Effect of Low Intensity Cathodal Direct Current on Rate of Healing and Quality Of Life in Diabetic Patients with Ischemic Foot Ulcer

Introduction: Adjunctive treatment using electrical stimulation has recently been shown to promote healing in patients with diabetic foot ulcer. The aim of the present study was to evaluate whether low intensity cathodal direct current electrical stimulation improves healing rate of foot ulcers and health related quality of life in diabetic patients. Materials and methods: A total of 30 type 2 diabetic patients with ischemic foot ulcer were included in the present randomized, single-blind, placebo controlled trial. Participants were randomly assigned to receive either electrical stimulation therapy (direct current with low intensity, ES group, n=15) or sham treatment (placebo group, n=15) for 1 h/day, 3 days/week, for 4 weeks (12 sessions). Improvement ratio of wound and quality of life was evaluated at the 1st and 12th sessions. The quality of life was assessed using SF-36 questionnaire. Results: The mean of improvement ratio was significantly higher in the electrical stimulation group (59.4%) compared with that of the placebo group (27.07%) at the 12th session (P=0.02). Overall score of quality of life significantly increased in the electrical stimulation group as compared with that for the placebo group (0.01). Conclusion: By promotion of wound healing, applied low intensity cathodal direct current may increase the health-related quality of life in diabetic patients with ischemic foot ulcer.Key words: Diabetics, Ischemic foot ulcers, Low intensity direct current, Wound improvement rate, Quality of lif

The Relationship Between Knee Moments and Function with Western Ontario and McMaster Universities in Moderate Knee Osteoarthritis

Introduction: The knee is the most affected weight-bearing joint by osteoarthritis. The kinetics parameters are correlated with the progression of knee osteoarthritis (KOA). This study was done to investigate the relationship between kinetics parameters and functional tests with Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores in people with moderate KOA. Materials and Methods: Twenty- three participants with moderate KOA participated in this study. Gait analysis involved the measurement of the external peak knee adduction moment (PKAM), peak knee flexion moment (PKFM), knee adduction moment impulse (KAM impulse), and knee flexion moment impulse (KFM impulse) during level walking. Functional tests included timed up and go (TUG) and figure of eight walkings (FO8W) tests. Pearson’s correlation coefficient was used to investigate the correlation between kinetics parameters and functional test scores with WOMAC total scores and sub-scores. Results: There was a significant inverse correlation between the first PKAM and WOMAC total score and pain sub-score (r=-0.43 P=0.03 and r=-0.6 P=0.002, respectively). Also, there was a significant inverse correlation between the second PKAM and pain sub-score (r=-0.46 P=0.02). There was no significant correlation between functional tests and WOMAC scores. Conclusion: The low score of the WOMAC in the moderate KOA should not be attributed to the low level of joint knee moments

Biomechanical Evaluation of Spontaneous Repair of Osteochondral Defects in the Rabbit Knee

Background: Examination of cartilage repair in animal work is dependent upon the thickness and radius of the induced impalement. Full-thickness defects with a radius of 3 mm have been commonly used in animal studies to evaluate new procedures designed to improve the quality of articular cartilage repair. The aim of the present study was to define the biomechanical characteristics of the repair of 5×4 mm full-thickness osteochondral defects in adult male rabbits. Methods: In a controlled clinical trial study 5 mm diameter and 4 mm deep osteochondral defects were drilled in the femoral patellar groove of twenty-one rabbits, and examined at 4, 8, and 16 weeks. The left knee was kept intact and was regarded as control. The knee joints were removed, and both legs were examined biomechanically by in situ indentation method at three time intervals (4, 8, 16 weeks). The instantaneous and equilibrium elastic- modulus (after 900 second) were measured during the test. Results: There were no differences in cartilage mechanical properties (instantaneous and equilibrium elastic-modulus) in different weeks (4, 8, 16 weeks) in the two groups (P=0.08). However, significant differences were seen between the experimental and control groups in 16 weeks in instantaneous elastic_ modulus (P=0.44). It suggests that new tissue in this group had more stiffness than control in 16 weeks. Conclusion: Full-thickness osteochondral defect, measuring 5×4mm in the patellar groove of the adolescent rabbit knee healed spontaneously

