본 연구에서는 경피신경전기자극(TENS)을 이용하여 다양한 자극 강도에 따른 뇌혈관에 미치는 영향을 확인하고 자 한다. 특히 비지각적 감각의 전기자극을 통해 총경동맥(CCA)에서의 혈류 변화 및 혈관의 구조적인 변화를 확인 해 보고자 한다. 본 연구에는 20대의 건강한 성인 24명이 참여하였다. 자극 강도는 감각 역치 미만, 감각 역치, 그리 고 감각 역치 초과 세 가지를 각각 랜덤 순서로 적용하였다. 측정위치는 CCA 분기점의 1cm 하단에서 측정하였고, 혈류속도는 C-mode 도플러, 혈관의 구조는 B-mode 영상을 통해 측정하였다. 측정은 각각의 자극별로 중재 전, 중재 중, 그리고 중재 후에 수행하였고 각 세션마다 혈압의 변화를 측정하였다. 그 결과 최고 수축기 속도(PSV)는 역치 미만의 비지각적 감각자극에서 중재 후 유의하게 감소함이 확인되었다(p = .008). 역치 미만의 자극 후 PSV는 자극 전보다 평균 3.04% 유의하게 감소한 것으로 나타났다(p = .011). 반면 CCA의 혈관 직경의 변화는 모든 강도에서 자극 전후 유의한 변화가 나타나지 않았다. 본 연구에서 적용한 단시간의 비지각적 전기자극이 혈관의 직경이나 혈 압의 유의한 변화를 주지 않으면서 즉각적인 혈류속도 감소에 효과가 있음을 발견했다. 따라서 본 연구는 경동맥 부위에 환자의 불편함과 부작용이 없는 전기자극을 통해 뇌혈류의 조절이 가능하다는 것을 보여주는 중요한 시도로 평가될 수 있다.

Background: Core muscle weakness occurs due to trunk asymmetry and spinal malalignment after stroke. Core exercise is being implemented to improve trunk control and sitting position in stroke patients. Objectives: To investigated the effects of core muscle electrical stimulation on trunk control and dynamic balance in stroke patients. Design: Quasi-experimental study. Methods: A total of 30 stroke patients were recruited and divided into two groups: experimental group (core muscle electrical stimulation group) and control group (sham core muscle electrical stimulation group). Trunk impairment scale (TIS) was used to measure trunk control. BioRescue was used to measure sitting dynamic balance. Results: In both groups, all TIS scores and sitting dynamic balance abilities were improved increased significantly after intervention (P<.05). Changes in TIS scores and sitting dynamic balance abilities were significantly greater in the experimental group than the control group (P<.05). Conclusion: It was found that core muscle electrical stimulation can be used as an effective method for trunk control and balance recovery in stroke patients.

Background: Neuromuscular electrical stimulation (NMES) is used for muscle strengthening. While voluntary muscle contraction follows Henneman et al.’s size principle, the NMES-induced muscle training disrespects the neurophysiology, which may lead to unwanted changes (i.e., declined balance ability). Objects: We examined how the balance was affected by abdominal muscle training with the NMES. Methods: Fifteen young adults (10 males and 5 females) aged between 21 and 30 received abdominal muscle strengthening with NMES for 23 minutes. Before and after the training, participants’ balance was measured through one leg standing on a force plate with eyes open or closed. Outcome variables included mean distance (MDIST), root mean square distance (RDIST), total excursion (TOTEX), mean velocity (MVELO), and 95% confidence circle area (AREA) of center of pressure data. Two-way repeated measures analysis of variance was used to test if these outcome variables were associated with time (pre and post) and vision. Results: All outcome variables were not associated with time (p > 0.05). However, all outcome variables were associated with vision (p = 0.0001), and MVELO and TOTEX were 52.4% (45.5 mm/s versus 95.6 mm/s) and 52.4% (364.1 mm versus 764.5 mm) smaller, respectively, in eyes open than eyes closed (F = 55.8, p = 0.0005; F = 55.8, p = 0.0005). Furthermore, there was no interaction between time and vision (F = 0.024, p = 0.877). Conclusion: Despite the different neurophysiology of muscle contraction, abdominal muscle strengthening with NMES did not affect balance.

