Ask a PT

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Posted - 12/07/2007 :  09:23:00  Show Profile  Reply with Quote
Our user asked: "I was wondering if anyone had come across any journal article on research of Estim and pts with Osteoperosis. More specifically Low Volt Estim. I am trying to determine its effectiveness for an 80 y/o female with thoracolumbar ms spasms."

Ask a PT Response: "You can utilize out CyberPT Medical Resource Library to assist you in finding research articles. http://www.cyberpt.com/CyberPTmedlib.asp - http://www.cyberpt.com/CyberPTmedlib.asp

We have also conducted a literature search for you for osteoporosis and electrical stimulation and have come upon the following articles which may be of interest. You can probably obtain the articles at a medical library or purchase a temporary subscription to the Journal for online access. We have attached the one article which was available online. We hope this helps and thank you for using CyberPT.

The skeleton after spinal cord injury part 2: management of sublesional osteoporosis. Segatore M; SCI Nursing, 1995 Dec; 12 (4): 115-20 (journal article) PMID: 8715335 CINAHL AN: 1996016656

Increases in bone mineral density after functional electrical stimulation cycling exercises in spinal cord injured patients. (includes abstract) Chen S; Disability & Rehabilitation, 2005 Nov 30; 27 (22): 1337-41 (journal article - research, tables/charts) CINAHL AN: 2009083414

PURPOSE: To assess the change in bone mineral density (BMD) after spinal cord injury (SCI) and to evaluate whether BMD loss can be reversed with the intervention of functional electric stimulation cycling exercises (FESCE). METHODS: Fifteen males with SCI were included. Fifteen able-bodied males were also tested to compare BMD. In the SCI group, the FESCE was performed for six months, and then was discontinued in the subsequent six months. BMD was performed before the FESCE, immediately after six months of the FESCE, and at the end of the subsequent six months. RESULTS: Before the FESCE, the BMD of the SCI subjects in every site, except the lumbar spine, was lower than that of the able-bodied subjects. After six months of FESCE, BMD of the distal femur (DF) and proximal tibia (PT) increased significantly, and BMD of the calcaneus (heel) showed a trend of increase. However, the BMD in the DF, PT, and heel decreased significantly after the subsequent six months without FESCE. The BMD of the femoral neck (FN) decreased progressively throughout the programme. CONCLUSIONS: Our study showed site-specific BMD changes after FESCE. The BMD loss in the DF and PT was partially reversed after six months of FESCE, but the effect faded once the exercise was discontinued.

Carter EL Jr, Pollack SR, Brighton CT.
Theoretical determination of the current density distributions in human vertebral bodies during electrical stimulation.
IEEE Trans Biomed Eng. 1990 Jun;37(6):606-14.

Electrical stimulation with a 60 kHz sinewave input signal, supplied via external plate electrodes on the skin surface, is presently being studied as a treatment for human systemic osteoporosis. In this paper, Maxwell's equations were solved for voltage and current density values at nodal points in a three-dimensional, anatomically-based, finite element grid model of the human trunk constructed from T5 to L5. Based on the dose response results from Luessenhop's castrated Sprague Dawley breeder rat experiment and our theoretical determination, the magnitude of the input current to the electrodes necessary to induce a response in the human vertebral body was determined. Four different electrode systems in current clinical use were evaluated, and the optimal input current determined. In addition, the effect of subcutaneous fat was studied.

Kenner GH, Gabrielson EW, Lovell JE, Marshall AE, Williams WS.
Electrical modification of disuse osteoporosis.
Calcif Tissue Res. 1975 Jul 25;18(2):111-7.

Localized electrical stimulation of the immobilized hind limb of young rabbits resulted in dramatically more bone in the tuber calcis (heel bone) compared to the severe loss of bone (osteoporosis) seen in unstimulated, immobilized controls. Detailed histological evaluation using microradiography and fluorescence and polarization microscopy showed that the increase was probably due to an overall inhibition of surface cortical bone loss )endosteal resorption) and an increase in the quantity of the new immature bone. There was also evidence of increased osteonal resorption in the stimulated animals.