Performance of the CMS Cathode Strip Chambers with Cosmic Rays

The Cathode Strip Chambers (CSCs) constitute the primary muon tracking device in the CMS endcaps. Their performance has been evaluated using data taken during a cosmic ray run in fall 2008. Measured noise levels are low, with the number of noisy channels well below 1%. Coordinate resolution was measured for all types of chambers, and fall in the range 47 microns to 243 microns. The efficiencies for local charged track triggers, for hit and for segments reconstruction were measured, and are above 99%. The timing resolution per layer is approximately 5 ns

Feasibility of a walking virtual reality system for rehabilitation: objective and subjective parameters

[EN] Background: Even though virtual reality (VR) is increasingly used in rehabilitation, the implementation of walking navigation in VR still poses a technological challenge for current motion tracking systems. Different metaphors simulate locomotion without involving real gait kinematics, which can affect presence, orientation, spatial memory and cognition, and even performance. All these factors can dissuade their use in rehabilitation. We hypothesize that a marker-based head tracking solution would allow walking in VR with high sense of presence and without causing sickness. The objectives of this study were to determine the accuracy, the jitter, and the lag of the tracking system and its elicited sickness and presence in comparison of a CAVE system. Methods: The accuracy and the jitter around the working area at three different heights and the lag of the head tracking system were analyzed. In addition, 47 healthy subjects completed a search task that involved navigation in the walking VR system and in the CAVE system. Navigation was enabled by natural locomotion in the walking VR system and through a specific device in the CAVE system. An HMD was used as display in the walking VR system. After interacting with each system, subjects rated their sickness in a seven-point scale and their presence in the Slater-Usoh-Steed Questionnaire and a modified version of the Presence Questionnaire. Results: Better performance was registered at higher heights, where accuracy was less than 0.6 cm and the jitter was about 6 mm. The lag of the system was 120 ms. Participants reported that both systems caused similar low levels of sickness (about 2.4 over 7). However, ratings showed that the walking VR system elicited higher sense of presence than the CAVE system in both the Slater-Usoh-Steed Questionnaire (17.6 +/- 0.3 vs 14.6 +/- 0.6 over 21, respectively) and the modified Presence Questionnaire (107.4 +/- 2.0 vs 93.5 +/- 3.2 over 147, respectively). Conclusions: The marker-based solution provided accurate, robust, and fast head tracking to allow navigation in the VR system by walking without causing relevant sickness and promoting higher sense of presence than CAVE systems, thus enabling natural walking in full-scale environments, which can enhance the ecological validity of VR-based rehabilitation applications.The authors wish to thank the staff of LabHuman for their support in this project, especially José Miguel Martínez and José Roda for their assistance. This study was funded in part by Ministerio de Economia y Competitividad of Spain (Project NeuroVR, TIN2013-44741-R and Project REACT, TIN2014-61975-EXP), by Ministerio de Educacion y Ciencia of Spain (Project Consolider-C, SEJ2006-14301/PSIC), and by Universitat Politecnica de Valencia (Grant PAID-10-14).Borrego, A.; Latorre Grau, J.; Llorens Rodríguez, R.; Alcañiz Raya, ML.; Noé, E. (2016). Feasibility of a walking virtual reality system for rehabilitation: objective and subjective parameters. Journal of NeuroEngineering and Rehabilitation. 13:1-9. https://doi.org/10.1186/s12984-016-0174-1S1913Lee KM. Presence. Explicated Communication Theory. 2004;14(1):27–50.Riva G. Is presence a technology issue? Some insights from cognitive sciences. Virtual Reality. 2009;13(3):159–69.Banos RM, et al. Immersion and emotion: their impact on the sense of presence. Cyberpsychol Behav. 2004;7(6):734–41.Llorens R, et al. Tracking systems for virtual rehabilitation: objective performance vs. subjective experience. A practical scenario. Sensors (Basel). 2015;15(3):6586–606.Navarro MD, et al. Validation of a low-cost virtual reality system for training street-crossing. A comparative study in healthy, neglected and non-neglected stroke individuals. Neuropsychol Rehabil. 