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Дисертації з теми "Percutaneous electrical nerve stimulation"

Автор: Grafiati
Опубліковано: 21 грудня 2024

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1

Colard, Julian. "Caractérisation des réponses neurophysiologiques aiguës et chroniques à l’exercice excentrique : influence de la longueur musculaire." Electronic Thesis or Diss., Nantes Université, 2024. http://www.theses.fr/2024NANU1027.

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Les contractions excentriques engendrent un contrôle nerveux distinct par rapport aux contractions isométriques et concentriques. Bien que certains mécanismes postsynaptiques, tels que l'inhibition récurrente, aient été identifiés comme jouant un rôle dans cette commande spécifique, l'implication des mécanismes présynaptiques reste à démontrer. Comme les contraintes mécaniques augmentent particulièrement en phase finale des contractions excentriques, les variations de longueur musculaire peuvent entraîner des retours afférents (Ia et II) différents vers la moelle épinière, affectant alors l’activité du motoneurone. L’objectif de cette thèse était d’explorer (i) les caractéristiques du système nerveux pendant les contractions excentriques, (ii) d’évaluer l’influence de la longueur musculaire sur le contrôle nerveux lors d’allongements musculaires passifs et actifs (contractions excentriques), et (iii) de déterminer si la longueur musculaire peut moduler les réponses adaptatives à long terme observées après un entraînement excentrique. Quatre études ont contribué à ce travail de thèse. Ces études ont mesuré des paramètres mécaniques, tels que le moment de force et la longueur des faisceaux musculaires, ainsi que des paramètres nerveux, incluant l’excitabilité corticospinale, l’efficacité de la transmission de l’influx nerveux entre les fibres afférentes Ia et les motoneurones α, le gain réflexe, les mécanismes régulateurs sous-jacents et l'activité électromyographique des muscles. Les résultats montrent que les mécanismes présynaptiques constituent un facteur déterminant dans le contrôle nerveux des contractions excentriques. Les variations de longueur musculaire, notamment lors des phases à grande longueur, influencent distinctement l’activité des mécanismes inhibiteurs spinaux durant les allongements passifs et actifs. Enfin, la longueur musculaire pourrait favoriser la plasticité neurale à long terme, en optimisant plus efficacement les mécanismes sous-jacents pour des contractions sous-maximales. Cependant, pour des contractions maximales, le système nerveux semble limiter les adaptations, reflétant peut-être un mécanisme protecteur
Eccentric contractions induce distinct neural control compared to isometric and concentric contractions. Although some postsynaptic mechanisms, such as recurrent inhibition, have been identified as playing a role in this specific control, the involvement of presynaptic mechanisms remains to be demonstrated. As mechanical constraints increase particularly in the final phase of eccentric contractions, variations in muscle length may lead to different afferent feedback (Ia and II) to the spinal cord, thereby affecting motoneuron activity. The aim of this thesis was to explore (i) the characteristics of the nervous system during eccentric contractions, (ii) to assess the influence of muscle length on neural control during passive and active (eccentric contractions) muscle elongations, and (iii) to determine whether muscle length can modulate the long-term adaptive responses observed following eccentric training. Four studies contributed to this thesis. These studies measured mechanical parameters, such as torque and muscle fascicle length, as well as neural parameters, including corticospinal excitability, the efficiency of synaptic transmission between Ia afferent fibres and α- motoneurons, reflex gain, underlying regulatory mechanisms, and electromyographic activity of the muscles. The results indicate that presynaptic mechanisms play a crucial role in the neural control of eccentric contractions. Variations in muscle length, particularly during phases at long length, distinctly influence the activity of spinal inhibitory mechanisms during both passive and active elongations. Finally, muscle length may promote long-term neural plasticity by more effectively optimising the underlying mechanisms for submaximal contractions. However, for maximal contractions, the nervous system appears to limit adaptations, potentially reflecting a protective mechanism
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2

Filin, Tex, and Victor Pierce. "Elektroakupunktur som behandlingsmetod vid ländryggssmärta : En litteraturstudie." Thesis, Luleå tekniska universitet, Institutionen för hälsovetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-63632.

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Bakgrund: Akupunktur är en gammal behandlingsmetod, beräknad ungefär 4100 år gammal och kommer från Kina. Elektroakupunktur är en något nyare behandlingsmetod där man för ström mellan nålarna. Denna behandlingsmetod används främst av fysioterapeuter. Behandlingarna som fysioterapeuten utför kräver ett vetenskapligt stöd, därför finns ett behov att granska den litteratur som behandlingsmetoden grundas på. Inom forskning och verksamhet använder man olika namn för denna metod, både “electroacupuncture” och “percutaneouselectricalnervestimulation” (PENS). Ryggsmärta är ett vanligt problem bland världens befolkning, det är beräknat att upptill 70% av befolkningen kommer någon gång i sitt liv uppleva ryggssmärta. Det är även beräknat att vara den vanligaste smärtförekomsten. Om elektroakupunktur fungerar mot ländryggssmärta kan terapeuter använda denna behandlingsmetod. Syfte: Syftet med denna studie var att undersöka vilket vetenskapligt stöd det finns för elektroakupunktur som behandlingsmetod vid ländryggssmärta. Metod: En systematisk sökning utfördes i databaserna CinAHL, PubMed, PEDro, Scopus och Web of Science angående elektroakupunktur och ländryggssmärta. Sökorden som användes var “electroacupuncture”, “lowback pain ”, “percuteaneous electricalnervestimulation” och “randomized controlled trial”. Resultat: Sammanlagt 15 RCT – studier inkluderades i denna studie. Sammanlagt 11 av 15 studier fann signifikanta skillnader i resultat. 8 studier behandlade kronisk ländryggssmärta, 4 behandlade diskogena besvär och resterande 3 behandlade andra ryggdiagnoser. Elektroakupunktur har visat ge en smärtlindring vid ländryggssmärta. Konklusion: Samtliga inkluderade studier fann smärtlindring av behandlingen, dock visade inte alla signifikanta skillnader. Det finns även metodologiska brister i den befintliga litteraturen vilket innebär att bör se resultaten kritiskt. Mer forskning inom området behövs.
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3

Honhold, Nick. "Paracetamol, percutaneous electrical stimulation and rat spinal neurones." Thesis, Royal Veterinary College (University of London), 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.522587.

