Electrical Stimulation And Neuromuscular Disorders

In many cases of neuromuscular disorders the physician is faced with a complete lack of therapeutic approaches. This helplessness places the doctor in a position of conflict between his desire to help and his awareness that there is no treatment. In this situation it is tempting to indiscriminately use any procedure that avoids an admission of medical helplessness while satisfying the patient's demand for treatment. Electrical interventions are often used to avoid this situation. Due to the random use of therapeutic approaches it is not known what really happens. Presumptions and biased empirical observations have led to the exten sive use of different forms of electrical stimulation regimes in neuromuscular diseases. Due to this unsatisfactory situation it is necessary to know more about appropriate methods that are being used in particular disorders. The search for a better understanding of nerve-muscle interaction has shown that certain activity patterns can influence muscle. These experi mental results provide a rational basis for a possible therapeutic use of electrical stimulation of nerve and muscle. Previously most research has been conducted in normal tissue, and little is known regarding the re sponses of diseased muscle. In an interdisciplinary approach to this, it is our intention to present the current knowledge about basic principles of electrical stimulation in normal muscle. Before electrical stimulation can be accepted as a therapeutic tool, we felt it necessary to summarize the effects of activity in normal and diseased muscle and nerve.

An engaging introduction to human and animal movement seen through the lens of mechanics. How do Olympic sprinters run so fast? Why do astronauts adopt a bounding gait on the moon? How do running shoes improve performance while preventing injuries? This engaging and generously illustrated book answers these questions by examining human and animal movement through the lens of mechanics. The authors present simple conceptual models to study walking and running and apply mechanical principles to a range of interesting examples. They explore the biology of how movement is produced, examining the structure of a muscle down to its microscopic force-generating motors. Drawing on their deep expertise, the authors describe how to create simulations that provide insight into muscle coordination during walking and running, suggest treatments to improve function following injury, and help design devices that enhance human performance.

The first evidence that electrical changes can cause muscles to contract was p- vided by Galvani (1791). Galvani’s ideas about ‘animal electricity’ were explored during the 19th and 20th century when it was firmly established that ‘electricity’ is one of the most important mechanisms used for communication by the nervous system and muscle. These researches lead to the development of ever more soph- ticated equipment that could either record the electrical changes in nerves and muscles, or elicit functional changes by electrically stimulating these structures. It was indeed the combination of these two methods that elucidated many of the basic principles about the function of the nervous system. Following these exciting findings, it was discovered that electrical stimulation and the functions elicited by it also lead to long-term changes in the properties of nerves and particularly muscles. Recent findings help us to understand the mec- nisms by which activity induced by electrical stimulation can influence mature, fully differentiated cells, in particular muscles, blood vessels and nerves. Electrically elicited activity determines the properties of muscle fibres by activating a sequence of signalling pathways that change the gene expression of the muscle. Thus, elect- cal activity graduated from a simple mechanism that is used to elicit muscle c- traction, to a system that could induce permanent changes in muscles and modify most of its characteristic properties.

Volume 1 of the Textbook of Neural Repair and Rehabilitation covers the basic sciences relevant to recovery of function following injury to the nervous system.

Increasing evidence identifies the possibility of restoring function to the damaged brain via exogenous therapies. One major target for these advances is stroke, where most patients can be left with significant disability. Treatments have the potential to improve the victim's quality of life significantly and reduce the time and expense of rehabilitation. Brain Repair After Stroke reviews the biology of spontaneous brain repair after stroke in animal models and in humans. Detailed chapters cover the many forms of therapy being explored to promote brain repair and consider clinical trial issues in this context. This book provides a summary of the neurobiology of innate and treatment-induced repair mechanisms after hypoxia and reviews the state of the art for human therapeutics in relation to promoting behavioral recovery after stroke. Essential reading for stroke physicians, neurologists, rehabilitation physicians and neuropsychologists.

Neuromuscular Electrical Stimulation, A Practical Guide, 4th Edition is an expansion and extension of previous editions. Comprehensive but readily understood review of physiological principles of electrical stimulation- Specific treatment programs with their key elements clearly presented- Detailed information regarding individual muscles and how best to activate them using neuromuscularelectrical stimulation- Over 100 photographs demonstrating electrode placements and stimulated contractions- General principles of stimulus parameter modification and the effects of parameter options discussed- treatment efficiency and subject comfort addressed. REVISED 2000