A recently published text discusses the application of electrical stimulation of the neuro-muscular system in combination with rehabilitation strategies based on the mirror neuron system (Mirror Neuron System) to improve the rehabilitation of function motor of the upper limbs and of the hand.
Motor dysfunctions of the upper limbs and hands have a significant impact on the daily lives of people with neurological diseases. Neuroplasticity is the ability of the nervous system to find other nerve circuits in response to external stimuli to activate specific muscles.
Electrical stimulation of the neuro-muscular system uses low-frequency electrical currents through surface electrodes to induce involuntary movements and facilitate motor rehabilitation. It is a common physiotherapy method, based on neuroplasticity and supposed to work by coupling between the sensory system and the motor system. We electrically activate a muscle (remember Volta's frog?), via a device controlled by the patient, the sensation of this activation reaches the brain through the sensory system, if this is not disturbed and the brain learns after numerous tests, there is a parallel path which activates this motor system. In a way it's similar to learning to drive a car, we activate different devices (brakes, accelerator, steering wheel, shifters), we have sensory feedback (the car accelerates, brakes, turns), and little by little these are maneuvers that we do instinctively.
Electrical stimulation of the neuromuscular system involves the use of electrodes placed on the skin over target muscles. These electrodes deliver controlled electrical impulses to the muscles, causing them to contract. Electrical stimulation of the neuromuscular system can be used to:
Muscle Activation: Electrical stimulation of the neuro-muscular system can activate muscles that are weak or paralyzed due to neurological problems or injuries. This is particularly useful when voluntary muscle activation is limited or impossible.
Build Strength and Endurance: Electrical stimulation of the neuro-muscular system can help strengthen muscles and improve endurance, which is important for regaining functional motor skills.
Prevent Atrophy: In cases of muscle disuse or atrophy, such as after surgery or during prolonged immobility, electrical stimulation of the neuro-muscular system can prevent muscle loss by maintaining muscle contractions.
*Improve blood flow: Electrical stimulation of the neuro-muscular system can promote blood circulation in the stimulated area, which facilitates tissue healing and recovery.
Although electrical stimulation of the neuro-muscular system has benefits, it is passive and can lead to limited patient engagement. The combination of electrical stimulation of the neuro-muscular system with active rehabilitation strategies or methods based on the mirror neuron system can improve the results.
The mirror neuron system plays an essential role in neuronal plasticity linked to motor learning. It is activated when a person performs an action but also when they observe a similar action. The mirror neuron system plays a crucial role in learning.
Various rehabilitation techniques, such as Action Observation Therapy (AOT), Mirror Therapy (MT), Motor Imagery (MI), and Virtual Reality (VR), are based on the system theory of mirror neurons and are widely used in neurological rehabilitation. The study described in this post uses functional near-infrared spectroscopy (fNIRS) to measure cortical activation patterns related to electrical stimulation of the neuromuscular system combined with strategies based on the mirror neuron system.
The study involved 66 healthy adults in various experimental tasks combining electrical stimulation of the neuro-muscular system with different mirror neuron system strategies, such as action observation, action execution, and action imitation.
The scientists used an fNIRS device with multiple channels to measure changes in blood oxygen levels in the brain during different tasks. This method is slower to acquire data than EEG, but it is also more reliable.
Results showed that combining electrical stimulation of the neuromuscular system with strategies based on the mirror neuron system activated brain areas, with active exercises showing the most significant activation. This suggests a potential for enhanced rehabilitation effects.
As our editorial policy concerns neurodegenerative diseases, among them ALS (Lou Gehrig's disease), we immediately consider which benefits a patient could derive from this technology.
Spinal cord injuries cause symptoms quite similar to those of ALS. Recently patients who had severed spinal cords have been able to walk again thanks to similar technologies.
The study suggests that brain-computer interface (BCI) systems based on fNIRS could be developed to aid rehabilitation, especially in cases where patients have lost the ability to perform active exercises.
Neuromuscular electrical stimulation (Electrical stimulation of the neuro-muscular system) may have some potential benefits for people with amyotrophic lateral sclerosis (ALS), but it is important to understand its limitations and consider it as part of an approach. comprehensive disease management. One would think that she might be of particular interest for the following points:
Muscle Preservation: Electrical stimulation of the neuro-muscular system may help slow muscle atrophy and maintain muscle function in people with ALS. This is particularly relevant when voluntary muscle activation becomes difficult or impossible.
Management of pain and spasticity: Some people with ALS may experience muscle pain and spasticity. Electrical stimulation of the neuro-muscular system can help alleviate these symptoms by promoting muscle relaxation and blood circulation.
In the future, one could even imagine that devices for electrical stimulation of the neuro-muscular system can be used as assistive devices to facilitate daily activities, such as grasping objects or walking, by stimulating specific muscle groups.
However, it is unlikely that this technology will be able to slow the progression of the disease: ALS is a progressive disease and, although electrical stimulation of the neuromuscular system can provide temporary relief and muscle preservation, it is unlikely to stop not the underlying neurodegenerative process.
There is also the problem of individual variability which is very broad in the context of ALS. ALS is more of a syndrome than a disease, each patient is unique which makes clinical trials terribly complicated, and in most patients, their health and motor skills evolve terribly quickly. As the response to electrical stimulation of the neuromuscular system can vary greatly among individuals with ALS, some may find it beneficial, while others may not benefit or may even experience accelerated deterioration.
Electrical stimulation of the neuromuscular system could be considered part of a comprehensive approach to managing ALS, which may include physiotherapy, occupational therapy, speech therapy, and medical treatments.
In summary, electrical stimulation of the neuromuscular system may be helpful in managing specific symptoms and preserving muscle function in people with ALS. However, this should be part of a broader, multidisciplinary approach to ALS care. The effectiveness of electrical stimulation of the neuromuscular system can vary from person to person, so it is crucial to work closely with healthcare professionals to determine the most appropriate interventions and therapies for individual needs and the stage of the disease.
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