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4

Moen, Lars Lyse. "An Implantable Device for Electrical Nerve Stimulation." Thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for teknisk kybernetikk, 2014. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-26850.

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Neural stimulation is currently subject to heavy research for the control of obesity using Vagus Nerve Stimulation (VNS). The available devices for such research is however developed for human use only, causing unnecessary complications when testing in smaller animals models due to the physical size of the device. A device for use in small animal models based on commercially available components would serve as a low-cost and more optimal solution to VNS research and similar disciplines.The design of an small electrical nerve stimulator was developed based on a comprehensive literature study combined with a detailed analysis of the requirements given by the end user. The system is described using a modular architecture with explicit interfaces, supporting easy verification and reproduction of the essential parts of the system.The result is a prototype design for an implantable electrical nerve stimulator with the ability to be miniaturized into 1/4 of the size of similar stimulating systems. The design meets the requirements from the end user, but must be miniaturized and encapsulated together with a connector for the electrode pin to be ready for implementation in animals.This thesis describes a novel prototype design of an implantable stimulator with a primary use in VNS applications, compatible with the bipolar 304 leads from Cyberonics Inc. The stimulator is designed with commercially available components resulting in a low-cost and portable solution. A modular architecture describes the system with respect to specifications given by end user and limitations from a literature study.
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5

Woodcock, Alan. "Electrical stimulation of chronically denervated muscle." Thesis, University of Surrey, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301288.

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6

Mercadal, Cavaller Borja. "Electroporation and peripheral nerve stimulation." Doctoral thesis, Universitat Pompeu Fabra, 2019. http://hdl.handle.net/10803/667854.

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This thesis aimed at addressing questions within the fields of electroporation and peripheral nerve stimulation and, in particular, those that arise from the interaction between the two phenomenona. On the one hand, electroporation can have various direct and indirect effects in the neuronal functions. This thesis investigates the possible role of electroporation in pulsed radiofrequency treatments for chronic pain. On the other hand, during electroporation based treatments, electrical stimulation of peripheral nerves appears as an unwanted effect causing muscle contractions and acute pain. This thesis analyzes the rationale behind the use of bipolar pulses to mitigate this effect and the implications of such approach in irreversible electroporation treatments. In addition, this thesis provides a theoretical framework to explain a series of results that were in apparent contradiction with the common knowledge of the electroporation phenomenon. Finally, this thesis presents a neuromuscular model to study the recruitment patterns in intramuscular electrical stimulation.
Aquesta tesi té com a objectiu resoldre qüestions en els camps de l’electroporació i l’estimulació dels nervis perifèrics, i sobretot, aquelles que es deriven de l’interacció entre els dos fenòmens. L’electroporació pot tenir diversos efectes directes o indirectes en les funcions neuronals. En aquesta tesi s’investiga el possible paper de l’electroporació en els tractaments de radiofreqüència polsada. D’altra banda, durant els tractaments basats en l’electroporació, l’estimulació elèctrica dels nervis perifèrics apareix com a efecte secundari causant contraccions musculars i dolor. En aquesta tesi s’analitza com l’ús de polsos bipolar pot mitigar aquests efectes i quines implicacions té aquesta estratègia en els tractaments d’electroporació irreversible. En aquesta tesi també es presenta un marc teòric per explicar una sèrie de resultats que entren en aparent contradicció amb els nostres coneixements sobre l’electroporació. Finalment, es presenta un model neuromuscular que permet estudiar la resposta d’un múscul quan és estimulat mitjançant elèctrodes intramusculars.
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7

Hale, Janet L. "Transcutaneous electrical nerve stimulation in the management of spasticity." Thesis, McGill University, 1987. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=63995.

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8

Vance, Carol Grace T. "Examination of parameters in transcutaneous electrical nerve stimulation effectiveness." Diss., University of Iowa, 2013. https://ir.uiowa.edu/etd/4779.

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Pain is the oldest medical condition and has been referenced through the ages. TENS is a non-invasive treatment for pain. Despite conflicting reports of treatment outcomes, TENS has enjoyed widespread clinical utilization. Seminal work by Sluka and colleagues reported low frequency TENS produces anti-hyperalgesia through µ-opioid receptors and high frequency TENS produces anti-hyperalgesia through ä-opioid receptors in an animal model of inflammation. The experimental results suggested that pain can be reduced by both high and low frequency TENS but by differing opioid receptors. These important findings require translational experiments to be conducted in humans. Providing an adequate placebo for experimental investigation of any physical intervention presents as a challenge. An improvement in the placebo intervention is critical to ascertain the true effects of TENS on painful conditions. Clinical TENS experiments often only examine a single outcome - resting pain. Recent work suggests TENS is less effective on resting pain as compared to movement pain. Investigation to determine which outcome measures (pain at rest, movement pain, pain sensitivity, and function) are most likely to be affected by TENS in human subjects with pain are critical to inform the design of future studies. The least investigated parameter for application of TENS electrode site determination. One method of selection employs a technique of finding points on the skin with suspected lower impedance. To date, no literature exists to determine the effectiveness of this clinical practice and speculation has existed for decades regarding the existence of distinct electrical properties associated with specific points on the body. This series of experiments accomplishes the goals of improving the TENS placebo, testing established parameters from basic science experiments in a patient population, testing multiple outcome measures to direct future investigation; and examined the effect of electrode site selection in TENS analgesia. These experiments were the first to establish a placebo that can 100% blind the TENS examiner, to test this placebo in a patient population, and to show that although there are differences in impedance between optimal and sham sites, that this difference had no effect in the amount of analgesia produced by TENS.
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9

Luo, Yuanming. "Assessment of diaphragm electrical activity using electrical and magnetic phrenic nerve stimulation." Thesis, King's College London (University of London), 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270379.

