Breathing-controlled Electrical Stimulation (BreEStim) for Management of Neuropathic Pain and Spasticity

Journal of Visualized Experiments, 2013 · DOI: 10.3791/50077 · Published: January 10, 2013

Neurology Pain Management Rehabilitation

Simple Explanation

Electrical stimulation (EStim) involves applying electrical current to muscles or nerves for therapeutic purposes. A new protocol, Breathing-controlled Electrical Stimulation (BreEStim), enhances EStim's effects by synchronizing it with voluntary breathing. During BreEStim, an electrical stimulus is delivered when the airflow rate of a voluntary inspiration reaches a set threshold. This technique integrates physiological interactions activated during breathing. BreEStim has shown clinical success in managing post-stroke finger spasticity and neuropathic pain in spinal cord injury, using specific protocols for each condition.

Study Duration

Not specified

Participants

Two case studies: one post-stroke patient and one spinal cord injury patient

Evidence Level

Level 4; Case Series

Key Findings

1
BreEStim effectively reduced finger flexor spasticity in a post-stroke patient, improving hand function, with benefits lasting for at least eight weeks.
2
In a spinal cord injury patient, BreEStim demonstrated greater pain reduction compared to regular EStim, except when a urinary tract infection confounded the pain.
3
Voluntary breathing is crucial for BreEStim's success. Effective electrode placement varies based on whether the target is pain management or spasticity reduction.

Research Summary

Breathing-controlled electrical stimulation (BreEStim) has demonstrated clinical efficacy in spasticity management and subsequent hand function recovery in chronic stroke patients, as well as management of neuropathic pain of central origin in the above patient with a spinal cord injury or of peripheral origin in a patient with above-the-knee amputation. BreEStim encourages active engagement of patients since voluntary breathing is required. Patients feel they actively participate in managing their pain, rather than 'a passive participant in their own care'. In summary, this breathing-driven stimulation, BreEStim, is based on the newly discovered phenomenon of intrinsic physiological coupling activated during voluntary breathing. The BreEStim protocol has demonstrated clinical efficacy for neuropathic pain and post-stroke spasticity management.

Practical Implications

Enhanced Pain Management

BreEStim offers an alternative non-pharmacological treatment, particularly beneficial when neuropathic pain is difficult to manage with medication.

Improved Motor Rehabilitation

BreEStim's patient-centered approach and integration of voluntary breathing can lead to more effective spasticity reduction and motor recovery in stroke patients.

Broader Clinical Applications

The unique approach of BreEStim opens possibilities for treating patients with severe spasticity who are unable to perform voluntary contractions, expanding the applicability of electrical stimulation therapies.

Breathing-controlled Electrical Stimulation (BreEStim) for Management of Neuropathic Pain and Spasticity

Simple Explanation

Key Findings

Research Summary

Practical Implications

Enhanced Pain Management

Improved Motor Rehabilitation

Broader Clinical Applications

Study Limitations

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Breathing-controlled Electrical Stimulation (BreEStim) for Management of Neuropathic Pain and Spasticity

Simple Explanation

Key Findings

Research Summary

Practical Implications

Enhanced Pain Management

Improved Motor Rehabilitation

Broader Clinical Applications

Study Limitations

Your Feedback

Was this summary helpful?