2013;23(4):597–618.Parsons TD. Virtual reality for enhanced ecological validity and experimental control in the clinical, affective and social neurosciences. Front Hum Neurosci. 2015;9:660.Cameirao MS, et al. Neurorehabilitation using the virtual reality based Rehabilitation Gaming System: methodology, design, psychometrics, usability and validation. J Neuroeng Rehabil. 2010;7:48.Llorens R, et al. Improvement in balance using a virtual reality-based stepping exercise: a randomized controlled trial involving individuals with chronic stroke. Clin Rehabil. 2015;29(3):261–8.Llorens R, et al. Videogame-based group therapy to improve self-awareness and social skills after traumatic brain injury. J Neuroeng Rehabil. 2015;12:37.Fong KN, et al. Usability of a virtual reality environment simulating an automated teller machine for assessing and training persons with acquired brain injury. J Neuroeng Rehabil. 2010;7:19.Levin MF, Weiss PL, Keshner EA. Emergence of virtual reality as a tool for upper limb rehabilitation: incorporation of motor control and motor learning principles. Phys Ther. 2015;95(3):415–25.Llorens R, et al. Effectiveness, usability, and cost-benefit of a virtual reality-based telerehabilitation program for balance recovery after stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2015;96(3):418–25. e2.Cruz-Neira C, et al. Scientists in wonderland: A report on visualization applications in the CAVE virtual reality environment. In: 1993. Proceedings IEEE 1993 Symposium on Research Frontiers in Virtual Reality. 1993.Juan MC, Perez D. Comparison of the levels of presence and anxiety in an acrophobic environment viewed via HMD or CAVE. Presence. 2009;18(3):232–48.Yang YR, et al. Virtual reality-based training improves community ambulation in individuals with stroke: a randomized controlled trial. Gait Posture. 2008;28(2):201–6.Cho KH, Lee WH. Virtual walking training program using a real-world video recording for patients with chronic stroke: a pilot study. Am J Phys Med Rehabil. 2013;92(5):371–84.Darter BJ, Wilken JM. Gait training with virtual reality-based real-time feedback: improving gait performance following transfemoral amputation. Phys Ther. 2011;91(9):1385–94.Yang S, et al. Improving balance skills in patients who had stroke through virtual reality treadmill training. Am J Phys Med Rehabil. 2011;90(12):969–78.Walker ML, et al. Virtual reality-enhanced partial body weight-supported treadmill training poststroke: feasibility and effectiveness in 6 subjects. Arch Phys Med Rehabil. 2010;91(1):115–22.Riley PO, et al. A kinematic and kinetic comparison of overground and treadmill walking in healthy subjects. Gait Posture. 2007;26(1):17–24.Alton F, et al. A kinematic comparison of overground and treadmill walking. Clin Biomech. 1998;13(6):434–40.Lee SJ, Hidler J. Biomechanics of overground vs. treadmill walking in healthy individuals. J Appl Physiol. 2008;104(3).Slater M. Measuring presence: a response to the witmer and Singer presence questionnaire. Presence. 1999;8(5):560–5.Viau A, et al. Reaching in reality and virtual reality: a comparison of movement kinematics in healthy subjects and in adults with hemiparesis. J Neuroeng Rehabil. 2004;1(1):11.Parsons TD, et al. The potential of function-led virtual environments for ecologically valid measures of executive function in experimental and clinical neuropsychology. Neuropsychol Rehabil. 2015;11:1–31. doi: 10.1080/09602011.2015.1109524 .Aravind G, Lamontagne A. Perceptual and locomotor factors affect obstacle avoidance in persons with visuospatial neglect. J Neuroeng Rehabil. 2014;11:38.Darekar A, Lamontagne A, Fung J. Dynamic clearance measure to evaluate locomotor and perceptuo-motor strategies used for obstacle circumvention in a virtual environment. Hum Mov Sci. 2015;40:359–71.Whittle MW. Chapter 4 - Methods of gait analysis. In: Whittle MW, editor. Gait analysis. Edinburgh: Butterworth-Heinemann; 2007. p. 137–75.Hodgson E, et al. WeaVR: a self-contained and wearable immersive virtual environment simulation system. Behav Res Methods. 2015;47(1):296–307.Akizuki H, et al. Effects of immersion in virtual reality on postural control. Neurosci Lett. 2005;379(1):23–6.Thies SB, et al. Comparison of linear accelerations from three measurement systems during "reach & grasp". Med Eng Phys. 2007;29(9):967–72.Fiala M. Designing highly reliable fiducial markers. IEEE Trans Pattern Anal Mach Intell. 2010;32(7):1317–24.Garrido-Jurado S, et al. Automatic generation and detection of highly reliable fiducial markers under occlusion. Pattern Recognition. 