Abe Genji, Oyama Hideki, Liao Zhenyi, Honda Keita, Yashima Kenji, Asao Akihiko, Izumi Shin-Ichi
Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Department of Rehabilitation, Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University, Sendai, Miyagi, Japan.
Med Devices (Auckl). 2020 Dec 18;13:439-447. doi: 10.2147/MDER.S271258. eCollection 2020.
Both repetitive peripheral magnetic stimulation (rPMS) and transcutaneous electrical current stimulation (TES) could elicit the limb movements; it is still unclear how subjective sensation is changed according to the amount of limb movements. We investigated the pain and discomfort induced by newly developed rPMS and TES of peripheral nerves in the dorsal forearm.
The subjects were 12 healthy adults. The stimulus site was the right dorsal forearm; thus, when stimulated, wrist dorsiflexion was induced. The rPMS was delivered by the new stimulator, Pathleader at 10 stimulus intensity levels, and TES intensity was in 1-mA increments. The duration of each stimulation was 2 s. The analysis parameters were subjective pain and discomfort, measured by a numerical rating scale. The rating scale at corresponding levels of integrated range of movement (iROM) induced by rPMS or TES was compared. The subjective values were analyzed by two-way repeated measures ANOVA with the stimulus conditions (rPMS, TES) and the seven levels of iROM (20-140 ºs).
In the rPMS experiments, stimuli were administered to all subjects at all stimulus intensities. In the TES experiments, none of the subjects dropped out between 1 and 16 mA, but there were dropouts at each of the intensities as follows: 1 subject at 17 mA, 20 mA, 22 mA, 23 mA, 27 mA, 29 mA and 2 subjects at 21 mA, 24 mA, 26 mA. The main effects of the stimulus conditions and iROM were significant for pain and discomfort. Post hoc analysis demonstrated that pain and discomfort in rPMS were significantly lower compared to TES when the iROM was above 60 ºs and 80 ºs, respectively.
New rPMS stimulator, Pathleader, caused less pain and discomfort than TES, but this was only evident when comparatively large joint movements occurred.
重复经外周磁刺激（rPMS）和经皮电流刺激（TES）均可引发肢体运动；但尚不清楚主观感觉如何随肢体运动量的变化而改变。我们研究了新开发的对前臂背侧外周神经进行rPMS和TES所诱发的疼痛和不适。
受试者为12名健康成年人。刺激部位为右侧前臂背侧；因此，刺激时会诱发腕背屈。rPMS由新型刺激器Pathleader以10个刺激强度水平施加，TES强度以1 mA递增。每次刺激持续时间为2秒。分析参数为通过数字评分量表测量的主观疼痛和不适。比较rPMS或TES诱发的相应运动综合范围（iROM）水平下的评分量表。主观值通过双向重复测量方差分析，分析刺激条件（rPMS、TES）和iROM的七个水平（20 - 140°s）。
在rPMS实验中，所有刺激强度下均对所有受试者进行了刺激。在TES实验中，1至16 mA时无受试者退出，但在以下各强度时有受试者退出：17 mA、20 mA、22 mA、23 mA、27 mA、29 mA各有1名受试者，21 mA、24 mA、26 mA各有2名受试者。刺激条件和iROM对疼痛和不适的主效应显著。事后分析表明，当iROM分别高于60°s和80°s时，rPMS的疼痛和不适明显低于TES。
新型rPMS刺激器Pathleader比TES引起的疼痛和不适更少，但这仅在发生相对较大的关节运动时才明显。