The acute effect of whole body vibration on the h-reflex recruitment curve in soleus muscle

Introduction: Despite the facilitatory effects after applied whole body vibration (WBV), results of some studies have shown the increase of muscle response depression. The purpose of this study was to investigate the acute response of H-reflex recruitment curve in soleus muscle after one session of WBV. Materials and Methods: Twenty six non-athletes volunteer healthy women (mean age ± SD; 26.11 ± 2.85 years) were participated in this study. All subjects received two different sham and test sessions. They stood on the vibration plate in semi squat position. In test session, WBV was applied with frequency of 30Hz and peak to peak amplitude of 3mm during 3 minutes. Soleus H-reflex recruitment curve was recorded before, immediately after, 5 and 10 minutes after WBV. Results: The intensity of H-reflex recruitment curve threshold and Hmax were significantly increased immediately after WBV in both sessions (P 0.05). Conclusion: Considering the right shift of H-reflex recruitment curve and depression response in two sham and test sessions, it seems that maintaining of semi squat position and activated control mechanisms, such as extensor muscles contraction, affects this inhibitory response and WBV had no facilitatory effect on this depression response. Keywords: H-reflex, Soleus muscle, Whole body vibration, Semi squat positio

Does applying pulsed electromagnetic field on the lumbopelvic area of postmenopausal women with osteoporosis affect the motoneuron activities of soleus and gastrocnemius muscles? An emphasis on the H-reflex recruitment curve changes

Introduction: Applying Pulsed Electromagnetic Field (PEMF) on the primary osteoporotic women have been effective in increasing the bone synthesis biomarkers and decreasing of the amplitude and velocity of center of pressure. In the present study, in order to investigate the possible effect of PEMF on the neuromuscular responses, the acute effect of PEMF on the lumbopelvic area in the postmenopausal women with Osteoporosis was studied by recording the soleus and gastrocnemius recruitment curves. Materials and Methods: For investigating the acute effect of PEMF, 22 postmenopausal women with osteoporosis (age 48-65) voluntarily entered in the study and randomly participated in two separately sessions applying PEMF and placebo (magnet device off). PEMF was applied on the lumbopelvic area with frequency of 30Hz and intensity of 40G for 45 min. One-week interval was considered between placebo and PEMF sessions.&nbsp; Before and after each session, H- reflex recruitment curve was recorded for soleus and gastrocnemius muscles and then amplitude, intensity of stimulation and latency of threshold, maximum and final H-reflex were determined. Results: After application of 45 min PEMF, the mean stimulus intensity for recording of initial H-reflex was decreased significantly, in soleus and gastrocnemius muscles (0.48 and 0.55 mA respectively). The latency of this H threshold was decreased significantly also in both muscles (2.01 and 1.67 ms, respectively). The peak to peak amplitude of maximum H response increased significantly, in both muscles compared to the placebo session (p<0.05). Conclusion: Immediately after applying of PEMF, facilitation in H-reflex response was observed in both soleus and gastrocnemius as a slow and fast twitch muscle. In both muscles, after applying PEMF, recruitment curves shifted to the left side by decreasing the stimulus intensity of initial and maximum H-responses and also their latencies.&nbsp; Conlusivly, this may be caused by the facilitation in the activities of alpha motoneurons in the spinal cord level

Effects of sensory and motor cathodal electrical stimulatons on the injury potential and biomechanical properties of acute skin full-thickness wound in rats