Background: The transcutaneous electrical nerve stimulation (TNES) is the most used non-invasive treatment method in physical therapy. As the mobile TENS (MTENS) has become popular, patients with pain have started using MTENS to reduce pain. Objectives: To evaluate pain, range of motion, and muscle strength before and after using MTNES in patients with wrist pain. Design: Quasi-experimental research. Methods: We conducted an experiment with 80 patients; 15 patients were dropped out, and 35 and 30 patients were evaluated in the experimental group (EG) and control group (CG), respectively. Before and after using MTENS for 4 weeks, patients were evaluated using visual analogue scale (VAS), grip power, range of motion (ROM), and digital infrared thermography imaging (DITI). In the EG, electricity was applied for the MTENS device, while electricity was not applied in the CG. Results: A significant difference in pain reduction was observed between the EG and CG. In the EG, a significant difference in grip strength was also noticed before and after using the MTENS; patients showed significantly increased power grip and tip pinch. A significant difference was observed in pre-rest and post-test wrist ROM and DITI values. Conclusion: MTENS is an appropriate procedure for patients with wrist pain.

Background: Neuromuscular electrical stimulation (NMES) is a physical modality used to activate skeletal muscles for strengthening. While voluntary muscle contraction (VMC) follows the progressive recruitment of motor units in order of size from small to large, NMES-induced muscle contraction occurs in a nonselective and synchronous pattern. Therefore, the outcome of muscle strengthening training using NMES-induced versus voluntary contraction might be different, which might affect balance performance. Objects: We examined how the NMES training affected balance and proprioception. Methods: Forty-four young adults were randomly assigned to NMES and VMC group. All participants performed one-leg standing on a force plate and sat on the Biodex (Biodex R Corp.) to measure balance and ankle proprioception, respectively. All measures were conducted before and after a training session. In NMES group, electric pads were placed on the tibialis anterior, gastrocnemius, and soleus muscles for 20 minutes. In VMC group, co-contraction of the three muscles was conducted. Outcome variables included mean distance, root mean square distance, total excursion, mean velocity, 95% confidence circle area acquired from the center of pressure data, and absolute error of dorsi/plantarflexion. Results: None of outcome variables were associated with group (p > 0.35). However, all but plantarflexion error was associated with time (p < 0.02), and the area and mean velocity were 37.0% and 18.6% lower in post than pre in NMES group, respectively, and 48.9% and 16.7% lower in post than pre in VMC group, respectively. Conclusion: Despite different physiology underlying the NMES-induced versus VMC, both training methods improved balance and ankle joint proprioception.

Background: The superimposed technique (ST) involves the application of electrical muscle stimulation (EMS) during voluntary muscle action. The physiological effects attributed to each stimulus may be accumulated by the ST. Although various EMS devices for the quadriceps muscle are being marketed to the general public, there is still a lack of research on whether ST training can provide significant advantages for improving quadriceps muscle strength or thickness compared with EMS alone. Objective: To compare the effects of eight weeks of ST and EMS on the thicknesses of the rectus femoris (RF) and vastus intermedius (VI) muscles and knee extension strength. Methods: Thirty healthy subjects were recruited and randomly assigned to either the ST or EMS groups. The participants underwent ST or EMS training for eight weeks. In all participants, the thicknesses of the RF and VI muscles were measured before and after the 8-week intervention by ultrasonography, and quadriceps muscle strength was measured using the Smart KEMA tension sensor (KOREATECH Co., Ltd.). Results: There were significant differences in the pre- and post-intervention thicknesses of the RF and VI muscles as well as the quadriceps muscle strength in both groups (p < 0.05). RF thickness was significantly greater in the ST group (F = 4.294, p = 0.048), but there was no significant difference in VI thickness (F = 0.234, p = 0.632) or knee extension strength (F = 0.775, p = 0.386). Conclusion: EMS can be used to improve quadriceps muscle strength and RF and VI muscle thickness, and ST can be used to improve RF thickness in the context of athletic training and fitness.

