Rehabilitation and Therapy Commons^™

Evaluation Of The Healing Progress Of Pressure Ulcers Treated With Cathodal High-Voltage Monophasic Pulsed Current: Results Of A Prospective, Double-Blind, Randomized Clinical Trial, Anna Polak, Luther C. Kloth, Edward Blaszczak, Jakub Taradaj, Agnieszka Nawrat-Szoltysik, Lidia Bialek, Malgorzata Paczula, Andrzej Franek, Cezary Kucio

Physical Therapy Faculty Research and Publications

OBJECTIVE: To investigate the effectiveness of high-voltage monophasic pulsed current (HVMPC) as an adjunct to a standard wound care for the treatment of Stage II and III pressure ulcers (PrUs).

DESIGN: Prospective, randomized, double-blind, controlled clinical study.

SETTING: Two nursing and care centers.

PATIENTS: Patients with PrUs that did not respond to previous treatment for at least 4 weeks were randomly assigned to the electrical stimulation (ES) group (25 patients; mean age of 79.92 ± 8.50 years; mean wound surface area [WSA] of 10.58 ± 10.57 cm²) or to the control group (24 patients; mean age of 76.33 …

The Impact Of Electrical Stimulation And Exercise On Independent Static Standing Balance, Denise A. Gyselinck Spt, Jennifer R. Briant Spt, Elizabeth L. Goldstein Spt

Physical Therapy Research Symposium

Purpose: Maintaining balance requires a complex integration of input from multiple sensory systems. Studies have shown positive effects of using transcutaneous electrical stimulation (TENS) and neuromuscular electrical stimulation (NMES) to enhance somatosensory feedback and muscular strength associated with balance. The purpose of this study is to examine the effects of electrical stimulation on independent standing balance during single leg stance (SLS) using either NMES with exercise, TENS with exercise, or exercise alone.

Subjects: Fourteen subjects were recruited through a convenience sample on the University of Puget Sound campus.

Methods: Randomized control trial. Subjects participated in this study …

Comparing Nmes Stimulation Intensity At Various Lengths Of The Tibialis Anterior, Brent Brookbush, Maya Hakami, Jennifer Wolff, Amy Zelin

Dissertations, Theses, and Capstone Projects

The purpose of this study was to determine if placement of electrodes at various distances along the Tibialis Anterior muscle belly had a significant effect on the intensity of stimulation needed to evoke a contraction using neuromuscular electrical stimulation (NMES). Twenty subjects between the ages of 21-65 in good health and presented with no precautions to NMES were recruited from the CUNY Hunter College physical therapy department. Two reference lines were drawn on subjects’ legs, one outlining the tibial crest (L1), and another from the most lateral portion of the tibial plateau to the center of the lateral malleolus (L2). …

Sensory Electrical Stimulation Improves Foot Placement During Targeted Stepping Post-Stroke, Eric R. Walker, Allison Hyngstrom, Brian D. Schmit

Physical Therapy Faculty Research and Publications

Proper foot placement is vital for maintaining balance during walking, requiring the integration of multiple sensory signals with motor commands. Disruption of brain structures post-stroke likely alters the processing of sensory information by motor centers, interfering with precision control of foot placement and walking function for stroke survivors. In this study, we examined whether somatosensory stimulation, which improves functional movements of the paretic hand, could be used to improve foot placement of the paretic limb. Foot placement was evaluated before, during, and after application of somatosensory electrical stimulation to the paretic foot during a targeted stepping task. Starting from standing, …

Feasibility Of Electromyography-Triggered Neuromuscular Stimulation As An Adjunct To Constraint-Induced Movement Therapy, Stacy L. Fritz, Yi-Po Chiu, Matthew P. Malcolm, Tara S. Patterson, Kathye E. Light

Yi-Po Chiu

Background and Purpose. The purpose of this case report is to explore the feasibility of electromyography-triggered neuromuscular stimulation (EMG-stim) as an adjunct to constraint-induced movement therapy (CIMT). Case Description. The patient was a 72-year-old man, 10 years poststroke, who did not meet traditional CIMT criteria. The EMG-stim was applied to the wrist extensors of the patient's weaker arm for one half of the CIMT training hours. Outcomes. The intervention was feasible for this individual. Improvements were observed in motor behavior, quality and amount of use, muscle activity, wrist range of motion, and reaction time of the more-affected extremity. These improvements …

Feasibility Of Electromyography-Triggered Neuromuscular Stimulation As An Adjunct To Constraint-Induced Movement Therapy, Stacy L. Fritz, Yi-Po Chiu, Matthew P. Malcolm, Tara S. Patterson, Kathye E. Light

Physical Therapy Faculty Research

Background and Purpose. The purpose of this case report is to explore the feasibility of electromyography-triggered neuromuscular stimulation (EMG-stim) as an adjunct to constraint-induced movement therapy (CIMT).

Case Description. The patient was a 72-year-old man, 10 years poststroke, who did not meet traditional CIMT criteria. The EMG-stim was applied to the wrist extensors of the patient's weaker arm for one half of the CIMT training hours.

