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Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
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Functional intermuscular reduction in spasticity for people with multiple sclerosis.

Bobbette J Miller1, Thubi Ha Kolobe1, Rebecca D Larson

  • 1Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.

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Summary

This study shows a new treatment combining electrical stimulation and treadmill training can improve multiple sclerosis (MS) patients' gait, strength, and reduce spasticity without increasing fatigue.

Keywords:
Multiple sclerosis rehabilitationdry needlingfunctional electrical stimulationgaitphysical outcomesspasticitytreadmill training

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Physical Therapy

Background:

  • Multiple sclerosis (MS) frequently causes significant gait impairments affecting daily function in 85% of individuals.
  • Gait dysfunction in MS contributes to reduced mobility and quality of life.

Purpose of the Study:

  • To evaluate a novel therapeutic protocol combining intermuscular electrical stimulation (IES) and functional electrical stimulation (FES) with supported bodyweight treadmill training (SBWTT).
  • To assess the intervention's efficacy in improving gait, reducing spasticity and fatigue, and enhancing muscle strength in individuals with MS.

Main Methods:

  • A pre-post experimental design was employed over a six-week period.
  • Sixteen individuals diagnosed with MS participated in the study.
  • Data analysis included summary statistics and Wilcoxon sign rank tests with Bonferroni adjustment for longitudinal pre-post comparisons.

Main Results:

  • Significant improvements were observed in the Six Minute Walk Test (median increase 29.4 feet) and 25-Foot Walk Test (median decrease 0.7 s).
  • Muscle strength showed gains with increases in toe taps to fatigue (median 3.8) and heel raises (median 5.0).
  • Spasticity, measured by the Modified Ashworth Scale, significantly decreased after both IES and SBWTT (median change -0.5 for both).

Conclusions:

  • The combined IES, FES, and SBWTT protocol shows promise for improving gait speed, endurance, and muscle strength in individuals with MS.
  • The intervention effectively reduced spasticity without exacerbating fatigue.
  • This novel approach offers a potential strategy for managing gait impairments in multiple sclerosis.