2014;47(6):2280–92.Kim K, et al. Effects of virtual environment platforms on emotional responses. Comput Methods Programs Biomed. 2014;113(3):882–93.Slater M, Steed A. A virtual presence counter. Presence. 2000;9(5):413–34.Witmer BG, Singer MJ. Measuring presence in virtual environments: a presence questionnaire. Presence Teleop Virt. 1998;7(3):225–40.Martín-Gutiérrez J, et al. Design and validation of an augmented book for spatial abilities development in engineering students. Comput Graph. 2010;34(1):77–91.Lopez-Mir F, et al. Design and validation of an augmented reality system for laparoscopic surgery in a real environment. Biomed Res Int. 2013;2013:758491.Abawi DF, Bienwald J, Dorner R. Accuracy in optical tracking with fiducial markers: an accuracy function for ARToolKit. In: Third IEEE and ACM International symposium on mixed and augmented reality, ISMAR 2004. 2004.Malbezin P, Piekarski W, Thomas BH. Measuring ARTootKit accuracy in long distance tracking experiments. In: The first IEEE International workshop augmented reality toolkit. 2002.Paquette C, Paquet N, Fung J. Aging affects coordination of rapid head motions with trunk and pelvis movements during standing and walking. Gait Posture. 2006;24(1):62–9.Graham JE, et al. Walking speed threshold for classifying walking independence in hospitalized older adults. Phys Ther. 2010;90(11):1591–7.Gorea A. A refresher of the original Bloch’s Law paper (bloch, july 1885). i-Perception. 2015;6:4.Moss JD, Muth ER. Characteristics of head-mounted displays and their effects on Simulator sickness. Hum Factors. 2011;53(3):308–19.Draper MH, et al. Effects of image scale and system time delay on Simulator sickness within head-coupled virtual environments. Hum Factors. 2001;43(1):129–46.Fujisaki W. Effects of delayed visual feedback on grooved pegboard test performance. Front Psychol. 2012;3:61.Keshner EA, et al. Augmenting sensory-motor conflict promotes adaptation of postural behaviors in a virtual environment. Conf Proc IEEE Eng Med Biol Soc. 2011;2011:1379–82.Slaboda JC, Keshner EA. Reorientation to vertical modulated by combined support surface tilt and virtual visual flow in healthy elders and adults with stroke. J Neurol. 2012;259(12):2664–72.Tossavainen T. Comparison of CAVE and HMD for visual stimulation in postural control research. Stud Health Technol Inform. 2004;98:385–7.Akiduki H, et al. Visual-vestibular conflict induced by virtual reality in humans. Neurosci Lett. 2003;340(3):197–200.Duh HBL, et al. Effects of field of view on balance in an immersive environment. In: Virtual Reality, 2001. Proceedings. IEEE. 2001.Krijn M, et al. Treatment of acrophobia in virtual reality: the role of immersion and presence. Behav Res Ther. 2004;42(2):229–39.Mania K, Chalmers A. The effects of levels of immersion on memory and presence in virtual environments: a reality centered approach. Cyberpsychol Behav. 2001;4(2):247–64.Gorini A, et al. The role of immersion and narrative in mediated presence: the virtual hospital experience. Cyberpsychol Behav Soc Netw. 2011;14(3):99–105.Fromberger P, et al. Virtual viewing time: the relationship between presence and sexual interest in androphilic and gynephilic Men. PLoS One. 2015;10(5), e0127156.Slater M, et al. Visual realism enhances realistic response in an immersive virtual environment. IEEE Comput Graph Appl. 2009;29(3):76–84.Nir-Hadad SY, et al. A virtual shopping task for the assessment of executive functions: Validity for people with stroke. Neuropsychol Rehabil. 2015;11:1–26. doi: 10.1080/09602011.2015.1109523 .Vasilyeva M, Lourenco SF. Development of spatial cognition. Wiley Interdiscip Rev Cogn Sci. 2012;3(3):349–62.Banakou D, Groten R, Slater M. Illusory ownership of a virtual child body causes overestimation of object sizes and implicit attitude changes. Proc Natl Acad Sci U S A. 2013;110(31):12846–51.Yee N, Bailenson JN, Ducheneaut N. The proteus effect: implications of transformed digital self-representation on online and offline behavior. Commun Res. 2009;36(2):285–312.Baylor AL. Promoting motivation with virtual agents and avatars: role of visual presence and appearance. Philos Trans R Soc Lond B Biol Sci. 2009;364(1535):3559–65.Clemente M, et al. Assessment of the influence of navigation control and screen size on the sense of presence in virtual reality using EEG. Expert Sys App. 2014;41(4, Part 2):1584–92.Clemente M, et al. An fMRI study to analyze neural correlates of presence during virtual reality experiences. 2013. Interacting with Computers

