ObjectiveTo investigate changes in lumbar multifidus (LM) and deep lumbar stabilizing abdominal muscles (transverse abdominis [TrA] and obliquus internus [OI]) during transcutaneous neuromuscular electrical stimulation (NMES) of lumbar paraspinal L4-L5 regions using real-time ultrasound imaging (RUSI).MethodsLumbar paraspinal regions of 20 healthy physically active male volunteers were stimulated at 20, 50, and 80 Hz. Ultrasound images of the LM, TrA, OI, and obliquus externus (OE) were captured during stimulation at each frequency.ResultsThe thicknesses of superficial LM and deep LM as measured by RUSI were greater during NMES than at rest for all three frequencies (p<0.05). The thicknesses in TrA, OI, and OE were also significantly greater during NMES of lumbar paraspinal regions than at rest (p<0.05).ConclusionThe studied transcutaneous NMES of the lumbar paraspinal region significantly activated deep spinal stabilizing muscle (LM) and the abdominal lumbar stabilizing muscles TrA and OI as evidenced by RUSI. The findings of this study suggested that transcutaneous NMES might be useful for improving spinal stability and strength in patients having difficulty initiating contraction of these muscles.
[Purpose] To investigate the effectiveness of three different neuromuscular electrical
stimulation (NMES) protocols for the deep lumbar stabilizing muscles of patients with
lumbar degenerative kyphosis (LDK). [Subjects and Methods] Twenty patients with LDK were
recruited. Three stimulation protocols were investigated: stimulation of the abdominal
muscles (protocol A); stimulation of the lumbar muscles (protocol B); and simultaneous
stimulation of the abdominal and lumbar muscles (protocol A+B). Images of the obliquus
externus (OE), obliquus internus (OI), transversus abdominis (TrA), and lumbar multifidus
(LM) muscles were captured by real-time ultrasound imaging (RUSI). [Results] The thickness
of LM was significantly greater during stimulation than at rest for all three protocols.
Thicknesses of the abdominal muscles (TrA, OI, and OE) were significantly greater during
stimulation than at rest for protocols A and A+B. Thickness increases in LM were
significantly greater during protocols B and A+B, but not during protocol A. Thickness
increases in the abdominal muscles (TrA, OI, and OE) were significantly greater during
protocols A and A+B, but not during protocol B. [Conclusion] NMES can significantly
activate the deep lumbar stabilizing muscles of patients with LDK. Protocol A+B of NMES is
recommended to aid postural correction and low back pain (LBP) in patients with LDK.
According to the results of this study, the hybrid AFO showed a similar effect in function, except for ankle dorsiflexion angle at heel strike, and was superior with regard to convenience compared with the conventional plastic AFO in chronic hemiparetic stroke patients. Therefore, it seems that, in general, the hybrid AFO can be recommended for hemiparetic stroke patients who require an AFO.
ObjectiveTo evaluate the therapeutic effect of a Tibia Counter Rotator (TCR) with toe-out gait plate (GP) upon tibial internal torsion by a comparative analysis of transmalleolar angle (TMA) and gait analysis with GP alone.MethodsTwenty participants with tibial internal torsion were recruited for this study. Each 10 participants were included in group A with TCR and GP application and in group B with GP application only. The TMA and the kinematic results were used for the evaluation of the therapeutic effects of orthoses.ResultsWithin each group, TMA showed a significant increase after treatment. Group A showed a continuous improvement up to six months, however, group B showed an improvement up to five months only. Group A showed a significantly higher correction effect than group B after treatment. Regarding kinematic data, both groups showed a significantly decreased mean ankle adduction angle after treatment. However, group A showed a significantly lower mean ankle adduction angle than group B after six months.ConclusionThe group with TCR and GP showed a significantly better outcome and continued correction force compared to the group with GP only. Our results suggest that TCR with GP may be useful therapeutic orthoses for children with tibial internal torsion.
Our results indicate that NMES can preferentially stimulate contractions in deep abdominal stabilizing muscles. Most importantly, 50 Hz NMES produced greater muscle thickness increases than 20 or 80 Hz.
Transcutaneous NMES applied at optimal points on the lower abdomen and back could provide a means of treating gait problems caused by a stooped trunk in LDK patients.
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