Effects of Transcutaneous Electrical Nerve Stimulation depending on Frequency and Intensity for Postural Sway during Sit to Stand with Stroke Patients

  • Byun, Dong-Uk (Department of Physical Therapy, The Graduate School of Daejeon University) ;
  • Shin, Won-Seob (Department of Physical Therapy, College of Natural Science, Daejeon University)
  • Received : 2013.04.27
  • Accepted : 2013.06.10
  • Published : 2013.06.25

Abstract

Purpose: The application of transcutaneous electrical nerve stimulation (TENS) is beneficial for joint movements, inhibition of spasticity, and the improvement of walking ability in patients with chronic hemiplegia. This study aimed to identify the effect of the application of TENS to the knee extensor on the affected side with respect to postural-sway distance and velocity during the sit-to stand movement. Methods: We included 19 patients with post-stroke hemiplegia in this study. They underwent measurements during the sit-to stand movement on a force plate with 5 different stimulation dosages applied over 7 s:No TENS, high-frequency and high intensity TENS, high-frequency and low intensity TENS, low-frequency and high intensity TENS, and low-frequency and low intensity TENS The 5 different condition were administered in random order. Results: The group that received TENS application exhibited a significant decrease in path length and average velocity of center of pressure (COP) displacement compared with the group that did not receive TENS application. TENS dosage at low frequency (3Hz) and high intensity yielded a significant decrease in path length, average velocity, mediolateral distance and anteroposterior distance of COP displacement (p<0.05). Conclusion: Our results demonstrated the effectiveness of the application of low-frequency TENS on STS performance. These findings provide useful information on the application of TENS for the reduction of postural sway during the sit-to-stand movement after stroke.

