The effects of cycling with and without functional electrical stimulation on lower limb dysfunction in patients post-stroke: A systematic review with meta-analysis.

BACKGROUND: One of the leading causes of disability in the world with enormous economic burden is stroke. OBJECTIVE: To quantify the effectiveness of different protocols of cycling with/without functional electrical stimulation on functional mobility after stroke. METHODS: Multiple databases were searched till 2018. Data extraction was performed using a pre-determined data collection form. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation. RESULTS: A total of 14 trials satisfied eligibility criteria and were included. Cycling had a positive effect on the 6-meter walking test performance (SMD, 0.41; 95% CI, 0.11 -0.71; I2 = 0% ) compared with no or placebo intervention (control). Compared with control, cycling had a positive effect on 10-meter walking speed (SMD, 0.30; 95% CI, 0.05 -0.55; I2 = 0% ), and on balance based on the Berg score (SMD, 0.32; 95% CI, 0.06 -0.57; I2 = 49% ). Cycling with functional electrical stimulation had a positive effect on balance (SMD, 1.48; 95% CI, 0.99 -1.97; I2 = 91% ) compared with cycling alone. CONCLUSIONS: It appears that cycling has a positive effect on walking speed, walking ability and balance. Functional electrical stimulation combined with cycling has positive effects on balance beyond cycling alone.

Comparison of the recruitment of transverse abdominis through drawing-in and bracing in different core stability training positions.

There are many proposed core stability exercises in a variety of positions; however, it is not clear that in which position, activation of transverse abdominis muscle is utmost. We aimed to compare the activation of transverse abdominis muscle in different core stability exercise positions through ultrasound imaging. in a 20 subjects' study we compared the effectiveness of drawing-in and bracing maneuvers on transverse abdominis in different core stability exercise positions (supine, hook lying, supine with 90° flexed knee and hip, supine with stretched knees and 90° flexed hips, bridge, bridge with one stretched knee and Bird dog). We used activation ratio and preferential activation ratio as measurements of transverse abdominis activation. Abdominal Bracing in the bridge position showed the highest activation of transverse abdominis (P<0.05). The results showed significantly higher activation of transverse abdominis, measured by preferential activation ratio, in bridge position during abdominal bracing.

The effect of exercise therapy, dry needling, and nonfunctional electrical stimulation on radicular pain: a case report.

A 43-year-old male, office worker with history of chronic radicular low back pain radiating into the left leg was admitted to a sports medicine research center, neuroscience institute. During the past year, he visited a physiotherapist and orthopedic experts. Magnetic resonance imaging revealed a protruded disc at L4-5 level. Additionally, electromyography indicated that there was bilateral moderate irritation at the L5-S1 root. We designed a management package including exercise therapy, dry needling, and nonfunctional electrical stimulation for four sessions. Outcomes included pain intensity, pain with lumbar flexion, with the numerical rating scale (NRS), visual analogue scale (VAS), and function measured with the Oswestry Disability Index before and after the intervention. After 4 treatment sessions, the patient reported a reduction in pain intensity from a 9 to 2 on the NRS and from 90 to 30 on the VAS. In addition, the patient was able to perform lumbar flexion fully without pain.