Neuromodulation : journal of the International Neuromodulation Society
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Objectives. Our objective was to describe and analyze through a third party disinterested observer the results obtained by using motor cortex stimulation (MCS) for the treatment of central dysesthetic diffuse-distal type of paraplegic pain and intentional tremor secondary to the total removal of a cervical ependymoma. Design. ⋯ In this single case report MCS was extremely useful in eliminating almost all of the patient's pain-evoked phenomena. Both steady burning pain and tremor were also improved. This is only one case report and MCS warrants further investigation as to its utility in controlling central dysesthetic pain in paraplegia and postchordotomy dysesthesias.
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The objective of this study was to test myoelectrically controlled functional electrical stimulation of the same muscle (AutoMCS) on patients with either stroke or spinal cord injury. The paretic anterior tibialis (TA) muscle was stimulated with an amplitude controlled continuously by the volitional myoelectric signal from the same muscle. Surface electrodes were used and volitional myoelectric signals were extracted by analog/digital signal processing techniques. ⋯ An immediate carryover effect was seen in one stroke subject. The analysis of the tracking control showed only little loss of controllability with the system. We conclude that for selected subjects this method can instantly increase the muscle force of the anterior tibialis without significantly compromising tracking control or tracking delay.
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We modified a commercial indoor rowing machine (Concept 2 Inc., Morrisville, NJ, USA) for a functional electrical stimulation (FES) assisted indoor rowing exercise in which the rowers must repeatedly press the two switches on the handle that stimulate their paralyzed leg muscles. The objective of this study was to automate the delivery of electrical stimulation to prevent potential repetitive strain injuries and to expand the user base to clients with impaired hand function. The modifications for development of the FES rowing machine and clinical trials were all performed in the University of Alberta. ⋯ Two paraplegic users of the older manual control system tested the new automatic controller. The automatic FES controller spent more electrical stimulation per rowing cycle but it did not require repetitive thumb presses, required less concentration, and was preferred by the clients. We conclude FES rowing with the new automatic controller was easier and safer and expanded the user base of the FES rowing exercise to those with affected hand.
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The objectives of this study were to examine the effects of ipsilateral vs. contralateral as well as simultaneous placement of transcutaneous electrical nerve stimulation (TENS) electrodes in somatic receptive fields on spontaneous and noxiously evoked dorsal horn cell activity in anesthetized cats. Recordings were made from cells in the left gray matter of lumbosacral segments. In this study ipsilateral means left and contralateral means right. ⋯ When comparing contralateral vs. ipsilateral effects, the most significant reduction (p < 0.004) in mean cell activity occurred with ipsilateral (left) placement of the electrodes. For bilateral application (simultaneous ipsilateral and contralateral) of TENS electrodes, 66% of the cells demonstrated a significant additive effect in reducing spontaneous and noxiously evoked cell activity. Clinically, the results might suggest that analgesia can result from bilateral placement of electrodes or by placement of electrodes in the contralateral dermatome (somatic field) when certain clinical conditions may prevent the placement of electrodes on the same side (ipsilateral) as the perceived pain.