Aligning the CMS Muon Chambers with the Muon Alignment System during an Extended Cosmic Ray Run

Peer reviewe

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Высокая эффективность акупунктуры при лечении пациента с фармакорезистентной формой невропатии лицевого нерва (случай из клинической практики)

In this work, a clinical case on the effectiveness of acupuncture in the treatment of a pharmacoresistant form of facial neuropathy is demonstrated.В данной работе демонстрирован клинический случай эффективности акупунктуры при лечении фармакорезистентной формы невропатии лицевого нерва

Применение экстракорпоральной ударно-волновой терапии для лечения и реабилитации больных (учебное пособие)

A manual for the system of postgraduate higher professional education: physiotherapists, neurologists, reflexologists and other physicians using extracorporeal shock wave therapy in the treatment and rehabilitation of patients. This manual is intended for mastering highly specialized professional competencies in extracorporeal shock wave therapy. The presented material makes it possible to obtain new competencies in modern methods of extracorporeal shock wave therapy for various pathologies. The manual is compiled on the basis of the Federal State Standard of Higher Professional Education and orders of the Ministry of Health of the Russian Federation. The manual presents materials on the mechanism of the physiological effect of ultrasonic shock wave factor on biological tissues and the environment of the human body. Particular methods of applying shock wave therapy in medical practice are presented. Indications and contraindications. Recommended by the Federal Educational and Methodological Association in the higher education system for larger groups of specialties and training areas 31.00.00 - «Clinical Medicine» (approved by the Order of the Ministry of Education and Science of August 19, 2016 № 1081) as a textbook on the specialties: physiotherapy, neurology, reflexotherapy, orthopedics and traumatology and for doctors of other specialties who have access to shock wave therapy devices.Учебное пособие для системы послевузовского высшего профессионального образования: врачей-физиотерапевтов, врачей-неврологов, врачей-рефлексотерапевтов и врачей других специальностей, использующих в лечении и реабилитации больных методы экстракорпоральной ударно-волновой терапии. Данное пособие предназначено для овладения узкоспециализированными профессиональными компетенциями по экстракорпоральной ударно-волновой терапии. Представленный материал позволяет получить новые компетенции по современным методикам экстракорпоральной ударно-волновой терапии при различной патологии. Учебное пособие составлено на основе Федерального государственного стандарта высшего профессионального образования и приказов Министерства здравоохранения РФ. В пособии представлены материалы о механизме физиологического действия ультразвукового ударно-волнового фактора на биологические ткани и среды организма человека. Представлены частные методики применения ударно-волновой терапии в лечебной практике. Показания и противопоказания. Рекомендовано Федеральным учебно-методическим объединением в системе высшего образования по укрупнённым группам специальностей и направлений подготовки 31.00.00 - «Клиническая медицина» (утверждён приказом Министерства образования и науки от 19.08.2016 № 1081) в качестве учебного пособия по специальностям: физиотерапия, неврология, рефлексотерапия, ортопедия и травматология и для врачей других специальностей, имеющих допуск к аппаратам ударно-волновой терапии