Background: Stroke patients have dosiflexor weakness. Functional electrical stimulation (FES) for motor and sensory threshold stimulation has been applied to patients with stroke. Objectives: To investigate effects of FES intervention for motor and sensory threshold on balance and gait in subacute patients with stroke. Design: A randomized controlled trial. Methods: In all, 34 patients with subacute stroke were recruited and randomly assigned to the motor threshold (MTG, n=17) and sensory threshold group (STG, n=17). The measured variables were static balance (BioRescue), dynamic balance (BBS), and gait (TUG test). The study period was 5 weeks, twice a day, 5 days a week. Results: There was a significant difference in all variables except the speed variable (open eye Romberg test) after the intervention; MTG improved more significantly except for the speed variable of the Romberg test (open eye). BBS score increased significantly only in the MTG group after the intervention, and the increase was more significant in the MTG group than in the STG group. The TUG test significantly decreased in both groups after the intervention, and the decrease was more significant in the MTG group than in the STG group. Conclusion: FES for motor threshold applied to patients with subacute stroke appears to be more effective in improving balance and gait ability than FES for sensory threshold.

본 연구에서는 전기 근육 자극(electrical muscle stimulation, EMS)에 사용되는 기존의 하이드로겔 패드의 단 점인 사용 편의성, 쾌적성 등을 보완할 수 있는 e-textile (electronic textile)을 이용한 전기 근육 자극(electrical muscle stimulation, EMS) 패드인 EMSCT (electrical muscle stimulation conductive textile)를 연구를 하고자 하 였다. SWCNT (Single-Walled Carbon Nanotube)와   의 농도 및 함침 공정 횟수를 변수로 하여, EMSCT는 5 가지 직물(라디론, 네오프렌, 스판쿠션, 폴리100%, 베르가모)에 전도성을 부여하여 실험이 진행되었다. SWCNT (Single-Walled Carbon Nanotube)와   을 이용한 패딩 공정을 거쳤으며, 교류 측정 결과 하이드로겔 과 가장 유사한 교류를 나타내는 것은 SWCNT:   = 2:1의 베르가모 원단이라는 결과를 얻을 수 있었다. 또한, 편 의성, 사용성, 심리적 만족성에 관한 사용성 평가를 통해 기존 하이드로겔 패드에 비해 EMSCT가 좋은 사용성을 가진다는 결과를 얻을 수 있다.

Background: Patients with dysphagia after stroke are treated with neuromuscular electrical stimulation (NMES), but its effect on masseter muscle thickness and bite force in the oral phase is not well known. Objectives: To investigated the effect of NMES on masseter muscle thickness and occlusal force in patients with dysphagia after stroke. Design: Two group, pre-post design. Methods: In this study, 25 patients with dysphagia after stroke were recruited and allocated to either the experimental or the control groups. Patients in the experimental group were treated with NMES to the masseter muscle at the motor level for 30 minutes and were additionally treated with traditional swallowing rehabilitation for 30 minutes. In contrast, patients in the control group were only treated with traditional swallowing rehabilitation for 30 minutes. Masseter muscle thickness was measured using ultrasonography before and after intervention, and bite force was measured using an bite force meter. Results: The experimental group showed significant improvement in masseter muscle thickness and bite force compared to the control group. Conclusion: NMES combined with traditional dysphagia rehabilitation is effective in improving masseter muscle thickness and bite force in patients with dysphagia after stroke.