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10

Al-Majed, Abdulhakeem A. "Promoting peripheral nerve regeneration, functional electrical stimulation and pharmacological approaches." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0009/NQ59560.pdf.

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11

Rahal, Mouhamed. "Optimisation of nerve cuff recordings for functional electrical stimulation applications." Thesis, University College London (University of London), 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.248136.

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12

Cramp, Alice Fiona Louise. "The physiological and hypoalgesic effects of transcutaneous electrical nerve stimulation." Thesis, University of Ulster, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.314031.

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13

Chen, Xisha. "Pulsatile electrical stimulation of auditory nerve fibres : a modelling approach." Thesis, University of Warwick, 2012. http://wrap.warwick.ac.uk/55936/.

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A stochastic leaky integrate-and-fire nerve model with a dynamical threshold (LIFDT) has been derived for the neural response to sinusoidal electrical stimulation. The LIFDT model incorporates both the refractory effects and the accommodation effects in the interpulse interactions. In this thesis, this phenomenological nerve model is extended for the neural response to pulsatile electrical stimulation, which is widely used in cochlear implants as it reduces inter channel interference. Neurophysiological data from adult guinea pigs were fitted to the LIFDT model. First, the parameters were constrained by the Input/output (I/O) curve analysis. Analysis of the data showed strong accommodation effects. The figures of I/O function for each pulse were plotted according to the physiological data. Fitting the I/O function of the data constrained the value of four variables of LIFDT model. The other five parameters were “optimised by eye”. Although the LIFDT is built with stimulus-dependent threshold, the response of short duration biphasic pulsatile stimuli exhibits weak accommodation effects. Then, in order to avoid the complication of full optimization, analytical approximation of the LIFDT model was derived for pulsatile electrical stimulation. It improves computational efficiency and provides information on how the parameters of the LIFDT model affect the accommodation effects. Theoretical predictions indicate that the LIFDT model could not capture the strong accommodation effects in the neurophysiological data due to structural problems. Alternatively, a Markov renewal process model was utilized to track the pulsetrain response. The stationary and non-stationary Markov renewal process models were fitted to the neurophysiological data. Both models can interpret the conventional PST histograms into conditional probabilities, which are directly related to the interpulse intervals. The consistent results from those two models provide a qualitative analysis of the accommodation characteristics.
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14

Chin, Steven R. (Steven Richard). "Transcutaneous electrical nerve stimulation (TENS) : effects of duration of stimulation on antinociception in man." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=68165.

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Transcutaneous electrical nerve stimulation (TENS) has been employed for over 2 decades in pain management, however, definitive analgesic parameters have yet to be determined. The objective of this study was to determine the influence of 10, 30 and 60 min of TENS on the time course and magnitude of modulation on flexion reflex (FR) and on subjective pain estimates (visual analogue scale, VAS), as well as determining the relationship between FR responses and VAS scores following TENS of different durations.
Ten (10) normal subjects received electrical stimuli of maximal tolerable intensity to the sole of their foot. Our results indicated that TENS could suppress the FR in 50% to 70% of subjects. However, longer durations (30 and 60 min) of TENS have a small, but discernible difference in the number of subjects that show inhibition of FR area and significant maximal FR suppression when compared to 10 min of TENS. Moreover, the 60 min of TENS generated significant depression of VAS scores in more subjects than 10 and 30 min of TENS and ensured that any increase in pain perception would not reach significance when compared to the shorter (10 and 30 min) durations of TENS.
Our results suggested that longer durations of TENS could be applied to produce antinociceptive and analgesic effects. (Abstract shortened by UMI.)
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15

Heygood, Erick Michael. "Multi-channel nerve electrodes for control of functional electrical stimulation systems." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ61565.pdf.

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16

Pylypiv, Galina Yevgenivna. "Short Term Electrical Stimulation for Isograft Peripheral Nerve Repair and Functional Recovery." University of Akron / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=akron1520934076073459.

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17

Green, Seth A. "Experimental pain in hypnosis research ischemic vs transcutaneous electrical nerve stimulation (tens) /." Pullman, Wash. : Washington State University, 2009. http://www.dissertations.wsu.edu/Dissertations/Fall2009/S_Green_101509.pdf.

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18

Dailey, Dana Leigh. "Pain, fatigue, function and transcutaneous electrical nerve stimulation in individuals with fibromyalgia." Diss., University of Iowa, 2013. https://ir.uiowa.edu/etd/1579.

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The American College of Rheumatology (ACR) 1990 criterion classifies fibromyalgia as a clinical syndrome characterized by chronic widespread muscular pain and tenderness with hyperalgesia to pressure over 11/18 tender points of at least 3 months duration. Fibromyalgia is characterized by chronic widespread musculoskeletal pain and is associated with fatigue and cognitive dysfunction. The cause of fibromyalgia is unknown, but it has been shown to demonstrate sensitization of the central nervous system pain pathways by demonstrating lower pain pressure thresholds and reduced conditioned pain modulation (CPM). Pain and fatigue associated with fibromyalgia can interfere with daily function, work, and social activities. Without greater understanding of the interaction of pain, fatigue and function, we are limited in our ability to improve these symptoms for individuals with fibromyalgia. We designed three experiments to examine the relationship of pain, fatigue and function in individuals with fibromyalgia. Regression analyses demonstrated significant models that included pain, fatigue and fear of movement for prediction of function and quality of life in individuals with fibromyalgia and healthy controls. The fatigue study (cognitive fatigue, physical fatigue and dual fatigue task) demonstrated that people with fibromyalgia show enhanced pain and fatigue to both cognitive and physical fatigue tasks and reduced function in the physical fatigue task in comparison to healthy controls. Our final study showed active TENS restores CPM, decreases deep tissue pressure pain, decreases pain and fatigue during movement for individuals with fibromyalgia.
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19

Hasan, Tahseen. "Transcutaneous electrical nerve stimulation (TENS) and temporary S3 nerve root stimulation in idiopathic detrusor instability and characterization of the human detrusor smooth muscle contraction." Thesis, University of Newcastle Upon Tyne, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310132.