Динамика количественных, словесных и проекционных характеристик нейропатического болевого синдрома при лечении пациентов с дистальной полинейропатией нижних конечностей с помощью прямой транскожной электронейростимуляции малоберцовых и большеберцовых нервов

Direct transcutaneous electroneurostimulation (TENS) of the fibular and tibial nerves has been used since 2015 in the treatment of neuropathic syndrome in patients with type 2 diabetes mellitus. However, a comparative analysis has not yet been conducted between the analgesic effect of high-frequency and low-frequency TENS using quantitative, qualitative and projective algic tests. Objective: to conduct a comparative analysis between high-frequency low-amplitude TENS and low-frequency high-amplitude TENS in the treatment of neuropathic pain syndrome in patients with type 2 diabetes mellitus. Materials and methods: 94 patients with pronounced neuropathic pain syndrome 31were examined. They underwent a course of standard medical therapy and besides drug therapy 31 patients underwent high-frequency low-amplitude TENS (100 Hz - 100 µs - painless sensory response) and 32patients - low-frequency high-amplitude TENS (1 Hz - 200 ms - painless motor response). Intensity of pain syndrome was assessed before, after treatment and in the follow-up period within 6 months by visual analogue scale (VAS), McGill Pain Questionnaire (MPQ), ND4 (Douleur Neuropathique en 4 Questions) and Pain Drawing. Results: TENS reliably enhances the analgesic effect of pharmаcotherapy in all applied algic tests: VAS, MPQ, DN4 and Pain Drawing. At the same time, TENS has a prolonged analgesic effect and lasts for the first 6 months of the follow-up period. Directly after treatment, it was revealed that HL TENS has a more pronounced analgesic effect than LH TENS by 35% in VAS, by 45,5% in the evaluative class of MPQ, by 57,6% in the sensory class of MPQ, by 20% in DN4. On the another hand, analgesic effect of LH TENS turned up to be significantly higher than analgesic effect of HL TENS by 51,3% in affective class of MPQ and 22% by Pain Drawing directly after treatment and 57,1% and 16% at the end of the 6th month of the follow-up period. Conclusion: there are significant differences between analgesic effects of HL TENS and LH TENS in different pain Assessments tools. Quantitative parameter and the sensory aspect of pain syndrome regresses more on the background of HL TENS, and the affective aspect of pain syndrome and the area of projection of pain syndrome regresses more on the background of LH TENS.Прямая транскожная электронейростимуляция (ТЭНС) малоберцовых и большеберцовых нервов применяется с 2015г. при лечении нейропатического синдрома у пациентов с сахарным диабетом 2 типа. Однако до сих пор не проведен сравнительный анализ между анальгезирующим эффектом высокочастотной и низкочастотной ТЭНС с помощью количественных, качественных и проекционных алгических тестов. Цель: провести сравнительный анализ между высокочастотной низкоамплитудной ТЭНС и низкочастотной высокоамплитудной ТЭНС при лечении нейропатического болевого синдрома у пациентов с сахарным диабетом 2 типа. Материалы и методы: были исследованы 94 пациента с выраженным нейропатическим болевым синдромом; 31 прошли курс стандартной медикаментозной терапии, и, кроме медикаментозной терапии, 31 пациент прошел высокочастотную низкоамплитудную ТЭНС (100 Гц - 100 мкс - безболезненный сенсорный ответ) и 32 пациента - низкочастотную высокоамплитудную ТЭНС (1Гц - 200 мкс - безболезненный моторный ответ). Выраженность болевого синдрома по ВАШ, РМБО, ND4 определена до и после лечения и в отдаленном периоде в течение 6 месяцев. Результаты: ТЭНС достоверно усиливает анальгезирующий эффект медикаментозной терапии во всех применяемых алгических тестах: ВАШ, РМБО, DN4 и схема тела. При этом анальгезирующий эффект после ТЭНС имеет пролонгированный характер и сохраняется в течение первых 6 месяцев отдаленного периода. Непосредственно после лечения было выявлено что ВН ТЭНС имеет более выраженный анальгезирующий эффект, чем НВ ТЭНС, на 35% по ВАШ, на 45,5% в эвалюативном классе РМБО, на 57,6% в сенсорном классе РМБО, на 20% по DN4. Другая картина была выявлена при определении болевого синдрома в аффективном классе РМБО и схеме тела, где НВ ТЭНС имел более выраженный анальгезирующий характер, чем ВН ТЭНС, на 51,3 и 22% соответственно В конце 6 месяца отдаленного периода НВ ТЭНС преобладала по анальгезирующему эффекту на 57,1% в аффективном классе РМБО и на 16% по схеме тела. Заключение: имеются достоверные отличия между ВН ТЭНС и НВ ТЭНС при определении болевого синдрома различными алгическими тестами, что отражает различные воздействия различных модальностей ТЭНС на различные аспекты болевого синдрома. При этом количественный параметр и сенсорный аспект болевого синдрома больше регрессирует на фоне ВН ТЭНС, а аффективный аспект болевого синдрома и площадь проекции болевого синдрома больше регрессирует на фоне НВ ТЭНС

