Michiue K1, Nishikawa Y1, Kimura H2
1Hiroshima University Hospital, Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima, Japan, 2Hiroshima University Hospital, Department of Rehabilitation Medicine, Hiroshima, Japan
Background: Neuromyelitis optica (NMO) is a disorder characterized by repeated exacerbation and remission of severe optic neuritis and transverse myelitis. Transverse myelitis often leads to flaccid paralysis along the area of neurarchy. Rehabilitation is one treatment for NMO. However, there are few reports regarding rehabilitation for NMO, and no published studies have focused on the effect of electrical muscle stimulation (EMS) on NMO.
Purpose: The purpose of this study was to examine the effect of EMS on NMO-related muscle atrophy in 2 patients with flaccid paralysis.
Methods: Two NMO patients (43 years old, female and 26 years old, male) with flaccid paralysis participated. We performed EMS at 20 Hz on the quadriceps femoris muscle of the participants' paralyzed side for 20 minutes for 5 days/week during hospitalization (49 days and 22 days, respectively). We evaluated the muscle thickness of the patients' vastus lateralis (VL) muscle and the circumference of their femurs. We measured the thickness of the VL muscle and the subcutaneous tissue at the muscle's belly using ultrasound images. The circumference of the femur on the paralyzed side was measured 5 cm and 10 cm above the patella. In addition, as an accessory evaluation, we assessed the subjects' activities of daily living (ADL) level using the Barthel index (BI) and the Functional Independence Measure (FIM).
Results: The increase in the thickness of the VL muscle ranged from 0.5 to 1.6 mm, while the increase in the circumference of the femur ranged from 0.0 to 5.0 mm. The subjects showed no decrease in the thickness of the VL muscle and the circumference of the femur. The BI and FIM scores improved (from 55 to 90 and from 94 to 117). No adverse events due to EMS were observed in either participant. The affected lower limb of both patients remained flaccid paralysis (e.g., grade 0 or 1 on the manual muscle test).
Conclusion(s): The findings of this study suggest that the use of EMS to treat flaccid paralysis caused by NMO can reduce subsequent muscle atrophy. Future studies recruitment of more NMO patients and a long-term follow up are needed to clarify the effect of EMS on the muscle performance in NMO patients.
Implications: The EMS intervention showed reduce muscle atrophy and improvement ADL scores in NMO patients. It is possible that this method may be an effective tool for flaccid paralysis caused by NMO.
Keywords: Neuromyelitis optica (NMO), electrical muscle stimulation (EMS), muscle atrophy
Funding acknowledgements: Not applicable.
Purpose: The purpose of this study was to examine the effect of EMS on NMO-related muscle atrophy in 2 patients with flaccid paralysis.
Methods: Two NMO patients (43 years old, female and 26 years old, male) with flaccid paralysis participated. We performed EMS at 20 Hz on the quadriceps femoris muscle of the participants' paralyzed side for 20 minutes for 5 days/week during hospitalization (49 days and 22 days, respectively). We evaluated the muscle thickness of the patients' vastus lateralis (VL) muscle and the circumference of their femurs. We measured the thickness of the VL muscle and the subcutaneous tissue at the muscle's belly using ultrasound images. The circumference of the femur on the paralyzed side was measured 5 cm and 10 cm above the patella. In addition, as an accessory evaluation, we assessed the subjects' activities of daily living (ADL) level using the Barthel index (BI) and the Functional Independence Measure (FIM).
Results: The increase in the thickness of the VL muscle ranged from 0.5 to 1.6 mm, while the increase in the circumference of the femur ranged from 0.0 to 5.0 mm. The subjects showed no decrease in the thickness of the VL muscle and the circumference of the femur. The BI and FIM scores improved (from 55 to 90 and from 94 to 117). No adverse events due to EMS were observed in either participant. The affected lower limb of both patients remained flaccid paralysis (e.g., grade 0 or 1 on the manual muscle test).
Conclusion(s): The findings of this study suggest that the use of EMS to treat flaccid paralysis caused by NMO can reduce subsequent muscle atrophy. Future studies recruitment of more NMO patients and a long-term follow up are needed to clarify the effect of EMS on the muscle performance in NMO patients.
Implications: The EMS intervention showed reduce muscle atrophy and improvement ADL scores in NMO patients. It is possible that this method may be an effective tool for flaccid paralysis caused by NMO.
Keywords: Neuromyelitis optica (NMO), electrical muscle stimulation (EMS), muscle atrophy
Funding acknowledgements: Not applicable.
Topic: Neurology; Disability & rehabilitation
Ethics approval required: Yes
Institution: Hiroshima University
Ethics committee: Hiroshima University’s Committee of Ethics
Ethics number: No. E-1171-1
All authors, affiliations and abstracts have been published as submitted.
