We investigated the effect of two frequencies of transcutaneous electrical nerve stimulation (TENS) applied immediately after lesion on peripheral nerve regeneration after a mouse sciatic crush injury. The animals were anesthetized and subjected to crushing of the right sciatic nerve and then separated into three groups: nontreated, Low-TENS (4 Hz), and High-TENS (100 Hz). The animals of Low- and High-TENS groups were stimulated for 2 h immediately after the surgical procedure, while the nontreated group was only positioned for the same period. After five weeks the animals were euthanized, and the nerves dissected bilaterally for histological and histomorphometric analysis. Histological assessment by light and electron microscopy showed that High-TENS and nontreated nerves had a similar profile, with extensive signs of degeneration. Conversely, Low-TENS led to increased regeneration, displaying histological aspects similar to control nerves. High-TENS also led to decreased density of fibers in the range of 6–12 μm diameter and decreased fiber diameter and myelin area in the range of 0–2 μm diameter. These findings suggest that High-TENS applied just after a peripheral nerve crush may be deleterious for regeneration, whereas Low-TENS may increase nerve regeneration capacity.

The use of self-medication, physiotherapy and the presence of depression are independently associated with neurological symptoms in HTLV-1 infected patients. Religious practice and physical activity are both protective for the development of pain.

BackgroundKnee osteoarthritis (OA) has been linked to maladaptive plasticity in the brain, which may contribute to chronic pain. Neuromodulatory approaches, such as Transcranial Direct Current Stimulation (tDCS) and Peripheral Electrical Stimulation (PES), have been used therapeutically to counteract brain maladaptive plasticity. However, it is currently unclear whether these neuromodulatory techniques enhance the benefits of exercise when administered together. Therefore, this protocol aims to investigate whether the addition of tDCS combined or not with PES enhances the effects of a land-based strengthening exercise program in patients with knee OA.MethodsPatients with knee OA (n = 80) will undertake a structured exercise program for five consecutive days. In addition, they will be randomized into four subgroups receiving either active anodal tDCS and sham PES (group 1; n = 20), sham tDCS and active PES (group 2, n = 20), sham tDCS and PES (group 3, n = 20), or active tDCS and PES (group 4, n = 20) for 20 min/day for five consecutive days just prior to commencement of the exercise program. The primary outcomes will be subjective pain intensity (VAS) and related function (WOMAC). Secondary outcomes will include quality of life (SF-36), anxiety and depression symptoms (HAD), self-perception of improvement, pressure pain thresholds over the knee, quadriceps strength, and quadriceps electromyographic activity during maximum knee extension voluntary contraction. We will also investigate cortical excitability using transcranial magnetic stimulation. Outcome measures will be assessed at baseline, 1 month after, before any intervention, after 5 days of intervention, and at 1 month post exercise intervention.DiscussionThe motor cortex becomes less responsive in knee OA because of poorly adapted plastic changes, which can impede exercise therapy benefits. Adding tDCS and/or PES may help to counteract those maladaptive plastic changes and improve the benefits of exercises, and the combination of both neuromodulatory techniques must have a higher magnitude of effect. Trial registration: Brazilian Registry on Clinical Trials (ReBEC) – Effects of electrical stimulation over the skull and tight together with exercises for knee OA; protocol number RBR-9D7C7B.Trial registrationID: RBR-9D7C7B. Registered on 29 February 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2332-6) contains supplementary material, which is available to authorized users.

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AAM of hip flexion is a safe predictor of mobility in ALS. Retarding loss of this AAM may maintain these subjects functional for a longer time. It was not possible to use MF of the muscles evaluated to predict mobility.

Objetivo: Esta revisão fornece evidências sobre exercício e exercício combinado com a estimulação elétrica em indivíduos com OA do joelho. Método: Uma revisão narrativa foi realizada com termos de estratégias não-farmacológicas, particularmente exercício, estimulação transcraniana por corrente contínua (ETCC) e estimulação elétrica neuromuscular (EEN). As variáveis analisadas foram dor, função, qualidade de vida e excitabilidade cortical. Resultados: Os resultados mostraram que o exercício foi benéfico para melhorar a dor e função em pessoas com OA do joelho. Exercício associados os ETCC pode melhorar os benefícios terapêuticos. As evidências na OA são raras, porém promissoras. Achados semelhantes foram encontrados com o EEN. Estudos sugerem que a combinação é melhor do que isolado exercício. Conclusões: Ambos os estímulos eléctricos pode ser envolvido no exercício com aumento do tamanho do efeito. Isto é devido à melhoria da plasticidade cerebral que ocorre de forma diferente nas duas técnicas. Os efeitos da interação entre os estímulos voluntários (exercício) e exógenos (elétrica) na plasticidade cerebral nos pacientes com OA do joelho requerem maior detalhamento. Informações sobre a intensidade, frequência e duração dos programas de intervenção são divergentes. Revisões sistemáticas com meta-análises podem ser desenvolvidas para identificar a combinação mais efetiva na dor, função e qualidade de vida desses indivíduos.

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