Document Detail


Neuromuscular electric stimulation enhances endothelial vascular control and hemodynamic function in paretic upper extremities of patients with stroke.
MedLine Citation:
PMID:  15241759     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the effects of neuromuscular electric stimulation (NMES) on endothelial vascular control and hemodynamic function in patients in rehabilitation after acute stroke. DESIGN: Before-after trial. SETTING: Inpatients in a tertiary hospital. PARTICIPANTS: Sixteen stroke patients (11 women, 5 men) with a mean age of 60.6+/-19.5 years. INTERVENTIONS: All patients received NMES for paretic wrist extensor and flexor muscles 30 minutes daily, 5 days a week, for 4 weeks. The nonparetic upper extremities, which served as controls, did not receive NMES. MAIN OUTCOME MEASURES: Laser Doppler perfusion testing was conducted to measure cutaneous microcirculatory responses to transdermal iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP), as specific endothelium-dependent and -independent vasodilators, respectively. Arterial and venous hemodynamic function was also measured by impedance plethysmography. RESULTS: Before NMES treatment, the venous capacity and compliance of the paretic extremities did not differ significantly from those of the nonparetic extremities. However, hyperemic arterial inflow, ACh-induced cutaneous perfusion, and the ratio of ACh- to SNP-induced cutaneous perfusion were lower in the paretic than in the nonparetic extremities. After NMES treatment, hyperemic arterial inflow and venous outflow increased by 21.5% and 57.2%, respectively, in the paretic extremities (P<.05). ACh-induced cutaneous perfusion and the ratio of ACh- to SNP-induced cutaneous perfusion were also significantly enhanced in the paretic extremities. In contrast, hyperemic arterial inflow decreased by 39.6% in the nonparetic extremities (P<.05), and endothelium-dependent cutaneous vasodilation also decreased significantly. CONCLUSIONS: NMES therapy may enhance the hyperemic arterial response and endothelium-dependent dilation in skin vasculature in the paretic upper extremities of patients with stroke.
Authors:
Jong-Shyan Wang; Ssu-Yuan Chen; Ching Lan; May-Kuen Wong; Jin-Shin Lai
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  85     ISSN:  0003-9993     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-07-08     Completed Date:  2004-08-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1112-6     Citation Subset:  AIM; IM    
Affiliation:
Graduate Institute of Rehabilitation Sciences and Center for Gerontological Research, Chang-Gung University, Tao-Yuan, Taipei, Taiwan 10016.
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MeSH Terms
Descriptor/Qualifier:
Acetylcholine / pharmacology
Adult
Aged
Cerebral Hemorrhage / rehabilitation
Cerebral Infarction / rehabilitation
Electric Stimulation Therapy*
Endothelium, Vascular / drug effects
Female
Ferrous Compounds
Hemodynamics
Humans
Iontophoresis
Male
Microcirculation
Middle Aged
Nitroprusside / pharmacology
Paresis / rehabilitation*
Stroke / rehabilitation*
Upper Extremity
Vasodilation*
Vasodilator Agents / pharmacology
Chemical
Reg. No./Substance:
0/Ferrous Compounds; 0/Vasodilator Agents; 15078-28-1/Nitroprusside; 51-84-3/Acetylcholine; 7720-78-7/ferrous sulfate

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