Outcomes. The intervention was feasible for this individual. Improvements were observed in motor behavior, quality and amount of use, muscle activity, wrist range of motion, and reaction time of the more-affected extremity. These improvements …

A Comparison Of Four Electrical Stimulation Types On Staphylococcus Aureus Growth In Vitro, Harold L. Merriman, Chris A. Hegyi, Cheryl R. Albright-Overton, John Carlos Jr., Robert W. Putnam, Janet A. Mulcare

Faculty Publications

We evaluated the efficacy of common electrical stimulation (ES) types on bacterial growth in vitro using clinically relevant conditions. Four types of ES-continuous micro-amperage direct current (μADC), high-voltage pulsed current (HVPC), low-voltage monophasic milliamperage pulsed current (LVMmAPC), and low-voltage biphasic milliamperage pulsed current (LVBmAPC)-were each applied to a separate set of culture plates containing Staphylococcus aureus for 1 h at 37°C on 3 consecutive days. After ES treatment, the zone of inhibition surrounding each electrode was measured. Zone of inhibition measurements showed a significant inhibitory effect for continuous μADC and HVPC (p < 0.05), but not for LVM-mAPC and LVBmAPC. Differences in bacterial growth inhibition were not found for polarity and time. These data suggest that for infected wounds, HVPC and continuous μADC treatments may have an initial bacterial inhibitory effect, which does not significantly change with subsequent treatments.

Variable-Frequency-Train Stimulation Of Skeletal Muscle After Spinal Cord Injury, C. Scott Bickel, Jill Slade, Leslie R. Vanhiel, Gordon L. Warren, Gary A. Dudley

Physical Therapy Faculty Publications

Skeletal muscle, after spinal cord injury (SCI), becomes highly susceptible to fatigue. Variable-frequency trains (VFTs) enhance force in fatigued human skeletal muscle of able-bodied (AB) individuals. VFTs do this by taking advantage of the "catch-like" property of skeletal muscle. However, mechanisms responsible for fatigue in AB and SCI subjects may not be the same, and the efficacy of VFT stimulation after SCI is unknown. Accordingly, we tested the hypothesis that VFT stimulation would augment torque-time integral in SCI subjects. The quadriceps femoris muscle was stimulated with constant frequency trains (CFTs) (six 200 s square wave pulses separated by 70 ms) …

In Vitro Effects Of Two Silver Electrodes On Select Wound Pathogens, Linda Jean Laatsch-Lybeck, Poh Chye Ong, Luther C. Kloth

Physical Therapy Faculty Research and Publications

The use of electrical current to promote wound healing is well documented. However, little is understood about the effects of micro-amperage direct current (μADC) on growth of wound pathogens. The purpose of this project was to investigate the antibacterial effects of a silver wire/silver nylon electrode carrying μADC in vitro on several Gram positive and Gram negative bacteria. The current was delivered via silver wire and silver nylon electrodes at an amplitude of 100 μA for a 30-minute duration in an in vitro system. Results demonstrated that only silver wire carrying current inhibited bacterial growth around …

Antibacterial Effects Of A Silver Electrode Carrying Microamperage Direct Current In Vitro, Poh Chye Young, Luther C. Kloth, Linda Jean Laatsch-Lybeck

Physical Therapy Faculty Research and Publications

Currently, electrical stimulation is an accepted method used clinically to promote chronic wound healing. A literature review revealed that similar therapeutic current has been shown to suppress growth of common wound pathogens in vitro and in vivo. To date, little has been reported on the factors contributing to the antibacterial effects of microamperage direct current (μADC) stimulation. The purpose of this project was to investigate the role of electric field strength, current density, pH, and type of electrode used in vitro, to gain a better understanding of how these factors contribute to inhibiting growth of select wound pathogens. …

Chronic Dermal Ulcer Healing Enhanced With Monophasic Pulsed Electrical Stimulation, Jeffery A. Feedar, Luther C. Kloth, Gary D. Gentzkow

Physical Therapy Faculty Research and Publications

The purposes of this randomized, double-blind, multicenter study were to compare healing of chronic dermal ulcers treated with pulsed electrical stimulation with healing of similar wounds treated with sham electrical stimulation and to evaluate patient tolerance to the therapeutic protocol. Forty-seven patients, aged 29 to 91 years, with 50 stage II, III, and IV ulcers were randomly assigned to either a treatment group (n=26) or a control (sham treatment) group (n=24). Treated wounds received 30 minutes of pulsed cathodal electrical stimulation twice daily at a pulse frequency of 128 pulses per second (pps) and a peak amplitude of 29.2 mA …

Acceleration Of Wound Healing With High Voltage, Monophasic, Pulsed Current, Luther C. Kloth, Jeffery A. Feedar

Physical Therapy Faculty Research and Publications

The purpose of this study was to determine whether high voltage electrical stimulation accelerates the rate of healing of dermal ulcers. Sixteen patients with stage IV decubitus ulcers, ranging in age from 20 to 89 years, participated in the study. The patients were assigned randomly to either a Treatment Group (n = 9) or a Control Group (n = 7). Patients in the Treatment Group received daily electrical stimulation from a commercial high voltage generator. Patients in the Control Group had the electrodes applied daily but received no stimulation. The ulcers of patients in the Treatment Group healed at a …