Background: Stroke patients have weak trunk muscle strength due to brain injury, so a single type of exercise is advised for restoring functionality. However, even after intervention, the problem still lies and it is suggested that another intervention method should be applied with exercise in order to deal with such problem. Objectives: To Investigate the effect of bridge exercise combined with functional electrical stimulation (FES) on trunk muscle activity and balance in stroke patients. Design: Randomized controlled trial. Methods: From July to August 2020, twenty stroke patients was sampled, ten patients who mediated bridge exercises combined with functional electrical stimulation were assigned to experiment group I, and ten patients who mediated general bridge exercises were assigned to experiment groupⅡ. For the pre-test, using surface EMG were measured paralyzed rectus abdominis, erector spinae, transverse abdominis/internal oblique muscle activity, and using trunk impairment scale were measured balance. In order to find out immediate effect after intervention, post-test was measured immediately same way pre-test. Results: Change in balance didn’t show significant difference within and between groups, but muscle activity of trunk was significant difference rectus abdominis and erector spinae within groups I (P<.01), also between groups was significant difference (P<.05). Conclusion: Bridge exercise combined with FES could improve trunk function more effectively than general bridge exercise due to physiological effect of functional electrical stimulation.

Background: The spinal nerves, which start at the lumbar level, are connected to the nerve innervation in the knees. Currently, there is a lack of research on the treatment of knee pain through lumbar mobilization. Objectives: To investigate the effects of lumbar joint mobilization (LJM) and transcutaneous electronic nerve stimulation (TENS) on proprioception and muscular strength in volleyball players with chronic knee pain. Design: Two group pre-posttest. Methods: A total of 26 professional volleyball players with chronic knee pain were allocated to the LJM (n=13) and TENS (n=13) groups. In the LJM group, grade III - IV amplitude was applied 3 times for 1 minute (80 times per minute) at the affected lumbar (L2-3) facet joint in the prone position. In the TENS group, the TENS treatment device was used to directly apply or 15 minutes to the area of chronic knee pain (100 Hz, 150 ㎲). Proprioception was measured by knee flexion and extension angles, and muscle strength was evaluated using an isokinetic test. Measurements were taken before and after interventions. Results: In the eye opened conditiond, proprioception significantly increased during both knee extension and flexion after LJM, while only knee extension was significantly increased in the TENS group. There was also a significant difference in knee extension between the two groups. In the eye close conditiond, proprioception was significantly improved only during knee extension in the LJM group, and the difference in knee extension between the groups was also significant (P<.05). The maximum torque of the affected knee joint was significantly improved at 60°/sec in both groups (P<.05); however, there was no difference between the two groups. There was no significant difference in the maximum flexion torque within or between the groups. Conclusion: This study suggests that LJM improved proprioception and muscular strength in volleyball players with chronic knee pain.

Background: Stroke patients experience multiple dysfunctions that include motor and sensory impairments. Therefore, new intervention methods require a gradational approach depending on functional levels of a stroke patient’s activity and should include cognition treatment to allow for a patient’s active participation in rehabilitation. Objects: This study investigates the effect of integrated revision of electrical sensory stimulation, which stimulates somatosensory and action observation training, which is synchronized cognition intervention method on stroke patients’ functions. Methods: Twenty-one stroke patients were randomized into two groups. The two groups underwent twenty minutes of intervention five times a week for three weeks. This study used an electromyogram to evaluate symmetric muscle activation of lower extremities and muscle onset time when performing sit to stand before and after intervention. A weight-bearing ratio was used to evaluate the weight-bearing of the affected side in a sit to standing. To evaluate sit to stand performance ability, this study performed five timed sit to stand tests. Results: The two groups both showed statistically significant improvement in muscle onset time of lower extremity, static balance ability in a standing position, and sit to stand performance after the intervention (p < 0.05). In addition, the action observation and synchronized electrical sensory stimulation group showed significant improvement in symmetric muscle activation of lower extremities and weight–bearing ratio of the affected side (p < 0.05). Conclusion: action observation and synchronized electrical sensory stimulation (AOT with ESS) can have positive effects on a stroke patient’s sit to stand performance, and the intervention method that provides integrated AOT with ESS can be used as new nervous system intervention program.

