrophic muscles was well-accepted and provided effective rehabilitation in these two clinical conditions.
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Spinal cord stimulation (SCS) is a popular method of treatment of chronic pain. Unfortunately, migration of the lead continues to be a serious complication of this therapy. ⋯ The use of "midline anchoring" resulted in a decrease in lead migration from 23% to 6% after trial insertion and from 24% to 7% after implantation. We conclude that "midline anchoring" of the SCS lead is an effective method of preventing lead migration.
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Deep brain stimulation (DBS) therapy is a continually expanding field of functional neurosurgery for the treatment of movement disorders and neuropathic pain. However, occurrence of adverse events related to implanted hardware cannot be ignored, particularly in patients with dystonic conditions. We report on two such patients who required emergency hospital admission and pulse generator re-implantation following sudden and unexpected cessation of DBS effectiveness resulting from battery failure.