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20

Lim, S. P. "Electrical basis for inhibition and excitation in non-propulsive autonomically innervated smooth muscle." Thesis, University of Glasgow, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.377171.

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21

Tsang, Henry Hing-Yuen. "Diffuse inhibition of flexion reflex by transcutaneous electrical nerve stimulation (Tens) in man." Thesis, McGill University, 1986. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=65443.

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22

Chen, Chih Chung. "The hypoalgesic effects of different pulse frequencies of transcutaneous electrical nerve stimulation (T.E.N.S.)." Thesis, Leeds Beckett University, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.445605.

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23

Shawley, Lucinda. "Women's experiences of Transcutaneous Electrical Nerve Stimulation (TENS) for pain control in labour." Thesis, University of Southampton, 2011. https://eprints.soton.ac.uk/210925/.

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The vision for maternity services focuses on women-centred care with choice, control and promoting normality at its centre, thus emphasising the need to empower women to make choices and decisions regarding their care in labour and birth. Some women will choose the medical model of care, however others prefer to be in control and choose to use non-pharmacological alternatives for pain control in labour such as Transcutaneous Electrical Nerve Stimulation (TENS). TENS has enabled the provision of non-invasive, mobile, self-controlled pain relief for women in labour and is used extensively by women in the UK who, when asked, assess it favourably and say they would use it again. Currently the available literature on TENS fails to consider individual women’s experiences of using TENS for labour and birth, this study therefore seeks to redress this balance. Set in the south of England, the study uses Interpretative Phenomenological Analysis (IPA) in order to explore the experiences of twenty purposively selected women, who were interviewed to expose their in-depth experiences of using TENS for pain control in labour and birth. The analysis of the verbatim transcripts revealed comprehensive findings ensuring an idiographic focus along with making claims for the larger group of women. In this study women used TENS as part of a combination of more natural pain control or as a ‘sole’ form of pain control for labour and birth. TENS was recognised as being part of a wider strategy for the maintenance of control in labour and normal birth for women. A super-ordinate theme of ‘control’ emerged from the data particularly relating to ‘internal control of self’, ‘external control of others’ and ‘control of the TENS machine’. Women’s positive experiences were enhanced by remaining mobile, using drug free pain control, being knowledgeable, having partners’ and midwives’ support, being distracted from their pain and trusting in TENS. By uncovering a group of women’s in-depth experiences of using TENS for pain control in labour and birth this study has filled a “gap” in the knowledge base. In addition, the findings suggest that TENS was identified as an ‘enabling mechanism’ for the women in order to be in control of a normalised birth. Women were able to maintain their independence, make decisions and actively take part in their pain control using TENS.
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24

Peterson, Erik J. "INFRARED NEURAL STIMULATION AND FUNCTIONALRECRUITMENT OF THE PERIPHERAL NERVE." Case Western Reserve University School of Graduate Studies / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=case1363640552.

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25

Freeberg, Max J. "Anatomically-Versatile Peripheral Nerve Electrodes Preserve Nerve Health, Recruit Selectively, and Stabilize Quickly." Case Western Reserve University School of Graduate Studies / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=case1509114024578108.

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26

Johnson, Mark Ian. "Factors influencing the analgesic effects and clinical efficacy of transcutaneous electrical nerve stimulation (TENS)." Thesis, University of Newcastle Upon Tyne, 1991. http://hdl.handle.net/10443/539.

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Transcutaneous electrical nerve stimulation (TENS) is a simple, non-invasive technique used in the control of chronic pain. Despite the success of TENS and its continued use for over twenty years, some patients either fail to respond or show only a partial response. Furthermore some patients respond initially to TENS but then become tolerant to its analgesic effects. The reasons for poor response to TENS are unknown; different clinics report widely differing success rates, and information on long-term efficacy is sparse. Furthermore, TENS is still administered on an empirical basis in which the patient determines by trial and error the most appropriate stimulator settings (i. e. electrical characteristics of TENS) to treat his or her particular pain. It is impossible to predict whether an individual patient will respond to TENS or which stimulator settings will be optimal. In an attempt to elucidate these problems, the clinical, electrophysiological, neuropharmacological, psychological and sociological factors that influence the analgesic effects and clinical efficacy of TENS have been examined in this thesis. Three clinical studies were performed. The first (Study 2.1) reviewed the use of TENS since its introduction to Newcastle Pain Relief Clinic in 1979. It was found that 1582 patients have been given a trial of TENS of which 927 (58.6%) continue to use a stimulator on a long-term basis (Study 2.1). The clinical use of TENS by 179 of these patients was examined in-depth (Study 2.2). Although previous literature suggests that TENS is most efficacious for pains of neurogenic (neuropathic) origin, it was found that any type of pain may respond. No relationships were found to exist between the electrical characteristics of TENS (i. e. stimulator settings) used by patients during TENS treatment and the cause and site of pain. However, patients utilised specific pulse frequencies and patterns and consistently used these settings on subsequent treatment sessions (Study 2.3). These clinical studies showed that in this population, 41.4% of patients failed to respond to TENS and half using TENS on a long-term basis achieved less than 50% relief of pain. Thus, a systematic investigation to determine optimal electrical characteristics of TENS was performed. Three experiments were undertaken to examine separately the analgesic effects of different electrical characteristics of TENS (pulse frequency, pulse pattern and stimulation mode) on cold-pressor pain in healthy subjects. The effects of a range of Long Abstract pulse frequencies (10Hz to 160Hz) applied to produce a 'strong but comfortable' electrical paraesthesia within the painful site were measured (Exp. 3.1). It was found that frequencies between 20-80Hz were most effective. However, no differential effects were observed between a range of pulse patterns (continuous, burst, modulation, random; Exp. 3.2). When TENS was applied in burst mode at an intensity sufficient to produce phasic muscle twitches at a site distant yet myotomally related to the site of pain (acupuncture-like TENS) a powerful analgesic effect was observed during and post-stimulation (Exp. 3.3). It is suggested that continuous mode stimulation at 80Hz, producing a 'strong but comfortable' electrical paraesthesia within the painful site, should be the primary TENS treatment choice in the clinic but that in selected cases AL-TENS may be more effective. A number of improvements in stimulator design are suggested. Further experiments were aimed at elucidating the mechanism of TENS effects by investigating the influence of TENS on electrophysiological and neuropharmacological variables. It was found that TENS reduced peak-to-peak amplitudes of the late waveform components (N1P2) of somatosensory evoked potentials (Exp. 4.1) and increased alpha, beta and theta activity of spontaneous EEG in healthy subjects (Exp. 4.2) and/or pain patients (Exp. 4.3). As TENS produced changes in SEPs elicited from non-painful stimuli, and also changes in spontaneous EEG in pain-free subjects, it is suggested that the effects of TENS may be due in part to changes in sensory processing at several levels in the nervous system which may not specific for the perception of pain. The surprising finding that TENS increased peripheral circulating met-enkephalin in chronic pain patients was attributed to a stress-like release although this observation remains to be confirmed using a larger population sample (Exp. 5.1). The results of these experiments suggest that baseline electrophysiological and neuropharmacological variables may be important determinants of individual response to TENS. Thus, a prospective investigation was undertaken on 29 patients who were undergoing a trial of TENS to control chronic pain, in an attempt to identify predictors of patient response. Patient response to TENS was related to baseline SEP amplitudes and spontaneous EEG but was not related to biochemical, psycho-social, personality or pain related factors (Exp. 6.1). Thus, patients with small peak-to-peak amplitudes of the SEP, and low power spectrum of spontaneous EEG showed poor response to TENS (Exp. 6.1). It is suggested that an individual's intrinsic central response pattern to external stimuli may influence response to TENS.
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27

