Eduardo Mendonça Scheeren

Iontophoresis: principles and applications

Introduction Iontophoresis is a noninvasive technique used to increase transdermal penetration of substances through the skin layer (epidermis, dermis and hypodermis) in a controlled manner. Technological advance in recent decades have provided reduced cost of equipment needed for implementation, which allowed for the expansion of this technique. Objective The aim of this paper is to present the state of the art on iontophoresis, ranging from the atomic characteristics of the ion formation to the current applications of the technique. Methods Were researched papers from databases: IOP publishing, ScienceDirect, Pubmed, Springer, IEEE Xplore, Google Scholar and books with keywords iontophoresis, ions, topical applications between 1967 and 2010. Results Were selected (number of papers and database) 1 IOP Publishing, 1 from ScienceDirect, Central, 1 from Springer, 2 from PubMed, 11 from IEEE Xplore, 35 from Google Scholar, and 15 books, totaling 66 references and websites with nationally marketed electrotherapy products. Conclusion Iontophoresis is suitable for applications such as acetic acid (calcific tendinitis and myositis ossificans), calcium chloride and magnesium sulfate (control of musculoskeletal spasms), dexamethasone (inflammation), lidocaine (inflammation of soft tissues), zinc oxide (rheumatoid arthritis). It is also used in cosmetic applications with devices attached to the skin and for eye treatment aimed at specific tissues of the eye, providing a treatment option for various eye diseases, reducing the complications secondary to traditional methods of treatment. The advantages are the significant increase in the release and control of therapeutic agents, including drugs with high molecular weight. The disadvantages of iontophoresis are the complexity of the drug release system and prolonged exposure of the skin to an electrical current.

A new approach to assess the spasticity in hamstrings muscles using mechanomyography antagonist muscular group

Several pathologies can cause muscle spasticity. Modified Ashworth scale (MAS) can rank spasticity, however its results depend on the physician subjective evaluation. This study aims to show a new approach to spasticity assessment by means of MMG analysis of hamstrings antagonist muscle group (quadriceps muscle). Four subjects participated in the study, divided into two groups regarding MAS (MAS0 and MAS1). MMG sensors were positioned over the muscle belly of rectus femoris (RF), vastus lateralis (VL) and vastus medialis (VM) muscles. The range of movement was acquired with an electrogoniometer placed laterally to the knee. The system was based on a LabVIEW acquisition program and the MMG sensors were built with triaxial accelerometers. The subjects were submitted to stretching reflexes and the integral of the MMG (MMGINT) signal was calculated to analysis. The results showed that the MMGINT was greater to MAS1 than to MAS0 [muscle RF (p= 0.004), VL (p= 0.001) and VM (p= 0.007)]. The results showed that MMG was viable to detect a muscular tonus increase in antagonist muscular group (quadriceps femoris) of spinal cord injured volunteers.

Descrição do Protocolo PediaSuitTM

INTRODUCTION: PediaSuit ProtocolTM is an intensive therapy with a holistic approach to the treatment of individuals with neurological disorders like cerebral palsy (CP), developmental delays, traumatic brain injuries, autism and other conditions which affect a childs motor and/or cognitive functions. OBJECTIVE: The aim of the present work is to describe the PediaSuit ProtocolTM. METHODS: The authors team remained two months observing the care provided in a clinic with physical therapists trained by the PediaSuit ProtocolTM team (USA). RESULTS: The PediaSuitTM is a therapeutic protocol which uses a suit combined with intensive physical therapy and consists of up to four hours of therapy a day, five days a week, during three or four weeks. The PediaSuit ProtocolTM is customized to fit the needs of each child, with specific functional goals, and usually involves an intensive rehabilitation program. It combines the best elements of various techniques and methods, and has a sound rationale based on exercise physiology. CONCLUSION: This protocol anticipates results obtained only with long periods of conventional physical therapy.

Investigation of muscle behavior during different functional electrical stimulation profiles using Mechanomyography

Mechanomyography (MMG) is a technique for measuring muscle oscillations and fatigue. Functional electrical stimulation (FES) has been applied to control movements mainly in people with spinal cord injury (SCI). The goal of this study is the application of the MMG signal as a tool to investigate muscle response during FES. Ten healthy individuals (HI) and three SCI were submitted to four FES profiles in the rectus femoris (RF) and vastus lateralis (VL) muscles. Four FES profiles were applied in different days. The FES profile set to 1 kHz pulse frequency, 200 us active pulse duration and burst frequency of 50 Hz presented the lowest MMG root mean square and spectral median frequency values, suggesting less muscle modification. The MMG signal was different between HI and SCI but there was no difference between the RF and VL muscles.

Optimal FES parameters based on mechanomyographic efficiency index

Functional electrical stimulation (FES) can artificially elicit movements in spinal cord injured (SCI) subjects. FES control strategies involve monitoring muscle features and setting FES profiles so as to postpone the installation of muscle fatigue or nerve cell adaptation. Mechanomyography (MMG) sensors register the lateral oscillations of contracting muscles. This paper presents an MMG efficiency index (EI) that may indicate most efficient FES electrical parameters to control functional movements. Ten healthy and three SCI volunteers participated in the study. Four FES profiles with two FES sessions were applied with in-between 15min rest interval. MMG RMS and median frequency were inserted into the EI equation. EI increased along the test. FES profile set to 1kHz pulse frequency, 200εs active pulse duration and burst frequency of 50Hz was the most efficient.

