A single trial of ICT is a useful intervention for immediately improving spasticity, balance, and gait abilities in chronic stroke patients, but not for long-term effects. Further study on the effects of repeated ICT is needed.

Neuropathic pain is a devastating chronic condition and is often induced in the upper limb following nerve injury or damage. Various drugs or surgical methods have been used to manage neuropathic pain; however, these are frequently accompanied by undesirable side effects. Transcutaneous electrical nerve stimulation (TENS) is a safe and non-invasive intervention that has been used to alleviate different types of pain in the clinic, but it is unclear whether TENS can improve chronic neuropathic pain in the upper limb. Thus, the aim of this study was to investigate the effects of a single trial of TENS on chronic neuropathic pain following median nerve injury. Male rats weighing 200-250 g received median nerve-ligation of the right forearm, while the control group received only skin-incision without nerve-ligation. Neuropathic painbehaviors, including mechanical, cold, and thermal allodynia, were measured for 4 weeks. After the development of chronic neuropathic pain, TENS (100 Hz, 200 µs, sub-motor threshold) or placebo-TENS (sham stimulation) was applied for 20 min to the ipsilateral or contralateral side. Neuropathic pain behavior was assessed before and after intervention. Median nerve-ligation significantly induced and maintained neuropathic pain in the ipsilateral side. TENS application to the ipsilateral side effectively attenuated the three forms of chronic neuropathic pain in the ipsilateral side compared to sham-treated rats (peripheral and central effects), while TENS application to contralateral side only reduced mechanical allodynia in the ipsilateral side (central effect). Our findings demonstrate that TENS can alleviate chronic neuropathic pain following median nerve injury.

[Purpose] This study investigated the effect of chin tuck exercise (CTE) using a neckline slimmer device on suprahyoid (SH) and sternocleidomastoid (SCM) muscle activation in healthy adults. [Subjects and Methods] We measured activation of the SH and SCM muscles using surface electromyography in 20 healthy adults during head lift exercise (HLE) and CTE using a neckline slimmer device. The order of exercises was randomized and the mean and peak values of each muscle’s activation were assessed. [Results] During the CTE using a neckline slimmer device, SH activation was significantly greater and SCM activation was significantly lower than during the HLE. [Conclusion] This study suggest that chin-tuck exercise using a neckline slimmer device may be more helpful than HLE for swallowing training.

Disc afferent nerve fiber Low back pain In vivo single nerve recording Dynamic weight bearing Morphine s u m m a r y Objective: We aimed to investigate mechano-sensitivity at the afferent nerve fibers projecting to degenerated intervertebral disc (IVD) and nociceptive behaviour in a rat model of low back pain (LBP). Design: Animal model with LBP was established by lumbar 4/5 IVD puncture and nucleus pulposus aspiration. In vivo single nerve recordings (n ¼ 121) were introduced to measure discharge frequency at the afferent nerve fiber innervating the IVD during mechanical stimulations (von Frey filament or intradiscal pressure). Nerve growth factor (NGF) expression levels in the IVD (n ¼ 20) were assessed by Western blot. LBP-related behaviour (n ¼ 22) was assessed by measuring changes in rearing, mechanical paw-withdrawal threshold, and dynamic weight bearing in a freely walking rat. Inhibitory effect of morphine on the neuronal excitability (n ¼ 19) and painful behaviour (n ¼ 28) was also assessed. Results: Compared to those with sham or naïve IVD, animal group with degenerated IVD displayed the sensitized neuronal responses and painful behaviour, with hyperexcitability of the afferent nerve fibers in any range of mechanical stimulations (von Frey filament stimulation; 1, 2, and 26 g; intradiscal pressure, 1,500e3,000 mm Hg), strong upregulation of NGF (200e250 % increase), and LBP-like behaviour such as failure of rearing, front limbs-dependent walking pattern, and hypersensitivity in hind-paws. However, the neuronal hyperexcitability and pain behaviour were attenuated after local (30 mM) or systemic (3 mg kg À1) morphine administration. Conclusions: Our study suggests that enhanced mechano-sensitivity at the afferent nerve fiber innervating degenerated IVD is deeply correlated with LBP development, which supports the hypothesis that hyperexcited responses at the nerve fibers represent a decisive source of LBP.

