Investigating the Effects of Peripheral Electrical Stimulation on Corticomuscular Functional Connectivity Stroke Survivors

Lai, Meei I.; Pan, Li; Tsai, Mei Wun; Shih, Yi Fen; Wei, Shun Hwa; Chou, Li Wei

doi:10.1080/10749357.2015.1122264

Cited by 38 publications

(66 citation statements)

References 44 publications

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“…Moreover, motor control, as measured by the percentage of force deviation in maintaining a steady force output, was also improved after cutaneous electrical stimulation 13. Studies have found that Uni‐TENS augments the effects of TOT in subjects with stroke 4, 5, 51.…”

Section: Discussionmentioning

confidence: 97%

“…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.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that a low‐to‐high shift of the electroencephalography‐electromyography coherence frequency is a clinical indicator of motor recovery after stroke 50. Lai and colleagues13 showed that the electroencephalography‐electromyography coherence in the high‐frequency band (>30 Hz) had increased significantly after repetitive TENS.…”

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%

“…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. At the cortical level, a single session of cutaneous electrical stimulation applied over a paretic hand reduced short‐interval intracortical inhibition12 and enhanced cortical‐muscular coupling during paretic thumb contraction 13. Previous studies from our laboratory4, 5 showed that 20 sessions of unilateral TENS (Uni‐TENS) applied over the paretic legs combined with task‐oriented training (TOT) led to greater improvement in lower‐limb muscle strength and walking performance than placebo‐TENS combined with TOT in subjects with chronic stroke.…”

Section: Introductionmentioning

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: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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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Cortical response induced by task‐oriented training of the upper limb in subacute stroke patients as assessed by functional near‐infrared spectroscopy

Huo

Sun

et al. 2022

Journal of Biophotonics

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Despite the popularity of task‐oriented training for stroke, the cortical reorganization associated with this type of therapy remains to be fully elucidated due to the lack of dynamic assessment tools. A good tolerance for motion artifacts makes functional near‐infrared spectroscopy (fNIRS) suitable for investigating task‐induced cortical responses in stroke patients. Here, patients were randomly assigned to receive task oriented (n = 25) or cyclic rotary training (n = 25) with simultaneous cortical activation and effective connectivity network analysis between prefrontal and motor cortices (PFC/MC). Compared with cyclic rotary training, task‐oriented training induced significantly increased activation in both hemispheres and enhanced influence of PFC on MC. In addition, significantly decreased activation lateralization and increased betweenness centrality of the contralesional MC suggested widespread involvement of the contralesional hemisphere during task‐oriented training. This study verifies the feasibility of fNIRS combined with motor paradigms for assessing neural responses associated with stroke rehabilitation in real time.

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Effect of training status on beta-range corticomuscular coherence in agonist vs. antagonist muscles during isometric knee contractions

et al. 2017

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Antagonist muscle co-activation is thought to be partially regulated by cortical influences, but direct motor cortex involvement is not fully understood. Corticomuscular coherence (CMC) measures direct functional coupling of the motor cortex and muscles. As antagonist co-activation differs according to training status, comparison of CMC in agonist and antagonist muscles and in strength-trained and endurance-trained individuals may provide in-depth knowledge of cortical implication in antagonist muscle co-activation. Electroencephalographic and electromyographic signals were recorded, while 10 strength-trained and 11 endurance-trained participants performed isometric knee contractions in flexion and extension at various torque levels. CMC magnitude in 13-21 and 21-31 Hz frequency bands was quantified by CMC analysis between Cz electroencephalographic electrode activity and all electromyographic signals. CMC was significant in both 13-21 and 21-31 Hz frequency bands in flexor and extensor muscles regardless of participant group, torque level, and direction of contraction. CMC magnitude decreased more in antagonist than in agonist muscles as torque level increased. Finally, CMC magnitude was higher in strength-trained than in endurance-trained participants. These findings provide experimental evidence that the motor cortex directly regulates both agonist and antagonist muscles. Nevertheless, the mechanisms underlying muscle activation may be specific to their function. Between-group modulation of corticomuscular coherence may result from training-induced adaptation, re-emphasizing that corticomuscular coherence analysis may be efficient in characterizing corticospinal adaptations after long-term muscle specialization.

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Investigating the Effects of Peripheral Electrical Stimulation on Corticomuscular Functional Connectivity Stroke Survivors

Cited by 38 publications

References 44 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

Cortical response induced by task‐oriented training of the upper limb in subacute stroke patients as assessed by functional near‐infrared spectroscopy

Effect of training status on beta-range corticomuscular coherence in agonist vs. antagonist muscles during isometric knee contractions

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