Osteoarthritis is a disorder characterized by a loss of cartilage as common aging-associated disease in humans and animals. However, unlike human clinical trials, investigational studies in pet animals are constrained by a lack of interest and funds. In addition, pet owners would often prefer the lowest cost method to treat arthritis of pet animals. Here, we report the outstanding and inexpensive way to prepare chondrocytes for cartilage repair using rabbit adipose derived mesenchymal stem cells (MSCs). This study focused on the development and enhancement of pre-chondrogenic condensation under external electric fields even without additional growth factors. We found that highly compact structures were formed within 3 days in micromass cultures of rabbit MSCs under electrical stimulation (ES), showing increased COL2A1 gene expression compared with their control 3D micromass cultures and 2D monolayer cultures. We further found that ES enhanced the production of proteoglycan, a highly produced extracellular matrix component in chondrocytes. Collectively, these results provide the commercial potential of electrical stimulation driving chondrogenesis of mesenchymal stem cells for repair of cartilage, which is a budget-friendly regimen.

Background: Multifaceted approaches will be needed, such as global synkinesis (GS) achieve functional improvements in the arms of stroke patients from involuntary movements during exercise. Objective: To identify changes in arm GS and muscle activity, functional evaluation and the correlation with variables through action observation training, combined with functional electrical stimulation (FES), thereby verifying the effect on stroke patients. Design: A quasi-experimental study. Methods: The subjects of this study were 20 stroke patients who were divided into two groups: Control group (n=10) and experimental group (n=10). Before the intervention, arm GS and muscle activity were measured using surface electromyography (EMG), and arm function was evaluated using the Fugl– Meyer Assessment (FMA) scale. At the end of the intervention, which lasted 4-wk, arm GS and muscle activity were measured again using the same scale. Results: There was a decrease statistically significant difference in GS during the bending action in experimental group (P<.01). Both groups showed a significant difference increased only in the activity of the anterior deltoid (AD) and biceps brachii (BB) (P<.05). The results of the arm functional assessment revealed a significant difference increase in both groups (P<.05). In the between-group comparison, there was a significant difference decrease in GS during the bending action (P<.05). Only the muscle activity of the AD and BB were significantly increase different (P<.05). There was a significant betweengroup difference increase in the arm functional assessment (P<.05). There was a positive correlation between GS and muscle activity on the FMA in the control group (r=.678, P<.05). In experimental group, GS during the bending arm action exhibited a negative correlation (r=-.749, P<.05), and the muscle activity of the AD and BB showed a positive correlation (r=.701, P<.05). Furthermore, in experimental group, the activity of the extensor carpi radialis increased, and the activity of the flexor carpi radialis decreased, which exhibited a negative correlation (r=-.708, P<.05). Conclusion: These results suggest that brain plasticity could be more efficiently stimulated by combining surface stimulation in the affected arm of stroke patients.

Electrical stimulation (ES) is known to guide the development and regeneration of many tissues. Use of low-frequency ES for therapeutic purposes has been increasing during the last decades. Mesenchymal stem cells (MSCs) represent an appealing alternative cell source for cartilage repair. There are studies that induce differentiation into cartilage cells by treating the growth factors in stem cells or altering the properties of stem cells by genetic modification. In this study, we exposed equine adipose tissue-derived MSCs (eAD-MSCs) to ES and assessed changes in the chondrogenic differentiation potential. The cells obtained from equine adipose tissue attached to culture plates and expanded in vitro. Flow cytometric analysis at third passage indicated that the cells were strongly positive for CD44, CD90, and CD105, but negative for CD13, CD34, and CD45. Next, ES was applied to eAD-MSCs cultured under condition of high-density micromass under ES of 10 V/cm, with duration of 10 ms and a frequency of 2.0 Hz for three days. Gene expression of chondrogenic markers such as collagen type II, Aggrecan, and Sox9 was analyzed at three days of ES. As a result, we observed the differentiation potential of eAD-MSCs into chondrocytes by specific ES in absence of exogenous growth factors. We also found that ES upregulated the expression of heat shock protein 70, which affects cartilage formation. This study may contribute to the differentiation of MSCs into chondrogenic lineage under specific ES condition.

