Background:Transcutaneous electrical nerve stimulation (TENS) is used to prevent venous stasis and thromboembolism. However, best electrostimulation parameters have yet to be established. The aim of the study was to compare the hemodynamic effects and the participants’ relative discomfort of 3 TENS sequences at the maximum tolerated intensity stimulus.Methods:Twenty-four healthy university students (50% male) participated in a cross-over, randomized study. Each participant received 2 TENS sequences on peroneal nerve at 1 and 5 Hz, and the third one on soleus muscle at 5 Hz. Popliteal flow volume (FV) and peak velocity (PV) were measured using Doppler ultrasound and the relative change from basal values was recorded. Discomfort questionnaires -visual analogue scale (VAS) and verbal rating scale (VRS)- were also administered to compare sensations among the three applications.Results:All interventions produced significant hemodynamic responses compared to baseline. Both 5 Hz applications obtained higher FV increments than 1 Hz TENS (P < .001). The muscle application resulted in the lowest PV increment (P < .001). TENS at 5 Hz on nerve location was the worst tolerated, with higher values in VRS (P = .056) and VAS (P = .11), although not significant.Conclusion:TENS at 5 Hz on soleus site may be the most appropriate protocol for enhancing venous return.

ResumenEl síndrome de Smith-Magenis es una alteración del desarrollo psicomotor de origen genético, incluido en el grupo de enfermedades raras. En el caso clínico que se presenta, se realizó una valoración inicial de la coordinación, la marcha y el equilibrio a través del test de desarrollo psicomotor (TEPSI), un circuito diseñado específicamente, la prueba del tablero de clavijas de Purdue y el test Timed up and Go. Al finalizar los 3 meses que duró el tratamiento, basado en actividades de tipo lúdico, se realizó una valoración final con las mismas pruebas, encontrándose importantes diferencias objetivas en los resultados obtenidos, además de una mejoría subjetiva reportada por los padres del paciente. A pesar de que la evidencia sobre el tratamiento de fisioterapia en este síndrome es escasa, atendiendo a los resultados encontrados creemos que dicho tratamiento está totalmente justificado en el abordaje integral de los pacientes que lo padecen.

HRQoL, especially physical components, was worse in women shellfish gatherers than in the general population and other population samples.

Background The interpolated twitch technique (ITT) is a ubiquitous test for assessing the level of voluntary muscle force generation, in which muscle twitches are evoked via percutaneous electrical stimulation. Traditionally, the stimulation timing during the ITT is not computer-controlled and usually delivered from 5 to 10 s after the maximal voluntary contraction (MVC) of the potentiated muscle. Methods In this work, we evaluated the sizes of the evoked twitches in the lower limb with different controlled stimulation time delays with respect to the MVC of the ankle plantar flexors. Fifteen healthy participants were included. We recorded the un-potentiated muscle twitch amplitudes at rest in response to doublet supramaximal stimulation of the tibial nerve, superimposed twitches (SITs) at three different delays from the beginning of the MVC force plateau (0.1, 0.75, and 1.5 s), and resting twitches in the potentiated muscle at four different delays once the MVC was finished (0.1, 2.5, 5.0, and 10.0 s). Results The magnitude of the SITs did not vary among the delays tested but varied among the potentiated resting twitch (PRT) amplitudes, with 2.5 s being largest and 0.1 s being the smallest. Remarkably, the resting twitch amplitudes reduced during the session despite the long rest periods between MVCs (5 min). Conclusion We conclude that proper control of the stimulation timing is mandatory to increase the sensitivity of the ITT, and a 2.5 s delay from the end of the MVC is recommended for the PRT. Controlling the development of fatigue, which can be intrinsic to testing with repeated MVCs, is also essential. We recommend reducing the number of MVC repetitions and increasing the rest periods between them.

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