Keywords

References

  1. Nam SH, Kang KW, Kwon JW et al. The effects of handrails during treadmill gait training in stroke patients. J Korean Soc Phys Ther. 2013;25(1):23-8.
  2. Son SM, Kwon JW, Nam SH et al. Induction of pain in the ipsilateral lower limb from long-term cane usage after stroke. J Korean Soc Phys Ther. 2013;25(1):36-41.
  3. Yang DJ, Park SK, Kang JI et al. Effect of computerized feedback postural training on balance and muscle activity in stroke patients. J Korean Soc Phys Ther. 2012;24(5):348-54.
  4. Song BK. Effect of somatosensory stimulation on upper limb in sensory, hand function, postural control and adls within sensorimotor deficits after stroke. J Korean Soc Phys Ther. 2012;24(5):291-9. https://doi.org/10.1589/jpts.24.291
  5. Lee KS, Kim CS. The effect of medio-lateral balance to head rotation in stroke patient. J Korean Soc Phys Ther. 2012;24(5):334-9.
  6. Jung KS, Chung YJ. The effect of changes in walking aids on weight bearing on the cane and foot in stroke. J Korean Soc Phys Ther. 2012;24(2):113-7.
  7. Sato S, Mizuma M, Kawate N et al. Evaluation of sit-to-stand motion using a pressure distribution measurement system-effect of differences in seat hardness on sit-to-stand motion. Disabil Rehabil Assist Technol. 2011;6(4):290-8. https://doi.org/10.3109/17483107.2010.522682
  8. Lomaglio MJ, Eng JJ. Muscle strength and weight-bearing symmetry relate to sit-to-stand performance in individuals with stroke. Gait Posture. 2005;22(2):126-31. https://doi.org/10.1016/j.gaitpost.2004.08.002
  9. Cheng PT, Liaw MY, Wong MK et al. The sit-to-stand movement in stroke patients and its correlation with falling. Arch Phys Med Rehabil. 1998;79(9):1043-6. https://doi.org/10.1016/S0003-9993(98)90168-X
  10. Dickstein R, Laufer Y, Katz M. Tens to the posterior aspect of the legs decreases postural sway during stance. Neurosci Lett. 2006;393(1):51-5. https://doi.org/10.1016/j.neulet.2005.09.039
  11. Ng SS, Hui-Chan CW. Does the use of tens increase the effectiveness of exercise for improving walking after stroke? A randomized controlled clinical trial. Clin Rehabil. 2009;23(12):1093-103. https://doi.org/10.1177/0269215509342327
  12. Tinazzi M, Zarattini S, Valeriani M et al. Long-lasting modulationmodulation of human motor cortex following prolonged transcutaneous electrical nerve stimulation (tens) of forearm muscles: Evidence of reciprocal inhibition and facilitation. Exp Brain Res. 2005;161(4):457-64. https://doi.org/10.1007/s00221-004-2091-y
  13. Mima T, Oga T, Rothwell J et al. Short-term high-frequency transcutaneous electrical nerve stimulation decreases human motor cortex excitability. Neurosci Lett. 2004;355(1-2):85-8. https://doi.org/10.1016/j.neulet.2003.10.045
  14. Chesterton LS, Foster NE, Wright CC et al. Effects of tens frequency, intensity and stimulation site parameter manipulation on pressure pain thresholds in healthy human subjects. Pain. 2003;106(1-2):73-80. https://doi.org/10.1016/S0304-3959(03)00292-6
  15. Durmus D, Alayli G, Canturk F. Effects of quadriceps electrical stimulation program on clinical parameters in the patients with knee osteoarthritis. Clin Rheumatol. 2007;26(5):674-8. https://doi.org/10.1007/s10067-006-0358-3
  16. Pai YC, Rogers MW. Control of body mass transfer as a function of speed of ascent in sit-to-stand. Med Sci Sports Exerc. 1990;22(3):378-84.
  17. Raymakers JA, Samson MM, Verhaar HJ. The assessment of body sway and the choice of the stability parameter(s). Gait Posture. 2005;21(1):48-58. https://doi.org/10.1016/j.gaitpost.2003.11.006
  18. Laufer Y, Dickstein R. Tens to the lateral aspect of the knees during stance attenuates postural sway in young adults. ScientificWorldJournal. 2007;7:1904-11. https://doi.org/10.1100/tsw.2007.279
  19. Kim JH. A study on the correlation between static, dynamic standing balance symmetry and walking function in stroke. J Korean Soc Phys Ther. 2012;24(2):73-81. https://doi.org/10.1589/jpts.24.73
  20. Zhang WT, Jin Z, Cui GH et al. Relations between brain network activation and analgesic effect induced by low vs. High frequency electrical acupoint stimulation in different subjects: A functional magnetic resonance imaging study. Brain Res. 2003;982(2):168-78. https://doi.org/10.1016/S0006-8993(03)02983-4
  21. Hahm TS. The effect of 2 hz and 100 hz electrical stimulation of acupoint on ankle sprain in rats. J Korean Med Sci. 2007;22(2):347-51. https://doi.org/10.3346/jkms.2007.22.2.347
  22. Han Z, Jiang YH, Wan Y et al. Endomorphin-1 mediates 2 hz but not 100 hz electroacupuncture analgesia in the rat. Neurosci Lett. 1999;274(2):75-8. https://doi.org/10.1016/S0304-3940(99)00670-9
  23. Gravelle DC, Laughton CA, Dhruv NT et al. Noise-enhanced balance control in older adults. Neuroreport. 2002;13(15):1853-6. https://doi.org/10.1097/00001756-200210280-00004
  24. Ross SE, Arnold BL, Blackburn JT et al. Enhanced balance associated with coordination training with stochastic resonance stimulation in subjects with functional ankle instability: An experimental trial. J Neuroeng Rehabil. 2007;4:47. https://doi.org/10.1186/1743-0003-4-47
  25. Kimura T, Kouzaki M. Electrical noise to a knee joint stabilizes quiet bipedal stance. Gait Posture. 2012.
  26. Sjolander P, Johansson H, Djupsjobacka M. Spinal and supraspinal effects of activity in ligament afferents. J Electromyogr Kinesiol. 2002;12(3):167-76. https://doi.org/10.1016/S1050-6411(02)00017-2
  27. Hogervorst T, Brand RA. Mechanoreceptors in joint function. J Bone Joint Surg Am. 1998;80(9):1365-78. https://doi.org/10.2106/00004623-199809000-00018
  28. Deuchert M, Ruben J, Schwiemann J et al. Event-related fmri of the somatosensory system using electrical finger stimulation. Neuroreport. 2002;13(3):365-9. https://doi.org/10.1097/00001756-200203040-00023
  29. Cho HY, Sung In T, Hun Cho K et al. A single trial of transcutaneous electrical nerve stimulation (tens) improves spasticity and balance in patients with chronic stroke. Tohoku J Exp Med. 2013;229(3):187-93. https://doi.org/10.1620/tjem.229.187
  30. Ng SS, Hui-Chan CW. Transcutaneous electrical nerve stimulation combined with task-related training improves lower limb functions in subjects with chronic stroke. Stroke. 2007;38(11):2953-9. https://doi.org/10.1161/STROKEAHA.107.490318