TENS to the Lateral Aspect of the Knees During Stance Attenuates Postural Sway in Young Adults

Somatosensory input is known to be essential for postural control. The present study examined the effects on postural sway of sensory input delivered via transcutaneous electrical nerve stimulation (TENS) applied to the knees during stance. Electrodes from a dual-channel portable TENS unit were adhered to the skin overlying the lateral and medial aspect of both knees of 20 young healthy volunteers (mean age 24.0 years, standard deviation 4.0). Postural sway parameters were obtained during static bipedal stance with an AMTI force platform. Four stimulation conditions were tested with eyes open and with eyes closed: no TENS; TENS applied bilaterally; and TENS applied to either the right or the left knee. Participants underwent two eight-trial blocks, with each trial lasting 30 seconds. The order of conditions was randomized for each participant. Stimulation consisted of a biphasic symmetrical stimulus delivered at the sensory detection level, with a pulse duration of 200μsec and a pulse frequency of 100Hz. The application of TENS induced significant reductions in mean sway velocity and in the medio-lateral dispersion of the center of pressure, with no corresponding effect on the anterior-posterior dispersion. These findings suggest that electrical stimulation delivered at the sensory detection level to the lateral aspects of the knees may be effective in improving balance control, and that this effect may be directionally specific

Functional Recovery Following Pertrochanteric Hip Fractures Fixated with the Dynamic Hip Screw vs. the Percutaneous Compression Plate

The Dynamic Hip Screw (DHS) is currently the most frequently used implant for the treatment of pertrochanteric hip fractures. The Percutaneous Compression Plate (PCCP) is a recently developed, alternative device that involves minimal invasive surgery. The objective of the present study was to compare functional recovery following these two surgical procedures. A total of 76 consecutive elderly subjects (mean age and standard deviation, 80.6 ± 5.5) following pertrochanteric hip fracture fixation were evaluated prospectively. Functional recovery was assessed 3 and 12 weeks and 2 years following surgery. Differences between groups 3 weeks postsurgery were found only in pain level during ambulation and in the weight-bearing capability of the operated extremity, which were both in favor of the PCCP. By 3 months, both groups had improved in all measures, but did not reach their preinjury level of independence. However, the PCCP group ambulated with fewer assistive devices and demonstrated better recovery of basic activities of daily living (BADL). While the majority of the subjects from both groups ambulated independently 2 years postsurgery, the PCCP group exhibited less pain during ambulation, was more independent in ADL, and required fewer assistive devices for ambulation. To summarize, the PCCP presents enhanced short- and long-term recovery of functional abilities in comparison to DHS. However, given the limited number of patients, further studies are necessary to substantiate these results

Effects of Dual-Channel Functional Electrical Stimulation on Gait Performance in Patients with Hemiparesis

The study objective was to assess the effect of functional electrical stimulation (FES) applied to the peroneal nerve and thigh muscles on gait performance in subjects with hemiparesis. Participants were 45 subjects (age 57.8 ± 14.8 years) with hemiparesis (5.37 ± 5.43 years since diagnosis) demonstrating a foot-drop and impaired knee control. Thigh stimulation was applied either to the quadriceps or hamstrings muscles, depending on the dysfunction most affecting gait. Gait was assessed during a two-minute walk test with/without stimulation and with peroneal stimulation alone. A second assessment was conducted after six weeks of daily use. The addition of thigh muscles stimulation to peroneal stimulation significantly enhanced gait velocity measures at the initial and second evaluation. Gait symmetry was enhanced by the dual-channel stimulation only at the initial evaluation, and single-limb stance percentage only at the second assessment. For example, after six weeks, the two-minute gait speed with peroneal stimulation and with the dual channel was 0.66 ± 0.30 m/sec and 0.70 ± 0.31 m/sec, respectively (). In conclusion, dual-channel FES may enhance gait performance in subjects with hemiparesis more than peroneal FES alone

The cientificWorldJOURNAL Clinical Study Effects of Dual-Channel Functional Electrical Stimulation on Gait Performance in Patients with Hemiparesis

The study objective was to assess the effect of functional electrical stimulation (FES) applied to the peroneal nerve and thigh muscles on gait performance in subjects with hemiparesis. Participants were 45 subjects (age 57.8 ± 14.8 years) with hemiparesis (5.37 ± 5.43 years since diagnosis) demonstrating a foot-drop and impaired knee control. Thigh stimulation was applied either to the quadriceps or hamstrings muscles, depending on the dysfunction most affecting gait. Gait was assessed during a two-minute walk test with/without stimulation and with peroneal stimulation alone. A second assessment was conducted after six weeks of daily use. The addition of thigh muscles stimulation to peroneal stimulation significantly enhanced gait velocity measures at the initial and second evaluation. Gait symmetry was enhanced by the dual-channel stimulation only at the initial evaluation, and single-limb stance percentage only at the second assessment. For example, after six weeks, the two-minute gait speed with peroneal stimulation and with the dual channel was 0.66 ± 0.30 m/sec and 0.70 ± 0.31 m/sec, respectively (P < 0.0001). In conclusion, dual-channel FES may enhance gait performance in subjects with hemiparesis more than peroneal FES alone