Характеристика анальгезирующего эффекта различных модальностей транскожной электронейростимуляции

Objective: To study the features of the analgesic effect of various modalities of transcutaneous electroneurostimulation using various algic tests aimed at studying the quantitative, verbal and projection characteristics of pain syndrome. Materials and methods: 135 patients with severe neuropathic pain syndrome 44 were studied. They underwent a course of standard medical therapy and in addition to drug therapy 45 patients underwent high-frequency low-amplitude TENS and 46 patients low-frequency high-amplitude TENS. The severity of pain syndrome in YOUR, RMBO, ND4 was determined before and after treatment and in the long-term period within 6 months. Results: TENS reliably enhances the analgesic effect of drug therapy in all applied algic tests. At the same time, the analgesic effect after TENS has a prolonged nature and lasts for the first 6 months of a remote period. Immediately after treatment, it was revealed that VN TENS has a more pronounced analgesic effect than NV TENS in the study of a patient using the sensory class of RBO and DN4. In determining pain syndrome with the help of affective class of rmbo and body schema, NV TENS turned out to be more effective than VN TENS. Conclusion: There are significant differences between analgesic effects of HL TENS and LH TENS in different pain Assessments tools. Quantitative parameter and the sensory aspect of pain syndrome regresses more on the background of HL TENS, and the affective aspect of pain syndrome and the area of projection of pain syndrome regresses more on the background of LH TENS.Цель: Изучить особенности анальгезирующего эффекта различных модальностей транскожной электронейростимуляции с помощью различных алгических тестов направленных на изучении количественных, вербальных и проекционных характеристик болевого синдрома Материалы и методы: были исследованы 135 пациентов с выраженным нейропатическим болевым синдромом 44 прошли курс стандартной медикаментозной терапии и кроме медикаментозной терапии 45 пациент прошли высокочастотную низкоамплитудную ТЭНС и 46 пациентов - низкочастотную высокоамплитудную ТЭНС. Выраженность болевого синдрома по ВАШ, РМБО, ND4 определена до и после лечения и в отдаленном периоде в течении 6 месяцев. Результаты: ТЭНС достоверно усиливает анальгезирующий эффект медикаментозной терапии во всех применяемых алгических тестах. При этом, анальгезирующий эффект после ТЭНС имеет пролонгированный характер и сохраняется в течении первых 6-и месяцев отдаленного периода. Непосредственно после лечения было выявлено что ВН ТЭНС имеет более выраженный анальгезирующий эффект чем НВ ТЭНС при исследовании больного с помощью сенсорного класса РМБО и DN4. При определении болевого синдром с помощью аффективного классе РМБО и схеме тела НВ ТЭНС оказалась более эффективной чем ВН ТЭНС. Заключение: Имеются достоверные отличия между ВН ТЭНС и НВ ТЭНС при определении болевого синдрома различными алгическими тестами. Что отражает различные воздействия различных модальностей ТЭНС на различные аспекты болевого синдрома. При этом количественный параметр и сенсорный аспект болевого синдрома больше регрессирует на фоне ВН ТЭНС, а аффективный аспект болевого синдрома и площадь проекции болевого синдрома больше регрессирует на фоне НВ ТЭНС