Annals of Rehabilitation Medicine

Stimulation Intensity of Functional Electrical Stimulation on Hemiplegic Upper Extremity.: Han, Tai Ryoon , Lim, Suk Jin , Kim, Dai Youl , Lee, Kyu Jin; J Korean Acad Rehabil Med 2002;26(4):379-384.

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Objective: This study aimed to assess optimal stimulation intensity and to investigate other variables on functional electrical stimulation (FES) for hemiplegic upper limb.

Method: We divided hemiplegic subjects into two groups, acute (n=28) and chronic (n=18), and control subjects into old (n=26) and young (n=27). Electrical stimulation was performed on the forearm of both sides in hemiplegic patients and of the nondominant side in normal controls. The stimulation site that aimed at open hand motion was targeted to the extensor digitorum and extensor pollicis brevis muscles. We measured the peak to peak amount of current and skin impedance while making hand extension.

Results: The acute and chronic hemiplegic groups required a greater current than the control groups (p＜0.01). The hemiplegic side required a greater current than the non- hemiplegic side (p＜0.001). There was no significant difference of current amount between the acute and chronic hemiplegic groups. The current amount was significantly correlated with subject's age (p=0.001). No difference of skin impedance was found among any of the groups.

Conclusion: Irrespective of disease duration on hemiplegia, a greater current is required in the hemiplegic upper limb than in the normal upper limb. Age was an important factor in determining stimulation intensity. (J Korean Acad Rehab Med 2002; 26: 379-384)

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Diagnostic Usefulness of Dermatomal Somatosensory Evoked Potentials by Low Intensity Stimulation in Lumbar Radiculopathy.: Seo, Jeong Hwan , Kim, Ji Yeon , Ko, Myoung Hwan , Eun, Jong Pil; J Korean Acad Rehabil Med 2007;31(3):341-345.

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Objective
To investigate diagnostic usefulness of dermatomal somatosensory evoked potentials (DSEP) in the evaluation of lumbar radiculopathy using stimulation intensity lower than conventional stimulation intensity. Method: Fifty-seven patients with low back pain were studied with DSEP and needle electromyography (EMG). The radiculopathy was diagnosed by lumbar MRI or operative findings. The DSEP study was performed with stimulation intensity of 1.0×, 1.5×, 2.5× sensory threshold, respectively. We compared the sensitivity and specificity of DSEP and needle EMG in the evaluation of L5 radiculopathy. Results: Radiological and operative findings revealed unilateral herniated disc and L5 root compression in 38 patients (66.7%). Nineteen patients had no significant L5 root compression. The sensitivity and specificity of abnormality were 68.4% and 78.9% in 1.0× sensory threshold stimulation; 71.1%, 78.9% in 1.5× sensory threshold stimulation; and 44.7%, 84.2% in 2.5× sensory threshold stimulation, respectively. Whereas they were 55.2% and 100% in needle EMG. Conclusion: DSEP using low stimulus intensity showed higher sensitivity in the diagnosis of L5 radilculopathy, and DSEP might provide additional diagnostic usefulness in the evaluation of patients with suspected L5 radiculopathy. (J Korean Acad Rehab Med 2007; 31: 341-345)

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Reference Data of Cervical Dermatomal Somatosensory Evoked Potentials Using Low Intensity Stimulation and Report of 2 Cases.: Seo, Min Ho , Park, Sung Hee , Ko, Myoung Hwan , Eun, Jong Pil , Seo, Jeong Hwan; J Korean Acad Rehabil Med 2011;35(2):236-242.

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Objective
To establish reference data for dermatomal somatosensory evoked potentials (DSEP) using a stimulation intensity lower than what is conventionally utilized. Method Fifty subjects (25 older adults＞48 years old; 25 younger adults＜32 years old) without history of neck pain or cervical spine surgery were enrolled. The DSEP study was performed with stimulation intensities of 1.0, 1.5, and 2.5 times sensory threshold (ST) on right arms for C5, C6, C7, and C8 dermatomes. Results The mean latencies of DSEP stimulating C5, C6, C7, and C8 dermatomes with 1.5 times ST intensity were 17.6±1.7 ms, 22.2±2.1 ms, 22.8±1.4 ms, and 22.6±1.8 ms, respectively. The mean amplitude (N1P1) of DSEP stimulating C5, C6, C7, and C8 dermatomes with 1.5 times ST intensity were 0.9±0.4 ՌV, 0.9±0.5 ՌV, 1.0±0.6 ՌV, and 1.1±0.8 ՌV, respectively. The C5, C6, C7, and C8 DSEP were evoked in 84%, 98%, 100%, and 96% of cases with 2.5 times ST compared to 64%, 56%, 60%, and 62% with 1.5 times ST, respectively. When one DSEP was not evoked, the DSEP of the opposite side was evoked only in 2 subjects. Conclusion This study provides the reference data of DSEP with lower stimulation intensities than are conventionally utilized. Additionally, two cases of clinical significance were reported.