Sensorimotor Function Group, Hospital Nacional de Parapléjicos, 45071, Toledo, Spain.
Toledo Physiotherapy Research Group (GIFTO), Faculty of Physiotherapy and Nursery, Castilla La Mancha University, 45071, Toledo, Spain.
J Neuroeng Rehabil. 2020 Feb 19;17(1):22. doi: 10.1186/s12984-020-00661-x.
High frequency alternating current (HFAC) stimulation have been shown to produce a peripheral nerve conduction block. Currently, all the studies applying HFAC stimulation in clinical studies, have employed frequencies below 10 kHz. The main aim of this work was to investigate the neuromodulatory effect of transcutaneous 20 kHz stimulation on somatosensory and pain thresholds, and maximal handgrip strength.
A randomized, crossover, single-blinded, placebo-controlled trial was conducted following recruitment of fourteen healthy volunteers. Transcutaneous stimulation at 20 kHz and sham stimulation were applied over the ulnar and median nerves of fourteen healthy volunteers for 20 min. Maximal handgrip strength (MHS), mechanical detection threshold (MDT) and pressure pain threshold (PPT) were registered prior to, during (15 min), immediately after the end (20 min), and 10 min following stimulation.
The 20 kHz stimulation showed a lower MHS during the stimulation at the 15 min (30.1 kgs SE 2.8) and at 20 min (31.8 kgs, SE 2.8) when compared to sham stimulation (35.1 kgs, SE 3.4; p < 0.001 and 34.2 kgs, SE 3.4; p = 0.03, respectively). The 20 kHz stimulation resulted in a slight increase in MDT at 15 min (0.25 mN; 0.25-2.00) when compared to the sham stimulation (0.25 mN; 0.25-0.25; p = 0.02), and no effects were showed for PPT.
High-frequency stimulation at 20 kHz suggests a partial block of nerve activity. Studies in subjects with neurological disorders characterized by nerve hyperactivity are needed to confirm the clinical impact of this non-invasive electrical stimulation technique.
NCT, NCT02837458. Registered on 12 April 2017.
高频交流(HFAC)刺激已被证明可产生外周神经传导阻滞。目前,所有在临床研究中应用 HFAC 刺激的研究都采用了低于 10 kHz 的频率。这项工作的主要目的是研究经皮 20 kHz 刺激对感觉和疼痛阈值以及最大握力的神经调节作用。
在招募了 14 名健康志愿者后,进行了一项随机、交叉、单盲、安慰剂对照试验。对 14 名健康志愿者的尺神经和正中神经进行 20 kHz 的经皮刺激和假刺激,持续 20 分钟。在刺激前、刺激期间(15 分钟)、刺激结束后即刻(20 分钟)以及刺激后 10 分钟,记录最大握力(MHS)、机械检测阈值(MDT)和压力疼痛阈值(PPT)。
与假刺激(35.1 公斤,SE 3.4;p < 0.001 和 34.2 公斤,SE 3.4;p = 0.03)相比,20 kHz 刺激在 15 分钟(30.1 公斤,SE 2.8)和 20 分钟(31.8 公斤,SE 2.8)时 MHS 较低。20 kHz 刺激导致 MDT 在 15 分钟时略有增加(0.25 mN;0.25-2.00),与假刺激相比(0.25 mN;0.25-0.25;p = 0.02),而 PPT 则没有影响。
20 kHz 的高频刺激表明神经活动有部分阻滞。需要在以神经过度活跃为特征的神经病变患者中进行研究,以证实这种非侵入性电刺激技术的临床影响。
NCT,NCT02837458。于 2017 年 4 月 12 日注册。