Advances and perspectives of mechanomyography

INTRODUCTION: The evaluation of muscular tissue condition can be accomplished with mechanomyography (MMG), a technique that registers intramuscular mechanical waves produced during a fibers contraction and stretching that are sensed or interfaced on the skin surface. OBJECTIVE: Considering the scope of MMG measurements and recent advances involving the technique, the goal of this paper is to discuss mechanomyography updates and discuss its applications and potential future applications. METHODS: Forty-three MMG studies were published between the years of 1987 and 2013. RESULTS: MMG sensors are developed with different technologies such as condenser microphones, accelerometers, laser-based instruments, etc. Experimental protocols that are described in scientific publications typically investigated the condition of the vastus lateralis muscle and used sensors built with accelerometers, third and fourth order Butterworth filters, 5-100Hz frequency bandpass, signal analysis using Root Mean Square (RMS) (temporal), Median Frequency (MDF) and Mean Power Frequency (MPF) (spectral) features, with epochs of 1 s. CONCLUSION: Mechanomyographic responses obtained in isometric contractions differ from those observed during dynamic contractions in both passive and functional electrical stimulation evoked movements. In the near future, MMG features applied to biofeedback closed-loop systems will help people with disabilities, such as spinal cord injury or limb amputation because they may improve both neural and myoelectric prosthetic control. Muscular tissue assessment is a new application area enabled by MMG; it can be useful in evaluating the muscular tonus in anesthetic blockade or in pathologies such as myotonic dystrophy, chronic obstructive pulmonary disease, and disorders including dysphagia, myalgia and spastic hypertonia. New research becomes necessary to improve the efficiency of MMG systems and increase their application in rehabilitation, clinical and other health areas.

Correlation between mechanomyography features and passive movements in healthy and paraplegic subjects

Mechanomyography (MMG) measures both muscular contraction and stretching activities and can be used as feedback in the control of neuroprostheses with Functional Electrical Stimulation (FES). In this study we evaluated the correlation between MMG features and passive knee angular movement of rectus femoris and vastus lateralis muscles acquired from healthy volunteers (HV) and spinal cord injured volunteers (SCIV). Twelve HV and thirteen SCIV were submitted to passive and FES elicited knee extensions and in each extension, eleven windows of analysis with 0.5s length were inspected. Temporal (RMS and INT) and frequency (MF and μ3) features were extracted. Spearman correlation coefficients (p) were computed in order to check correlations between the features obtained from both MMG sensors. The correlation between MMGMF and MMG temporal analysis (RMS and INT) to HV was classified as positive, moderate (p from 0.635 to 0.681) and high (p from 0.859 to 0.870), and weak (positive e negative) to SCIV. These results differ from those obtained in voluntary contraction or artificially evoked by functional electrical stimulation and may be relevant in applications with closed loop control systems.

Mechanomyographic response during FES in healthy and paraplegic subjects

Mechanomyography (MMG) registers lateral oscillations of contracting muscles. Functional electrical stimulation (FES) improves the rehabilitation of paraplegic subjects and can be used in neuroprosthesis control. During FES application, muscular contraction responses may vary, possibly due to fatigue or adaptation of nerve cells face to electrical stimuli. This study measured the differences in MMG RMS and median frequency (MF) features between healthy (HV) and spinal cord injury (SCI) volunteers. Ten HV and three SCI participated in the research. FES waveform consisted of a monophasic square wave, 1kHz pulse frequency, 100us active pulse period and 3ms active burst period with burst frequency of 70Hz. For each stimulation series, three analysis windows were inspected. RMS and MF variations were inversely related. The obtained results may help to create new strategies of muscular closed-loop control.

Influence of Skinfold Thickness in Mechanomyography Features

The assessment and physiological register of muscular tissue can be done through mechanomyography (MMG). The oscillation of muscular displacement is acquired on the skin surface, insomuch that the skinfold thickness can influence in MMG response. The aim of this study is verify the influence of different skinfold thickness on MMG features responses. Triaxial MMG was used over the rectus femoris muscle belly of ten volunteers during maximal voluntary contraction. MMG spectral and temporal analyses were made and specific features (root mean square (RMS), Integral (Int), mean frequency (MF), zero-crossing (ZC), and μ3) were correlated with skinfold thickness. Moderate and high negative correlation occurred to MMG mean frequency in axes X (ρ = - 0.57) and Y (ρ = -0.75), respectively. As the fat tissue behaves like a low-pass filter, i.e. the thicker his skinfold the shorter its bandwidth; therefore, the skinfold thicknesses result in lower frequency responses. So, hereafter these results may be applied to calibrate MMG responses as biofeedback systems in, for instance, neuroprostheses.

Potencial de ação: do estímulo à adaptação neural

INTRODUCTION: The action potential (AP) arises due to a disturbance of the resting state of the cell membrane with consequent flow of ions across the membrane and ion concentration changes in intra and extra cellular space. OBJECTIVES: This article aims to summarize the scientific knowledge accumulated to date on the action potential and neural adaptation in the process of applying a constant stimulus. MATERIALS AND METHODS: This is a literature review on the bases Springer, ScienceDirect, PubMed, IEEE Xplore, Google Scholar, Capes Periodicals Portal as well as books on the topic. The selected preferred language was English with the keywords: action potential; adaptation, accommodation; rheobase; chronaxy; nerve impulse. We conducted a search of articles with a wide time window from 1931 to 2010 and books from 1791 to 2007. RESULTS: In the selected studies was extracted information about the following topics: action potential and its stages; nerve conduction; rheobase; chronaxie, accommodation, and adaptation. CONCLUSION: A stimulus that creates AP, if applied consistently, can reduce the frequency of depolarization as a function of time and, consequently, to adapt the cell. The time it takes the cell in the absence of stimuli, to recover its original frequency, is defined as a disadaptation.