The first goal of the 08Rise2-Italy Project is to identify among the clinical cases of the Physical Medicine and Rehabilitation Unit of the University of Padua a group of subjects with permanent injuries (complete or incomplete) of arm/leg skeletal muscles aimed at extending the results of the European Project RISE [1-4]. Demonstration that a highpower electrical stimulator associated with large surface electrodes induces single (twitch) or sustained (tetanus) contractions in long-term denervated human muscles of paraplegics, open the opportunity to obtain trophic effect and some functional recovery of denervated muscle in patients with severe muscle atrophy secondary to peripheral nerve lesions. The eligible patients suffered traumatic injuries to plexus or single nerve (e.g., circonflessus or femoral nerve). At enlistment, shoulder or leg muscles of the patients do not respond to the clinical stimulation protocols for innervated muscle (twitch stimulation with 0.5 msec long impulse at 5- 20 V/mAmp, or tetanising “Kotz currents”). Using an electrical stimulator for denervated muscle (i.e., with an adequate power) that discharges triangular waves 150-200 msec long at 20-80 mAmp to large surface wet electrodes (20x40cm, in Lap case) the denervated muscle produces repeatedly single contractions (twitch training). Patient will be revaluated monthly to verify if the denervated muscle partially recovers its excitability to a sufficiently shortstimulations (duration <50msec), to be able to respond to short trains of impulse at 10-20 Hz frequency to perform tetanic contractions 2-3 sec long. This electrical stimulation protocol (5 times a week) will not replace, but complement the standard University of Padua Rehabilitation Unit protocol that includes passive and active functional rehabilitation. To monitor changes in thickness and tissue composition of trained muscles ultrasound scan will be performed before and every three months during the 12 months of programmed treatment. Extent of innervation/reinnervation will be checked with periodic EMG. Our first observations suggest that this pilot study of the Padua Rehabilitation Unit could be extended with clinically significant results.

Rise2-Italy trial: muscle FES after peripheral nerve lesion. Our approach.

STRAMARE, ROBERTO;MASIERO, STEFANO;FERRARO, CLAUDIO
2008

Abstract

The first goal of the 08Rise2-Italy Project is to identify among the clinical cases of the Physical Medicine and Rehabilitation Unit of the University of Padua a group of subjects with permanent injuries (complete or incomplete) of arm/leg skeletal muscles aimed at extending the results of the European Project RISE [1-4]. Demonstration that a highpower electrical stimulator associated with large surface electrodes induces single (twitch) or sustained (tetanus) contractions in long-term denervated human muscles of paraplegics, open the opportunity to obtain trophic effect and some functional recovery of denervated muscle in patients with severe muscle atrophy secondary to peripheral nerve lesions. The eligible patients suffered traumatic injuries to plexus or single nerve (e.g., circonflessus or femoral nerve). At enlistment, shoulder or leg muscles of the patients do not respond to the clinical stimulation protocols for innervated muscle (twitch stimulation with 0.5 msec long impulse at 5- 20 V/mAmp, or tetanising “Kotz currents”). Using an electrical stimulator for denervated muscle (i.e., with an adequate power) that discharges triangular waves 150-200 msec long at 20-80 mAmp to large surface wet electrodes (20x40cm, in Lap case) the denervated muscle produces repeatedly single contractions (twitch training). Patient will be revaluated monthly to verify if the denervated muscle partially recovers its excitability to a sufficiently shortstimulations (duration <50msec), to be able to respond to short trains of impulse at 10-20 Hz frequency to perform tetanic contractions 2-3 sec long. This electrical stimulation protocol (5 times a week) will not replace, but complement the standard University of Padua Rehabilitation Unit protocol that includes passive and active functional rehabilitation. To monitor changes in thickness and tissue composition of trained muscles ultrasound scan will be performed before and every three months during the 12 months of programmed treatment. Extent of innervation/reinnervation will be checked with periodic EMG. Our first observations suggest that this pilot study of the Padua Rehabilitation Unit could be extended with clinically significant results.
2008
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/2450139
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