مقدمه: هدف این مطالعه بررسی اثر شدت جریان حسی و حرکتی تحریک الکتریکی کاتدی بر پتانسیل آسیب، بسته شدن سطح زخم و ویژگی‌های بیومکانیکی بافت ترمیم شده بود. مواد و روش‌ها: 30 سر موش صحرایی نر بالغ نژاد اسپراگ دالی با وزن 400-300 گرم به صورت تصادفی در سه گروه شاهد، تحریک شدت حسی و شدت حرکتی قرار گرفتند. برش تمام ضخامت پوستی به طول 5/2 سانتی‌متر در ناحیه پشتی حیوان ایجاد شد. در گروه تحریک حسی، جریان مستقیم با شدت 600 میکروآمپر و در گروه تحریک حرکتی، جریان تک فاز با پالس‌های مربعی یک سویه، عرض پالس 300 میکروثانیه و شدت 3/2-2/5 میلی‌آمپر به مدت یک ساعت و یک روز در میان تا 21 روز اعمال گردید. سطح زخم و پتانسیل تفاضلی پوست از روز اول و سپس یک روز در میان اندازه‌گیری شد. در روز 21 تست کششی یک محوری انجام شد و تنش، کرنش، مدول الاستیک، و سطح زیر منحنی نیرو- تغییر شکل محاسبه شد. یافته‌ها: پتانسیل پوست در گروه تحریک حسی و شاهد در روز 15 و در گروه تحریک حرکتی در روز 17 به سطح طبیعی رسید. سطح زخم در گروه تحریک حسی در روز 15 و در گروه تحریک حرکتی و شاهد در روز 17 ترمیم به طور کامل بسته شد. تفاوت معنی‌داری در پارامترهای بیومکانیکی بافت ترمیم شده بین سه گروه مشاهده نشد (0/05 > P). نتیجه گیری: شدت جریان حرکتی بر خلاف تصور، تأثیر بیشتری بر پارامترهای بیومکانیکی بافت ترمیم شده نداشت. به نظر می‌رسد تغییر محیط مکانیکی ایجاد شده با اعمال تحریک الکتریکی، نتوانسته است نقش تنش‌ها و کرنش‌های طبیعی روزانه را که به بافت وارد می‌شود، بازسازی نماید و موجب بلوغ زودهنگام فیبرهای کلاژن و پیوندهای درون و بین مولکولی شود. کلید واژه‌ها: تحریک الکتریکی کاتدی، شدت حرکتی، شدت حسی، قدرت کششی، پتانسیل آسی

Evaluation of Reliability of H-Reflex Recruitment Curve Parameters of Soleus and Lateral Gastrocnemius Muscles in Assessment of Motor Neuron Pools Excitability

Background and Objectives: In Recent years, recording of the H-reflex recruitment curve for assessment of the excitability of group Ia afferent monosynaptic reflex has been growing. The purpose of this study was to evaluate the reliability of H-reflex recruitment curve parameters of gasterosoleus muscle in the assessment of motor neuron pool excitability.Methods: In this descriptive study, 50 non-athlete healthy volunteers were assessed. Percutaneously, 40 electrical pulses of 1 millisecond duration and 3 stimulations per each stimulus intensity were induced on tibial nerves and H-reflex recruitment curve were recorded in 4 phases. Also, each person was assessed in two sessions with 1-week interval.Results: The intraclass correlation coefficients )ICCs( was obtained between 0.97-0.99 for inter-session reliability of intensity for recording the threshold, HMax and HLast reflexes, amplitude of HMax, and the total slope of the ascending and descending arms. The inter-session correlation coefficient (test-retest) of these variables were obtained between 0.91-0.95 for soleus muscle, and the inter-session ICCs for peak-to-peak amplitude of HMax and the total slope of the ascending arm of gastrocnemius were obtained 0.65 and 0.67. The slope of initial and final three points of the ascending arm revealed a different reliability in inter-session and intra-session reliability analysis (0.64-0.96). Conclusion: The reliability analysis showed a high inter-session and intra-session ICCs for the functional principal components of soleus recruitment curve. Also, recruitment curve parameters, such as intensity for record of threshold and HMax of soleus and lateral gastrocnemius muscles as well as total slope of ascending and descending arms, and peak to peak amplitude of HMax of soleus muscle had a very high Reliability