Chesterton, Linda Shirley. "The relevance of transcutaneous electrical nerve stimulation (TENS) parameter manipulation to observed hypoalgesic effects." Thesis, Keele University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.411882.

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28

Boger, Adam Sprott. "Application of High Frequency Electrical Block on the Efferent Nerves to the Lower Urinary Tract for Bladder Voiding." Cleveland, Ohio : Case Western Reserve University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=case1238788042.

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29

Levin, Mindy F. "The influence of transcutaneous electrical nerve stimulation (tens) on hemiplegic spasticity and voluntary muscle power /." Thesis, McGill University, 1990. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=74642.

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These studies investigated possible relief of spasticity in hemiparetic subjects by transcutaneous electrical nerve stimulation (TENS) and its underlying mechanisms. The first two studies quantified the disorders in reflex and voluntary motor functions and addressed the reproducibility of their measurement and their correlation with spasticity scores. Soleus stretch reflexes were enhanced and isometric voluntary contraction force was decreased linearly with increasing spasticity. The last two studies addressed the effects of single and repetitive TENS stimulation on spasticity, reflex and isometric voluntary contractions. Compared to placebo stimulation, single 45 min sessions of TENS prolonged H and stretch reflex latencies for up to 60 min following stimulation. Repetitive (15 daily, 60 min) applications significantly decreased spasticity scores, Hvib/Hctl ratios, stretch reflexes and co-contraction while improving dorsiflexion force. The improvement in spasticity and voluntary motor control may partly have been mediated by presynaptic inhibition and reduced hyperactive stretch reflexes thereby 'unmasking' descending control.
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30

Mulvey, Matthew R. "The Use of Transcutaneous Electrical Nerve Stimulation for Phantom Pain,Stump Pain and Prosthesis Embodiment." Thesis, Leeds Beckett University, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.529461.

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31

Foster, Nadine Elizabeth L. "Current clinical management of low back pain and hypoalgesic effects of transcutaneous electrical nerve stimulation." Thesis, University of Ulster, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.243735.

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32

Leung, Harvey. "The physiological and psychological effects of electrical vagus nerve stimulation in patients with refractory epilepsy." Thesis, University of Sheffield, 2018. http://etheses.whiterose.ac.uk/19881/.

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The vagus nerve is the longest cranial nerve in the body and has innervations and influence on many organs, yet the mechanisms that mediate these effects are still to be fully understood. Electrical stimulation of the vagus nerve has been used to treat refractory epilepsy for over 30 years despite an incomplete understanding of how it produces anti-epileptic effects. More recently, vagus nerve stimulation (VNS) has gained huge attention after the discovery that it may also have therapeutic benefit in mood and inflammatory disorders. This thesis explored the possible mechanisms that mediate the beneficial effects of VNS with a particular focus on the immune system in patients with refractory epilepsy. We also explored other potential therapeutic effects of VNS on anxiety, fatigue and perceived stress as well as heart rate variation As a non-invasive biomarker for the associated beneficial effects. By 6 months post-VNS implantation, a trend in reduced perceived stress was observed and was independent of changes in seizure frequency, seizure severity, mood, age, and gender. In heart rate variation studies, a significant decrease in high frequency relative power was seen at 6 months after VNS implantation, suggesting a reduction in sympathetic tone. This however did not correlate with other measures tested in the thesis. Flow cytometry analysis did not identify a trend in increasing Treg frequency following VNS treatment. However, functional analysis suggests a reduction in Treg function in response to anti-CD3 antibody which mimics antigen-presenting cell mediated expansion of T cells. Finally, cytokine array assays identified a significant reduction in the expression of BDNF, FGF-7, FGF-9, IL-1α, IL-1β, and MDC from plasma 3 months following VNS implantation. In summary, this thesis has identified novel findings which open additional avenues for exploring the therapeutic potential of VNS to treat stress disorders and its effects on Tregs for anti-inflammatory effects.
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33

Brill, Natalie Amber. "Optimization of High Density Nerve Cuff Stimulation in Upper Extremity Nerves." Case Western Reserve University School of Graduate Studies / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=case1418147191.

