Neuromodulation : journal of the International Neuromodulation Society
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Objective. To investigate the effect of interval training supported by Functional Electrical Stimulation (FES) on ambulation ability in complete spinal cord injury (SCI). Methods. We trained four men with sensorimotor-complete (ASIA A) SCI, who achieved gait through FES of the quadriceps femoris, gluteus maximus, and common peroneal nerve on each side on a motorized treadmill. Training involved progressive interval walking exercise, consisting of periods of activity followed by equal periods of rest, repeated until muscle fatigue. ⋯ Some subjects increased the total distance walked by as much as 300% with progressive improvement over the entire training period; however, others made more modest gains and appeared to reach a performance plateau within a few training sessions. Conclusions. FES-supported interval training offers a useful and effective strategy for strength-endurance improvement in the large muscle groups of the lower limb in motor-complete SCI. We believe that this training protocol offers a viable alternative to that of continuous walking training in people with SCI using FES to aid ambulation.
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Introduction. Chronic pain is a prevalent medical condition in the general population and is one of the most common reasons patients visit their primary care doctors. When the pain is resistant to the common treatment modalities, it presents a challenge for the physician and may have profound consequences for the quality of life of the patient. ⋯ The patients reported decreased use of pain medications, increased quality of life, and high satisfaction with the procedure results. Conclusion. The use of subcutaneous peripheral nerve stimulation as a viable treatment alternative in certain cases of chronic neuropathic pain should continue to be rigorously evaluated.
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Objectives. To investigate the different approaches in the field of functional electrical stimulation (FES) control of gait and address fundamental perquisites to enable FES walking systems to become safer, more practical, and therefore clinically efficacious. Design. Systematic review was conducted from electronic data bases up to March 2008. Studies with innovative control strategies were highlighted for analysis, but all relevant literatures were described to deliver a broad viewpoint. ⋯ Finite state controllers based on a set of deterministic rules to process feedback signals seemed more suitable to provide accurate command-and-control compared with dynamic or neural network controllers. Conclusions. Progress in the development of closed-loop FES walking systems has been impeded by their lack of practicality. In the near future, this obstacle could be overcome via implanted systems, especially if using controllers based on deterministic rule sets derived from motion sensor feedback.
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Objectives. The hypothesis of the study is that adding percutaneous tibial nerve neuromodulation (Urgent PC, Uroplasty Inc., Minneapolis, MN, USA) with pelvic floor muscle rehabilitation (Evadri System, Hollister Inc., Libertyville, IL, USA) is safe, and more successful than either therapy alone for the treatment of urge incontinence. Material and Methods. Two hundred and fifty-six female patients with urge incontinence or mixed incontinence were included in this investigation. Patients were treated sequentially (on the same day) with both pelvic floor muscle rehabilitation and percutaneous tibial nerve neuromodulation twice per week at the Southern Arizona Urogynecology Center, Tucson, Arizona. ⋯ The median follow-up is now 19 months. There were no adverse side events. Conclusions. Neuromodulation of the pudendal, hypogastric, and tibial nerves is a highly effective treatment for urge incontinence, and superior to either treatment alone by a factor of greater than two times (see Table 1). [Table: see text].