Functional electrical nerve stimulation (FES) is a non-invasive technique for neuromodulation and may have the potential for motor rehabilitation following incomplete spinal cord injury (iSCI). Axonal degeneration in motor fibers of lower extremity nerves is an inevitable secondary pathological change in iSCI subjects, despite no direct damage to lumbosacral neuromeres. This study evaluated the role of FES with individual parameters based on results of comparative neurophysiological studies. Forty-two participants with C4 to Th12 iSCI received repetitive sessions of electrostimulations applied to peroneal and tibial motor fibers, performed five times a week from 6 to 14 months, and the uniform system of kinesiotherapeutic treatment. The average duration of one electrostimulation session was 17 min, stimulation frequency of a train 20–70 Hz, duration of 2–3 s, intervals 2–3 s, pulses intensity 18–45 mA. The algorithm change was based on objective tests of subsequent surface electromyography (sEMG), and electroneurography (ENG) recordings. The same neurophysiological studies were also performed in patients after C2-Th12 iSCI treated with kinesiotherapy only (K group, N = 25) and compared with patients treated with both kinesiotherapy and electrostimulation (K + E, N = 42). The study revealed improvements in sEMG parameters recorded from tibialis anterior, gastrocnemius, extensor digitorum brevis muscles, and ENG evoked a compound muscle action potential recorded following bilateral stimulation of more peroneal than tibial nerves. Neurophysiological recordings had significantly better parameters in the K + E group of patients after therapy but not in the K group patients. The improvement of the motor transmission peripherally may reflect the specific neuromodulatory effect of FES algorithm evaluated with sEMG and ENG. FES may inhibit degeneration of axons and support functional recovery after iSCI.

3.

sEMG is a suitable tool for prosthodontists because it provides objective results on the stomatognathic system muscles function. Pain and other temporomandibular symptoms detected mostly unilaterally significantly increase muscle tension of the masticatory muscles and diminish muscle motor units recruitment during maximal contraction. Effects may spread to the neck and shoulder girdle muscles.

Introduction. Sympathetic skin response (SSR) is applied in evaluation of dysfunctions in autonomic nervous system. Among others, electrical and sound stimuli are most frequently used to evoke SSR. Aim. The aim of this study was to determine if the bell ring stimulus with parameters different from standard sound stimulation evokes similar reactions in autonomic system as electrical stimulus with defi ned parameters. Material and methods. SSR parameters were recorded following simultaneous sound and electrical stimulation. Twenty young volunteers (aged 23 ± 2.1 years) were examined once with SSR and R-R interval variation (RRIV) tests in order to confi rm lack of functional changes in autonomic nervous system. Results. Values of mean amplitudes of SSR were always higher during recordings from upper limbs than the lower ones irrespective of the three types of applied stimuli. Mean values of latencies were comparable when SSR were induced with acoustic, electrical and both stimuli during recordings performed from upper and lower extremities. Bell ring stimulus infl uenced only mean values of SSR area recorded both from upper (p ≤ 0.011) and lower (p ≤ 0.023) extremities. Heart beats variability in RRIV recordings changed at 13.5% which is comparable to results obtained by other authors. Conclusions. Results indicate that the application of different modalities stimuli evokes SSR with comparable parameters. Each of them can be used for objective evaluation of the sympathetic nervous system function. Both SSR and RRIV tests evaluating the function of two effector types should be applied for the diagnosis of the probable dysautonomia in patients who show unclear clinical symptoms.

Introduction Neuromonitoring (IOM) is a procedure for verification of the nerve impulse transmission along structures of central and peripheral nervous system during surgical procedures. Motor evoked potentials (MEPs) recordings from muscles induced with electrical pulses transcranially to motor cortex centers are especially useful during the surgery with an increased risk of iatrogenic damage to efferent nerve structures. Aim of the study The aim of this report is to present the scenario of the reversible inhibition in pathways transmitting nerve impulses during surgical correction of Sprengel’s deformity with the assessment of IOM. Material and methods Nine-year old girl was admitted to the hospital due to congenital high scapula. Corrective surgery was performed using the Woodward technique with an assessment of IOM. Results The amplitudes and latencies of the MEPs from muscles of upper right extremity were recorded as decreased and increased, respectively at about 20% during the final fixation of scapula. Thanks to these recordings surgeons could prevent the permanent damage of the brachial plexus fibers, by partial releasing of applied sutures. After surgery and subsequent rehabilitation the patient returned to the normal activity in right upper extremity. Association of electromyography and MEPs results helped with ordering and controlling the course of treatment. Conclusions The benefit of IOM relay on the safety of orthopedic surgery and decreasing the number of iatrogenic perioperative complications. This diagnostic procedure is also a strong point for argumentation in hospital administration during negotiations with lawyer representing the patient when iatrogenic complication appear.