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34

Logan, Michael P. (Michael Paul). "The Effect of Transcranial Stimulation on the Mechanical Efficiency of Persons with Cerebral Palsy." Thesis, North Texas State University, 1987. https://digital.library.unt.edu/ark:/67531/metadc330982/.

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The problem of this study concerns the reduction of spasticity in physically handicapped persons with CP. The hypotheses tested were: that there would be no significant difference between the mechanical efficiency (ME) of persons with spastic CP following application of the TENS Unit and following application of the placebo unit; that there would be no significant difference between the ME of males with spastic CP, following application of the TENS Unit or the placebo unit, and the ME of females with spastic CP, following application of the TENS Unit or the placebo unit; and that there would be no significant interaction between the treatment factor and the gender category.
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35

Gittins, John. "Electrical stimulation as a therapeutic option to restore eyelid movements in patients with seventh nerve damage." Thesis, University of Leicester, 1999. http://hdl.handle.net/2381/29596.

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Damage to the seventh nerve is a relatively common clinical problem, the most important consequence of which can be the inability to close the eyelid. The purpose of this study was to investigate whether electrical stimulation could be used to restore eyelid function. Two electrical stimulation regimes were investigated. The first was based on a commercial electrical stimulator and used rectangular pulses (pulse width 200s, pulse repetition frequency 10 Hz, burst length 5s, applied for 1 hour daily for a period of 3 months) on ten patients. The second regime, (based on 15 ms rectangular pulses applied at a pulse repetition frequency of 10 Hz burst length 5s, applied for one hour daily for a period of three months), was implemented using a programmable stimulator designed specifically for this task and was used on seven patients. Treatment outcome was assessed in terms of maximum displacement and velocity of eyelid movement during blinks compared to normal values, and was measured with a purpose built imaging system. Key results from this study were that both stimulation methods improved the amplitude of voluntary eyelid closure, but spontaneous eyelid movements were not affected. Eyelid velocities during closure remained below normal values for both stimulation regimes. The observed increases in voluntary closure were attributed to a reduction in stiffness of the eyelid mechanics rather than an improvement in muscle function. Some functional movement (<2 mm) was obtained with the regime based on long pulses in direct response to electrical stimulation, which was not observed with the shorter pulses. The observed function was attributed to stimulation of surviving motorneurons. The regime using shorter pulses was better tolerated by patients because long pulses induced a visual aura and were more uncomfortable.
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36

Liu, Jiaqiang. "Do the effects of repetitive transcutaneous electrical nerve stimulation (TENS) on experimental pain cumulate over time?" Thesis, McGill University, 1994. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=68203.

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This study investigated the immediate and possible cumulative effects respectively of a single 60 min of TENS and of 10 repeated daily applications on subjective pain sensation and flexion reflex. Twenty young healthy subjects were randomly assigned to a TENS or a placebo group, with 10 in each. TENS or placebo stimulation was applied to the lumbro-sacral region for 60 minutes on 10 treatment days over a two-week period. Before, during and after TENS and placebo stimulation on Day$ sb1$, Day$ sb5$ and Day$ sb{10}$, the FR was elicited by electrically stimulating the sole of subject's right foot and recorded electromyographically from biceps femoris (BF) and tibialis anterior (TA) muscles. Subjective pain sensation was measured using the visual analog scale (VAS). Compared to placebo stimulation, a single session of 60 min TENS significantly decreased the VAS scores (p $<$ 0.05) and TA FR areas (p $<$ 0.05) obtained during the 60 min post-stimulation period. However, the between-group difference in the decrease of the BF FR area did not reach statistical significance. After 10 repeated daily applications of TENS, the pre-stimulation VAS scores and FR areas of both muscles were significantly more inhibited (p $<$ 0.01) than placebo stimulation. Furthermore, the suppression of VAS scores during and after TENS was linearly correlated with that of FR areas of both muscles in each of the 3 testing days. These findings indicated that repeated daily TENS applications produced cumulative inhibitory influence on both subjective pain sensation and FR over a two-week period. Such a gradual development probably implicated that plastic changes could have been induced in the neural pathway. The similar time course of the inhibitory effects of TENS on the two pain indices, which could cumulate over time, suggest possible similar processing at both cortical (subjective pain) and spinal (FR) levels.
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37

Francis, Richard Paul. "The Hypoalgesic Effects of Acupuncture-Like Transcutaneous Electrical Nerve stimulation (AL-TENS) Compared to Conventional TENS." Thesis, Leeds Beckett University, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.491234.

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Introduction: Transcutaneous electrical nerve stimulation (TENS) is used to reduce pain. TENS is applied as conventional TENS (50-100 Hz, causing paraesthesia) or acupuncture-like TENS (AL-TENS). AL-TENS is inconsistently characterised and research comparing its hypoalgesic effects to conventional TENS is lacking. Aim: To compare the hypoalgesic effects of acupuncture-like transcutaneous electrical nerve stimulation (AL-TENS) and conventional TENS.
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38

Slovak, Martin. "Investigation of transcutaneous electrical nerve stimulation with a specific focus on the treatment of overactive bladder." Thesis, University of Sheffield, 2015. http://etheses.whiterose.ac.uk/12301/.

