Neuromodulation : journal of the International Neuromodulation Society
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The calculation of the parameters of the pump is complicated for a mixture of two drugs in continuous intrathecal therapy with implantable and programmable pumps. It is important to determine the best proportion of drug solutions to obtain the desired clinical results and also to adapt their proportion to obtain the maximal volume of solution so that the time between two fillings is maximized. This paper proposes mathematical formulas that make easier and faster the calculation of the flow of the pump, the volume of each drug solution to be added to the pump, the concentration of each drug in the mixture, and the duration of the infusion. ⋯ The calculated values cannot be directly applied because the syringes used to measure the volume of each drug solution have limited accuracy. It is necessary to round the volume of each drug solution and to hold their sum equal to the total volume of the reservoir. All the parameters are then recalculated, and the physician has to choose between several combinations of volumes.
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The purpose of this study was to investigate the short-term history effect of a decreasing frequency train on force and the influence of joint angle on such effect in human dorsiflexor muscles. Six able-bodied and three spinal cord injured (SCI) subjects took part in the study. Their isometric left dorsiflexor muscles were stimulated with two-second bursts at three ankle joint positions and movements at the ankle were measured. ⋯ This was true for all the subjects at dorsiflexed positions, but the effect is highly dependent on joint ankle. At plantar flexed positions moment enhancement was seen only in SCI subjects. We conclude that effects of joint angle as well as individual muscle properties should be taken into account when optimizing muscle force by means of frequency modulation.
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This paper reports on 80 patients using dual electrode, spinal cord stimulation (SCS) over a four-year period Implant status, stimulation mode, anode-cathode configuration (array), cathode position, paresthesia overlap, explantation rates, complications, Visual Analog Scores (VAS), and overall satisfaction were examined in patients implanted with dual 8 contact, staggered, percutaneous electrodes. All patients had undergone implantation for chronic axial and extremity pain [e.g., Failed Back Surgery Syndrome (FBSS), Complex Regional Pain Syndrome (CRPS)]. Outcomes were evaluated in view of our previous reports in this same group at 24 and 30 months (1,2). ⋯ Thirty-five percent of patients with thoracic implants achieved paresthesia in the low back at 48 months. Explantation rates and overall patient satisfaction were significantly affected by painful radio frequency (RF) antenna coupling. This data supports the efficacy of dual electrodes in optimizing long-term SCS paresthesia overlap and complex pain outcomes.
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The purpose of this case study was to evaluate a patient with diplegic cerebral palsy who underwent soft tissue lengthening augmented with intramuscular electrical stimulation. This is a prospective case study, pre- and post-test design. ⋯ All measured parameters, except knee extensor strength, improved during the postoperative period (baseline to 4-month follow-up) and continued to improve during the rehabilitative period (4-12 month follow-up), despite no formal therapy or home exercise program during this period. We conclude that surgical releases augmented with electrical stimulation resulted in a satisfactory clinic outcome, and may offer a new approach to the treatment of patients with cerebral palsy.