Functional electrical stimulation (FES) has developed over the last 35 years to become a scientifically, technologically and clinically recognized field of interest in clinical medicine. FES has been applied to locomotion, grasping, ventilation, incontinence, and decubitus healing. However, all of these achievements illustrate the initial applications of FES; its true potential has not yet been realized. Recently, FES systems, which are miniaturized stimulation devices, have been utilized in the clinical setting. However, because the stimulating electrodes of the current FES devices are percutaneous electrodes, which are susceptible to wire breakage, and skin infection an implantable FES stimulating electrode has been introduced in the U.S. and Japan. In the present study, an external power supply method using radio frequency (RF) coupling and data transmission was developed for the control of the implantable FES device. In addition, we review the current understanding of FES devices and their application in clinical medicine.
Background :Inductive coupling links are frequently used for powering of implanted devices for functional electrical stimulation (FES) and cochlear. They are used in applications where implanted batteries are not capable of supplying a sufficient amount of power over the time of implantation or where continuous data exchange with external components is necessary like in a leg pacemaker.
Materials and Methods:This paper describes an inductive power transmission link, which was developed for an implantable stimulator for direct stimulation of denervated muscles. The carrier frequency is around 1 MHz, the transmitter coil has a diameter of 46 mm, and the implant coil is 46 mm. Data transmission to the implant with amplitude shift keying (ASK) and back to the transmitter with passive telemetry can be added without major design changes.
Results :We chose the range of coil spacing (2 to 30 mm) to care for lateral misalignment, as it occurs in practical use. If the transmitter coil has a well defined and reliable position in respect to the implant, a smaller working range might be sufficient. Under these conditions the link can be operated in fixed frequency mode, and reaches even higher efficiencies of up to 37%. The link transmits a current of 50 mA over a distance range of 2-15 mm with an efficiency of more than 20% in tracking frequency.
Conclusion :The efficiency of the link was optimized with different approaches. A class E transmitter was used to minimize losses of the power stage. The geometry and material of the transmitter coil was optimized for maximum coupling. Phase lock techniques were used to achieve frequency tracking, keeping the transmitter optimally tuned at different coupling conditions caused by coil distance variations.
PURPOSE: This study was carried out to evaluate the efficacy of intravaginal pelvic floor electrical stimulation (FES) therapy on bladder irritability symptoms in stress urinary incontinent women. MATERIALS AND METHODS: The evaluation before and after treatment included the Blaivas's female Bladder Questionnaire, the quality of life questionnaires and the overall satisfaction with present voiding state using visual analogue test (VAT). All patient were treated for 20 minutes, twice a week for 6 weeks, using a new intravaginal electrical stimulator with microchip (PIC16C74). RESULTS: After the FES therapy, the overall success rate of the SUI was 50.4.% at 9 months. The bladder irritability symptoms such as frequency, nocturia, urgency, residual urine sensation and lower abdominal discomfort were improved. In particular, the symptoms of frequency, urge incontinence, dysuria were significantly improved after the FES therapy at 9 months. The VAT score of the overall satisfaction with the present voiding state was significantly lower after the FES therapy. 73.7% of patients were satisfied with the FES therapy and complications such as hemorrhage, vaginitis, urinary tract infection and pain were not encountered. CONCLUSION: These results suggest that FES therapy with microchip improves some bladder irritability in SUI women. Therefore, electrical stimulation therapy should be considered as a first line therapy in SUI women with bladder irritability symptoms.
Citations
Citations to this article as recorded by
Effect of Spiritual Well-being on Mental Health in Nursing Students Nae-Young Lee, Ji-Young Han Journal of Korean Academy of Psychiatric and Mental Health Nursing.2014; 23(1): 21. CrossRef
BACKGROUND To evaluate the efficacy of EMG biofeedback and pelvic floor electrical stimulation in the stress urinary incontinence patients by Kontinence HMT2000. MATERIALS AND METHODS: A group of 14 patients with stress urinary incontinence were treated with combined biofeedback and intravaginal electrical stimulation during 12 sessions from 2 weeks to 6 weeks. RESULTS: At immediate post treatment, subjective cure rate was 28% and improvement rate was 57% and failure rate was 15%. Thus the overall success rate for this treatment was 85%. The result of 3 months after treatment showed cure rate 14% and improvement rate was 43%. Intravaginal pressure increased by an average of 11.9 cmH2O. Increased vaginal pressure was found in 93% of the patients and more than 50% increment of intravaginal pressure was 71%. CONCLUSIONS: Combined biofeedback and pelvic floor electrical stimulation by use of Kontinence HMT2000 is effective for the patients who have good compliance, relative low degree stress urinary incontinence. In order to attain good results, a well structured program that teaches specific muscle exercise and the patients should be followed by regular interval reinforcement treatment.
Citations
Citations to this article as recorded by
Effects of Electric Stimulation and Biofeedback for Pelvic Floor Muscle Exercise in Women with Vaginal Rejuvenation Women Jung Bok Lee, So Young Choi Journal of Korean Academy of Nursing.2015; 45(5): 713. CrossRef
A method to roll-over the paralyzed body by means of Functional Electrical Stimulation (FES) is considered. It is demonstrated that individual joint motions necessary for the rolling-over are realized by electrical stimulation. EMG measurements are also performed to analyze the cooperative activities of the muscles during rolling-over motion in a case where an upper extremity was used. These results of two experiments using normal subjects verifies the fundamental feasibility of body control by FES.