Electrical stimulation therapy for peripheral nerve injury

Abstract

Peripheral nerve injury is common and frequently occurs in extremity trauma patients. The motor and sensory impairment caused by the injury will affect patients' daily life and social work. Surgical therapeutic approaches don't assure functional recovery, which may lead to neuronal atrophy and hinder accelerated regeneration. Rehabilitation is a necessary stage for patients to recover better. A meaningful role in non-pharmacological intervention is played by rehabilitation, through individualized electrical stimulation therapy. Clinical studies have shown that electrical stimulation enhances axon growth during nerve repair and accelerates sensorimotor recovery. According to different effects and parameters, electrical stimulation can be divided into neuromuscular, transcutaneous, and functional electrical stimulation. The therapeutic mechanism of electrical stimulation may be to reduce muscle atrophy and promote muscle reinnervation by increasing the expression of structural protective proteins and neurotrophic factors. Meanwhile, it can modulate sensory feedback and reduce neuralgia by inhibiting the descending pathway. However, there are not many summary clinical application parameters of electrical stimulation, and the long-term effectiveness and safety also need to be further explored. This article aims to explore application methodologies for effective electrical stimulation in the rehabilitation of peripheral nerve injury, with simultaneous consideration for fundamental principles of electrical stimulation and the latest technology. The highlight of this paper is to identify the most appropriate stimulation parameters (frequency, intensity, duration) to achieve efficacious electrical stimulation in the rehabilitation of peripheral nerve injury.

Neuromodulation of the peripheral nervous system: Bioelectronic technology and prospective developments

“…This therapy uses electrodes on the skin surface to deliver low-intensity electrical impulses that stimulate peripheral sensory nerves without inciting muscle contractions. [96] The applications of TENS include improving sensory feedback, adjusting neural pathways, and reducing neuralgia by inhibiting the descending pathway. It has been extensively researched for several decades and is widely employed in clinical settings.…”

“…TENS is a non‐invasive electrical stimulation therapy that primarily targets sensory nerves to activate specific pain relief mechanisms. This therapy uses electrodes on the skin surface to deliver low‐intensity electrical impulses that stimulate peripheral sensory nerves without inciting muscle contractions [96] . The applications of TENS include improving sensory feedback, adjusting neural pathways, and reducing neuralgia by inhibiting the descending pathway.…”

Electrical Stimulation Use in Upper Extremity Peripheral Nerve Injuries

“…2,3 Electrical stimulation (ES) has been used as an intervention to attempt to overcome the limits of peripheral nerve surgery and improve patient outcomes after peripheral nerve injury. 4 ES is broadly defined as a treatment modality that applies electric current to nerve or muscle to assist in their regeneration. ES can be separated into three different categories: neuromuscular electrical stimulation (NMES), transcutaneous electrical nerve stimulation (TENS), and functional ES.…”

“…Current ES instruments are mostly small portable devices, and the electrodes can be implanted, percutaneous, or on the skin surface. 4 The intention of this review was to discuss ES, primarily NMES, as pertains to upper extremity peripheral nerve injury, including compressive neuropathies and nerve transections, as well as nerve transfers. We review both animal and human studies as well as the future direction of study and research in an effort to provide relevance to practitioners hoping to use this technology in clinical practice.…”

“…Current ES instruments are mostly small portable devices, and the electrodes can be implanted, percutaneous, or on the skin surface. 4…”