Effects of surface electrical stimulation on the muscle–tendon junction of spastic gastrocnemius in stroke patients

Chen, S. C.; Chen, Y. L.; Chen, C. J.; Lai, Chien Hung; Chiang, Wenchang; Chen, Woei-Luen

doi:10.1080/09638280400009022

Cited by 49 publications

(70 citation statements)

References 18 publications

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“…The mechanism that underlies the improved motor function in paretic limbs after TENS treatment is multifactorial; it involves alleviation of the hyperexcitability of alpha motor neurons,9, 11 reduction of intracortical inhibition,12 and enhancement of corticomuscular functional connectivity 13. Several clinical studies have demonstrated that the hyperexcitability of the alpha motor neurons that innervate the spastic ankle plantarflexor could be reduced by an increase in presynaptic inhibition after repetitive TENS 9, 11. Levin and Huichan reported that the ankle plantarflexor stretch reflex amplitude, as measured by the magnitude of integrated electromyography, was reduced significantly after a 3‐week regimen of repetitive TENS over the common peroneal nerve but not after placebo‐TENS stimulation 9.…”

Section: Discussionmentioning

confidence: 99%

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Bilateral Transcutaneous Electrical Nerve Stimulation Improves Lower‐Limb Motor Function in Subjects With Chronic Stroke: A Randomized Controlled Trial

Kwong

Chung

et al. 2018

JAHA

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BackgroundTranscutaneous electrical nerve stimulation (TENS) has been used to augment the efficacy of task‐oriented training (TOT) after stroke. Bilateral intervention approaches have also been shown to be effective in augmenting motor function after stroke. The purpose of this study was to compare the efficacy of bilateral TENS combined with TOT versus unilateral TENS combined with TOT in improving lower‐limb motor function in subjects with chronic stroke.Methods and ResultsEighty subjects were randomly assigned to bilateral TENS+TOT or to unilateral TENS+TOT and underwent 20 sessions of training over a 10‐week period. The outcome measures included the maximal strength of the lower‐limb muscles and the results of the Lower Extremity Motor Coordination Test, Berg Balance Scale, Step Test, and Timed Up and Go test. Each participant was assessed at baseline, after 10 and 20 sessions of training and 3 months after the cessation of training. The subjects in the bilateral TENS+TOT group showed greater improvement in paretic ankle dorsiflexion strength (β=1.32; P=0.032) and in the completion time for the Timed Up and Go test (β=−1.54; P=0.004) than those in the unilateral TENS+TOT group. However, there were no significant between‐group differences for other outcome measures.ConclusionsThe application of bilateral TENS over the common peroneal nerve combined with TOT was superior to the application of unilateral TENS combined with TOT in improving paretic ankle dorsiflexion strength after 10 sessions of training and in improving the completion time for the Timed Up and Go test after 20 sessions of training.Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02152813.

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Section: Discussionmentioning

confidence: 99%

“…The therapeutic effects of TENS may be mediated via peripheral9, 10, 11 and central mechanisms 12, 13. At the peripheral level, TENS applied over paretic legs reduced the amplitude of the H‐reflex9 and lengthened the stretch reflex latency10 and H‐reflex latency11 in subjects with chronic stroke.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Transcutaneous Electrical Nerve Stimulation Improves Lower‐Limb Motor Function in Subjects With Chronic Stroke: A Randomized Controlled Trial

Kwong

Chung

et al. 2018

JAHA

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“…These findings were in accordance with the previous studies of Aydin et al, [17] and Bryan Ping et al, [19] who also demonstrated a decrease in the modified Ashworth scores and Achilles tendon reflex with transcutaneous electrical nerve stimulation. Studies by Lee et al, [27], Chen SC et al, [18] and Robinson et al, [14,15] have also shown spasticity to decrease with surface electrical stimulation of spastic muscle. Physio-logically, this can be explained by enhanced recurrent inhibition, which is thought to be caused by Renshaw cell.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are various methods of electrical stimulation for spasticity reduction. Some studies described stimulation of the spastic muscle itself, i.e., the agonist muscle [14,15,[17][18][19], whereas some other studies have resorted to stimulation of the antagonistic muscle [20][21][22]. Stimulation of the spastic muscle is based on recurrent inhibition.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Agonist vs. Antagonist Stimulation on Triceps Surae Spasticity in Spinal Cord

Khanna

Kaur²

2017

IRJ

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Objectives:One of the most common and disabling complications that affects individuals with spinal cord injury is spasticity. The purpose of this study is to compare the effect of agonist and antagonist electrical stimulations on triceps surae muscle spasticity in patients with spinal cord injury. Methods:A total of 30 subjects with spinal cord injury were considered for the study. They were divided into two groups randomly. Group 1 received agonist electrical stimulation (stimulation of triceps surae) and group 2 received antagonist electrical stimulation (stimulation of tibialis anterior) for 20 min, once daily, and 5 days per week for two weeks. To evaluate the therapeutic effect, modified Ashworth score, deep tendon reflex score and clonus score were tested before and after the treatment. Post treatment evaluation was made 24 h after the last treatment session.Results: Both the groups showed significant reductions in the modified Ashworth scores and deep tendon reflex scores after the intervention, but these reductions were not found in the clonus score. Also, there was no significant difference in the post intervention scores of modified Ashworth scale, deep tendon reflex and clonus score between the two groups.Discussion: This study provides evidence that both agonist electrical stimulation and antagonist electrical stimulations are equally effective in reducing spasticity in triceps surae muscle in patients with spinal cord injury.

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“…Çalışma süresince spastisiteye yönelik verilmiş ilaçların dozlarında değişiklik yapılan hastalar çalışma dışı bırakıldı (10 (13,14). Bu nedenle elektrik stimülasyon, antagonist kas olan kuadriseps femoris kası üzerine hem kuvvetlendirme hem de bu kasın kontraksiyonu ile resiprokal inhibisyon yoluyla (15,16) hamstringleri gevşetme amacıyla uygulandı. Hamstring spastisitesini değerlendirmek amacıyla Modifiye Ashworth Ölçeği (MAÖ) kullanıldı (11).…”

Section: Gereç Ve Yöntemunclassified

Effect of High-Voltage Pulsed Galvanic Stimulation on Motor Development and Hamstring Spasticity in Diplegic Cerebral Palsy

Ün¹,

Kara²,

Ediz³

et al. 2016

Van Med J

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Effects of surface electrical stimulation on the muscle–tendon junction of spastic gastrocnemius in stroke patients

Abstract: In this study, we demonstrated a way to suppress spasticity at a metameric site and to increase walking speed effectively by applying surface ES on the muscle-tendon junction of spastic gastrocnemius muscles.

Cited by 49 publications

References 18 publications

Bilateral Transcutaneous Electrical Nerve Stimulation Improves Lower‐Limb Motor Function in Subjects With Chronic Stroke: A Randomized Controlled Trial

Bilateral Transcutaneous Electrical Nerve Stimulation Improves Lower‐Limb Motor Function in Subjects With Chronic Stroke: A Randomized Controlled Trial

Comparison of Agonist vs. Antagonist Stimulation on Triceps Surae Spasticity in Spinal Cord

Effect of High-Voltage Pulsed Galvanic Stimulation on Motor Development and Hamstring Spasticity in Diplegic Cerebral Palsy

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