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This thesis investigates transcutaneous electrical nerve stimulation (TENS), and in particular its role in the treatment of overactive bladder (OAB), which has been of interest for several decades. A standardization and an evaluation of various TENS parameters of stimuli would be beneficial to optimize the techniques used and to achieve the maximal effectiveness. Previously, Hoffman reflex (H reflex) inhibition was interpreted as a surrogate measure of bladder afferent nerve activity, and thus showed a potential to be useful for such evaluations. However, an influence of other factors, such as pelvic floor muscle contraction on this H reflex inhibition makes this surrogate measure unsuitable. In general TENS techniques are usually implemented in the patient’s treatment pathway as secondary treatment options. This is presumably due to a lack of effectiveness. Therefore a thought was given to enhance the effectiveness of the stimuli by producing a larger sensory input with a spatial temporal pattern. This lead to a development of a novel ‘Sensory Barrage Stimulation’, as introduced in this thesis. The technique showed promising effectiveness in comparison to a conventional type of TENS in the patients with elbow spasticity. Other researcher groups have tried to enhance the effectiveness by stimulating deep nerve structures (usually only targetable by implanted devices) using non/invasive transcutaneous stimulation and a specific waveform. However the “Transdermal Amplitude Modulated Signal” waveform introduced for the treatment of OAB symptoms, which claimed to pass through the skin more easily did not appear to be any different to a conventional stimuli and thus it is not of benefit for the routine clinical practice. Specifically, on the treatment for OAB syndrome symptoms, the most promising seems to be the Posterior Tibial Nerve Stimulation (PTNS) applied near the ankle. A well-established form of PTNS, which uses a needle to stimulate the nerve have disadvantages of being invasive and expensive due to the patient’s clinical sessions. The transcutaneous form of PTNS was investigated here in a home based randomized pilot trial of idiopathic overactive bladder patients. A promising effect indicates that there might be patients who can benefit from this type of non-invasive and low cost approach of PTNS. Additionally a numerical modelling of both types of PTNS showed that both techniques achieve a stimulation comparable in a way of physiological effects. Thus suggesting the evidence of percutaneous form of PTNS is plausible to be present in the transcutaneous form.
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39

Merkel, Daniel [Verfasser]. "Manual stimulation, but not acute electrical stimulation prior to reconstructive surgery, improves functional recovery after facial nerve injury in rats / Daniel Merkel." Köln : Deutsche Zentralbibliothek für Medizin, 2011. http://d-nb.info/1013607724/34.

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40

Rosen, Andrew M. "Effects of paired-pulse electrical stimulation of the chorda tympani nerve on cells in the nucleus of the solitary tract of the rat." Diss., Online access via UMI:, 2008.

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41

Walsh, Deirdre Mary. "Investigations of the neurophysiological and hypoalgesic effects of low intensity laser therapy and transcutaneous electrical nerve stimulation." Thesis, University of Ulster, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.385777.

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42

Fisher, Lee Erik. "Improving Neuroprosthesis-Assisted Standing with Nerve-Based Stimulating Electrodes." Case Western Reserve University School of Graduate Studies / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=case1332536090.

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43

Joseph, Laveeta. "Conduction block in peripheral nerves: effect of high frequency stimulation on different fiber types." Diss., Georgia Institute of Technology, 2010. http://hdl.handle.net/1853/42723.

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Selective stimulation and conduction block of specific nerve fibers has been a major area of research in neuroscience. The potential clinical and neurophysiological applications have warranted reliable techniques for transiently blocking conduction through nerves. High Frequency Alternating Current (HFAC) waveforms have been found to induce a reversible and repeatable block in peripheral nerves; however the effect of these waveforms on the neural activity of individual fiber types is currently unknown. Understanding this effect is critical if clinical applications are to be pursued. This dissertation work utilized extracellular electrophysiological techniques to characterize the activity of different fiber type populations in peripheral nerves during application of HFAC waveforms. First, we investigated the phenomenon in the homogeneous unmyelinated nerves of the sea-slug, Aplysia californica. Although complete reversible block was demonstrated in these nerves, a non-monotonic relationship of block threshold to frequency was found which differed from previously published work in the field. We then investigated the effect of HFAC waveforms on amphibian mixed nerves and studied the response of specific fiber types by isolating different components of the compound action potential. We validated our results from the Aplysia nerves by determining the block thresholds of the larger diameter, myelinated A-fibers and comparing them with those of the smaller diameter, unmyelinated C-fibers. We also showed that block threshold behavior during application of the HFAC waveform depends on the nerve fiber type, and this property can be used to selectively block specific fiber types. Finally, we examined the recovery time after block induction in unmyelinated nerves and found that recovery from block was dependent on the duration of application of the HFAC waveform. The time-dependent distribution of the recovery time and the non-monotonic threshold behavior in the smaller diameter unmyelinated nerves indicate that multiple mechanisms are involved in block induction using HFAC waveforms, and these mechanisms are dependent not only on the blocking stimulus but also on the characteristics of the nerve fiber. Overall, this work demonstrates that HFAC waveforms may enable inherent peripheral nerve properties to be exploited for potential clinical applications related to the treatment of unwanted neural activity.
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44

Bruns, Timothy Morris. "Afferent Stimulation for Exciting Reflex Micturition Circuits." Cleveland, Ohio : Case Western Reserve University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=case1238441084.

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45

White, Kevin Scott. "MODELING INTERFASCICULAR INTERFACES FOR PERIPHERAL NERVES." Case Western Reserve University School of Graduate Studies / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=case1347023787.

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46

Karpul, David. "On the application and generation of subsensory electrical nerve stimulation for the improvement of vibration perception in patients with HIV-related sensory neuropathy." Thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/1959.7/uws:54094.