Osteoarthritis occurs when the cartilage that gradually deteriorates as common aging-associated disease in humans and animals. There is no cure, but the treatments are available to manage to relieve pain through medication such as steroids. Growing interest has been focused on the role of cell-based therapies using mesenchymal stem cells (MSCs). In addition, mesenchymal stem cells can be isolated from almost adult tissues and known for their potential of becoming cartilage. Clinical and experimental studies indicate that the development of treatment using stem cells is double-edged sword involving a possibility such as tumorigenesis. This study focused on the electrical features during articular cartilage development and hypothesized that external electric fields promote pre-chondrogenic condensation without concern relating to genetic modification or exogenous factors. Here, it has been reported that exogenous direct electric fields drive pre-chondrogenic condensation which is the stage where cartilage formation begins by condensation of stem cells and cartilage cells in the microenvironment of the joint. Time-dependent observations also support the contribution of electrical stimulation (ES) to induce gradual aggregation of MSCs into highly compact structures within 3 days. Collectively, our findings provide the potential of electrical stimulation-driven chondrogenesis of mesenchymal stem cells in the absence of exogenous factors for repair of cartilage defects.

목적 : 뇌졸중 후 연하장애 중재에 포함된 임상가의 조기 접근을 위해 신경근전기자극(Neuromuscular Electronic Stimulation; NMES)와 비 침습성 뇌자극(Non-Invasive Brain Stimulation; NIBS)를 적용한 무작위 대조실험(Randomized Controlled Trials; RCTs) 연구의 메타분석을 통해 구체적인 효과와 방안을 제시하고자 한다. 연구방법 : Pubmed, CINAHL(EBSCOhost), Psycinfo, 한국학술정보원(Korean Studies Information Service System; KISS), 학술연구정보서비스(Research Information Sharing Service; RISS)를 통하 여 2008년부터 2019년까지의 논문을 검색하였다. 주요 용어는 “stroke OR CVA OR cerebrocascular accident OR vascular accident” AND “dysphagia OR swallowing disorder OR deglutition disorder” AND “tDCS OR transcranial direct current stimulation OR rTMS OR repetitive transcranial magnetic stimulation OR NMES OR neuromuscular electronic stimulation” AND “RCT OR randomized control trial”, “뇌졸중” 그리고 “연하장애 또는 삼킴곤란” 그리고 “경두개 자기자극 또는 경두개 직류자극 또는 신경근 전기자극” 그리고 “무작위대조실험”을 사용하였다. 포함기준과 배제기준을 적용하여 총 11개의 연구가 분석 대상으로 사용되었다. 결과 : 경두개 직류자극(Transcranial Direct Current Stimulation; tDCS)의 전기자극 강도는 1mA, 경 두개 자기자극(Repetitive Transcranial Magnetic Stimulation; rTMS)의 전기자극 강도는 3~5Hz, 신 경근 전기자극(Neuromuscular Electronic Stimulation; NMES)의 전기자극 강도는 8~15mA로 다양했으며, tDCS와 rTMS는 큰 효과크기, NMES는 중간 효과크기로 나타났다. 결론 : 본 연구는 메타분석을 통해 3가지 치료에 대한 효과를 확인하고 환자 특성과 중재 방향에 따라 다양한 결과를 확인할 수 있었다. 3가지 치료는 국내 뇌졸중 후 연하장애 회복에 효과가 있으며 안전하다고 판단한다. 향후 연하장애 회복을 이끄는 다양한 요인에 대한 명확한 연구가 활발히 이루어져야 할 것이다.