Work-related musculoskeletal symptom disorders (WMSDs) have a significant issue for dental professionals. This study investigated the effects of high-frequency transcutaneous electrical nerve stimulation (TENS) on work-related pain, fatigue, and the active range of motion in dental professionals. Among recruited 47 dental professionals with WMSDs, 24 subjects received high-frequency TENS (the TENS group), while 23 subjects received placebo stimulation (the placebo group). TENS was applied to the muscle trigger points of the levator scapulae and upper trapezius, while placebo-TENS was administered without electrical stimulation during 60 min. Pain and fatigue at rest and during movement were assessed using the visual analog scale (VAS), pain pressure threshold (PPT), and active range of motion (AROM) of horizontal head rotation at six time points: prelabor, postlabor, post-TENS, and at 1 h, 3 h, and 1 day after TENS application. Both groups showed significantly increased pain and fatigue and decreased PPT and AROM after completing a work task. The TENS group showed significantly greater improvements in VAS score, fatigue, PPT, and AROM at post-TENS and at 1 h and 3 h after application (all P < 0.05) as compared to the placebo group. A single session high-frequency TENS may immediately reduce symptoms related to WMSDs in dental professionals.

Objective: Elderly people with dementia experience not only cognitive dysfunction but also motor function deficits, such as balance and gait impairments. Recently, transcutaneous electrical nerve stimulation (TENS) has been used to reduce pain as well as to control muscle spasm, spasticity and motor performance in various types of subjects. The purpose of this study determined the effect of a single trial TENS on balance and gait function in elderly people with dementia. Design: A randomized controlled trial. Methods: Twenty-two subjects with dementia were assigned to the TENS group (n=12) and ten subjects were assigned to the control group (n=10) randomly. Subjects were classified into two groups: the TENS group (n=12) and the placebo-TENS group (n=10). The TENS group had electrical stimulation applied on the calf muscle for 15 minutes, while the placebo-TENS group had not received real electrical stimulation. The timed up and go test (TUG) and functional reach test (FRT) were used to measure the balance function, and the 10 meters walk test (MWT) and 6MWT were used to assess gait ability. All tests were performed before and after intervention under a single-blinded condition. Results: After intervention, there were significant improvements in TUG, FRT, 10MWT, and 6MWT results in the TENS group (p<0.05), while the placebo-TENS group did not show significant changes in all outcome measurements. There were also differences in all tests between the two groups at post-measurements (p<0.05). Conclusions: This study demonstrated that a single trial TENS application on the calf may be used to improve balance and gait function in elderly people with dementia.

Objective: Musculoskeletal neck pain have many symptoms which include decreased range of motion (ROM) and muscle strength, and increased pain. However, the management methods are controversial. The purpose of this study was to examine the effects of three interventions on ROM, strength, and pressure pain threshold (PPT) with musculoskeletal neck pain. Design: Pretest-posttest design. Methods: Thirty subjects participated in this experiment. They were randomly assigned to thefollowing groups: passive stretching (PS) group (n=10), massage (MASS) group (n=10), and muscle energy technique (MET) group (n=10). The treatment were applied bilaterally on the upper trapezius. The PS was applied 3 times for 30 seconds each time. The MASS was applied using two different techniques for 2 minutes per technique. For MET, the subjects performed 2 sets of 3 repetitions of isometric resistance exercise that was maintained for 10 seconds, followed by 10 seconds of rest. ROM, strength, and PPT parameters were measured after intervention. Results: In the MASS group, there was a significant improvement in all outcomes except for muscle strength (p<0.05). In the MET group, ROM and strength significantly improved compared to the pre-treatment results (p<0.05). As result of measuring the amount of change in each group, there was a significant difference in ROM (flexion) in the PS group compared with the MASS and MET group, a significant difference in strength in the MET group compared with the PS and MASS groups, and a significant difference in PPT in the MASS groups compared with the PS and MET groups (p<0.05). Conclusions: This study showed that PS, MASS, and MET are effective methods for improving ROM, strength, and PPT for musculoskeletal neck pain. Therefore, various therapeutic interventions for improving ROM, strength, and pain are suggested.

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