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This work investigates the application of Subsensory Electrical Noise Stimulation (SENS) to improve symptoms of HIV-related peripheral sensory neuropathy (HIV-PN). HIV-PN occurs in roughly half of the 5 million people in South Africa with HIV. The disease has been shown to reduce quality of life and increase the risk of secondary ailments. Currently there is no treatment available. Previously, SENS has shown promise to improve tactile sensitivity in healthy populations and elderly individuals with peripheral neuropathic desensitisation. This work first establishes if SENS can improve the peripheral sensitivity of patients with HIV-PN, and secondly addresses practical aspects of using SENS in a therapeutic context. The vibrotactile sensitivity deficits of participants with HIV-PN and a matched control cohort is documented and analysed. It is found that HIV-PN participants have reduced sensitivity at all tested vibration frequencies (25 Hz, 50 Hz and 128 Hz), but especially at low frequencies. The interaction with vibration frequency indicates that HIV-PN may interact differently with different types of peripheral mechanoreceptors. SENS is then applied at four different amplitudes in an attempt to improve perception thresholds of the three vibration frequencies. SENS was shown to generally have a beneficial effect on 50 Hz vibration sensitivity for low SENS amplitudes. It had no effect, or a detrimental effect, at high SENS amplitudes, and also for 25 Hz and 128 Hz vibration frequencies. This work is also the first to document measures of pain with interventions of this type. No clear effects of SENS on sensations of pain were observed, which is a vital outcome if the therapy is to be developed further, since neuropathic pain is a frequent symptom of HIV-PN. The application of SENS as a practical therapy requires the accurate measurement of the participant’s electrical perception threshold, and a wearable device to apply the electrical signal on an ongoing basis. Research into the stability of electrical perception thresholds specifically aimed at subthreshold signals that would improve tactile sensitivity is presented. It was found that these thresholds vary wildly and correlated very little with possible explanatory variables, which introduces a new challenge for the development of SENS in future research. Currently there are no devices available to apply SENS in non-laboratory settings or for continuous use. The electronic design of a stimulator for using SENS as a wearable intervention is presented and characterised. The circuit is an efficient, low-power voltage to current converter that generates high voltages (120 V peak to peak) from a small, low-voltage rechargeable battery. The design and testing of control and instrumentation circuitry, as well as the addition of various safety and interface features is also documented. The battery life of the circuit is tested to operate for up to 33 hours and the circuit is tested to operate as expected in vivo. The results of this work demonstrate the potential viability of SENS as a therapy for HIV-PN, reveals the variability of electrical perception thresholds, explores the measures of pain for SENS interventions, and provides a complete and thoroughly tested design and implementation of an unparalleled electronic stimulator for non-laboratory environments. The conclusions of this work form both a strong theoretical and practical basis for future SENS intervention research.
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47

Hao, Yawei. "An in vivo study of gene expressions during collateral sprouting accelerated by electrical stimulation in rat dorsal root ganglia." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ36131.pdf.

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48

Kirk, Kerry Alicia. "The influence of stimulus control on the effects of transcutaneous electrical nerve stimulation (TENS) on experimental ischaemic pain." Thesis, Open University, 1997. http://oro.open.ac.uk/57699/.

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A review of the relevant literature suggested a number of unresolved issues in the most efficacious use of TENS for pain-relief including the degree of control and the frequency of TENS. The study investigated the influence of giving subjects control of the TENS stimulus on reported pain intensity and unpleasantness during experimental ischaemic pain induction of the arm. The pain induction and assessment procedures were established during an initial series of three experiments. Subjects in these and the subsequent experiments were healthy female student volunteers from Queen Margaret College. A further series of experiments investigated the influence of control of the TENS intensity on VAS scores of pain intensity and unpleasantness. When used, TENS (symmetrical biphasic current; pulse duration 200ýts; intensity 'just perceptible') was applied for the 15 minutes prior to cuff inflation and during the 15 minutes of pain induction (electrodes placed over Erb's point and lateral to C6/7). The first TENS experiment investigated the. influence of three different conditions (experimenter controlling TENS intensity; subject controlling TENS intensity; no TENS) using high frequency (100Hz) TENS. All subjects (n=12) were randomly exposed to the three testing conditions using a repeated measures design. A 2-way ANOVA with repeated measures on both factors showed no statistically significant effects (p≥0.05) on either VAS pain intensity or unpleasantness scores. The procedure was repeated with different subjects (n=12) using low frequency (5Hz) TENS. The results showed that mean pain scores were statistically significantly lower (p≤0.05) in the subject control condition than in the other two conditions (experimenter control and no TENS). A final experiment (n=12) compared VAS pain intensity and unpleasantness scores between the three conditions of, subject controlling 100Hz TENS, subject controlling 5Hz TENS and no TENS. The results demonstrated a trend for the 5Hz TENS condition to give lower mean pain scores than the other two conditions with both intensity (p=0.239) and unpleasantness scores (p=0.110). From the results and discussion it was suggested that the pain-relieving benefit of TENS was enhanced when the subjects were given control of the current intensity, especially when using low frequency TENS. The clinical implications of the results are discussed.
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49

Schildt, Christopher J. "CLOSED-LOOP AFFERENT NERVE ELECTRICAL STIMULATION FOR REHABILITATION OF HAND FUNCTION IN SUBJECTS WITH INCOMPLETE SPINAL CORD INJURY." UKnowledge, 2016. http://uknowledge.uky.edu/cbme_etds/43.

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Peripheral nerve stimulation (PNS) is commonly used to promote use-dependent cortical plasticity for rehabilitation of motor function in spinal cord injury. Pairing transcranial magnetic stimulation (TMS) with PNS has been shown to increase motor evoked potentials most when the two stimuli are timed to arrive in the cortex simultaneously. This suggests that a mechanism of timing-dependent plasticity (TDP) may be a more effective method of promoting motor rehabilitation. The following thesis is the result of applying a brain-computer interface to apply PNS in closed-loop simultaneously to movement intention onset as measured by EEG of the sensorimotor cortex to test whether TDP can be induced in incomplete spinal cord injured individuals with upper limb motor impairment. 4 motor incomplete SCI subjects have completed 12 sessions of closed-loop PNS delivered over 4-6 weeks. Benefit was observed for every subject although not consistently across metrics. 3 out of 4 subjects exhibited increased maximum voluntary contraction force (MVCF) between first and last interventions for one or both hands. TMS-measured motor map volume increased for both hemispheres in one subject, and TMS center of gravity shifted in 3 subjects consistent with studies in which motor function improved or was restored. These observations suggest that rehabilitation using similar designs for responsive stimulation could improve motor impairment in SCI.
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50

Tebcherani, Tanya Marie. "A Computational Approach to Enhance Control of Tactile Properties Evoked by Peripheral Nerve Stimulation." Case Western Reserve University School of Graduate Studies / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=case1625780331134629.

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