Background: Stress urinary incontinence (SUI) is an involuntary leakage of urine from the urethra when intra-abdominal pressure increases, such as from sneezing, coughing, or physical exertion. It is caused by insufficient strength of the pelvic floor and sphincter muscles, resulting from vaginal delivery, obesity, hard physical work, or aging. The pelvic floor electrical stimulator is a conservative treatment generally used to relieve the symptoms of urinary incontinence. it recommended to applied before surgery is performed. Objects: The purpose of this study was to determine if the transcutaneous electrical stimulation (TCES) would be effective for the physiological symptoms and psychological satisfaction of women with SUI for an 8-weeks intervention. Methods: Easy-K is a specially designed user-friendly TCES. Five female who were diagnosed with SUI by a gynecologist but who did not require surgical intervention were included in this study. Intervention was implemented over an 8-week period. Outcome measures included vaginal ultrasonography, Levator ani muscle (LAM) contraction strength, incontinence quality of life (I-QOL), and female sexual function index (FSFI) questionnaires. Results: The bladder neck position significantly decreased across assessment time. Funneling index and urethral width significantly decreased after 8 weeks of intervention (p<.05). The bladder necksymphyseal distance and posterior rhabdosphincter thickness statistically increased and the anterior rhabdosphincter thickness showed a tendency to increase. All participants demonstrated a significant increase in the LAM contraction score across three assessment times (p<.05). Although the total score of the I-QOL did not show significant improvement, it steadily increased and among I-QOL subscales, only the “avoidance” subscale showed statistical improvements (p<.05). The total score of the FSFI statistically improved and the “desire” score significantly changed (p<.05). Conclusion: The TCES is recommended for women who want to apply conservative treatments before surgery and who have suffered from SUI in aspects of sexual function and quality of life.

Background: Surgery has been known as an inefficient approach to reduce back pain in patients with lumbar spinal stenosis; therefore, non-surgical treatments are necessary. However, there has been little research to analyze the effect of non-surgical treatments on lumbar spinal stenosis pain. Objective: To identify the effectiveness of 2 physiotherapeutic treatment approaches to relieve pain due to lumbar spinal stenosis. Design: Randomized controlled trial Methods: The participants were 36 lumbar spinal stenosis patients who were randomized in the joint mobilization group (JMG) and transcutaneous electrical nerve stimulation group (TENSG). Joint mobilization (JM) was conducted at the posteroanterior joint in the spinous process of the lumbar spine with stenosis. Transcutaneous electrical nerve stimulation (TENS) was applied on the lumbar spine with stenosis at a high frequency and intensity. Results: Visual analog scale (VAS) pain score significantly decreased in both groups, and the VAS value decreased more after JMG than that after TENSG. The pain thresholds of both groups also significantly increased, and that of JMG increased more compared to TENSG. In both the groups, significant improvements in VAS and pain thresholds were found, and JMG showed better results than TENSG. Conclusions: JM and TENS showed significant relief in both pain threshold and painpain, and JM showed more advanced relief compared to TENS.

c-Fos is known to related to synaptic plasticity and apoptosis in damage from ischemia or external injury. The purpose of this study was to investigate whether needle electrode electrical stimulation(NEES) is effective in increasing the number of c-Fos response cells and c-Fos expression in striatum after global ischemia in rats. There were no treatment and occlusion in the control group, global ischemia(GI) group were no treatment after carotid artery occlusion, and needle electrode electrical stimulation(NEES) group were treated with NEES after GI induced. The number of striatum c-Fos response cells and c-Fos protein expression significantly decreased in the NEES group compared to the GI group after 12, 24, 48 hours. The results of the present study suggest that NEES is ineffective in improving global ischemia in rats and may also be ineffective in the globally ischemic human brain.