Unit:
Τομέας ΧειρουργικήςLibrary of the School of Health Sciences
Author:
Konstantopoulos Theofanis
Dissertation committee:
Δέσποινα Περρέα, Ομότιμη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Σωτήριος Γεωργόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Κόντζογλου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Χρήστος Βερύκοκος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Δημήτριος Δημητρούλης, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεράσιμος Τσουρούφλης, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Στυλιανός Κύκαλος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Μελέτη παραγόντων αγγειογένεσης κατά τη διαλείπουσα εφαρμογή ηλεκτρικού νευρομυϊκού ερεθισμού σε ασθενείς με περιφερική αποφρακτική αρτηριοπάθεια
Translated title:
Study of angiogenetic factors after intermittent application of electrical neuromuscular stimulation in patients with peripheral arterial disease
Summary:
For many years, electrical muscle stimulation (EMS) has been widely used in medicine and mostly in physical therapy and rehabilitation, as a means of achieving quicker recovery times after muscle damage and trauma. Although the phenomenon of the transcutaneous muscle stimulation through low intensity electrical current has been largely studied, there are not safe and sound conclusions on the exact way the method works, the way it affects muscle growth and the gains for the patients . Aim of our study was to investigate whether transcutaneous electrical muscle stimulation could affect in a positive way patients with peripheral arterial disease (PAD), a disease widespread in the western world and expected to affect a growing part of the population . The positive effects of exercise and especially walking have been proved in patients presenting with PAD which are considered a crucial part of the conservative therapy and an adjunct to surgical therapy. The hypothesis that EMS in patients with PAD could subltitute walking and therefore help those patients adhere to a daily training and exercising protocol is quite attractive. Patients were selected with PAD criteria and were divided in two groups, 25 in study group and 10 in control group. After two 20 minute EMS sessions separated by a 10 minute break and a virtual application in control group, we studied the effect of EMS in the release of Vascular Endothelial Growth Factor (VEGF) (and it’s release in accordance to pO2, pCO2 and pH) which is considered a precursor for angiogenesis and new vascular bed formation . Aim of the EMS application was to simulate walking by stimulating as much muscle mass as possible without signs of exertion and without increased cardiovascular demand as patients remained bedsided. Laboratory analysis was performed before and after EMS application so as to investigate for possible VEGF levels increase and the possible correlation to patient demographics and particularly correlation to levels of partial Oxygen (pO2) and Carbon Dioxide (pCO2) pressure and pH measurement in peripheral blood measurements. Results did not reveal increase in VEGF levels which was the main requisite of the study hypothesis, but in three out of 24 patients and so the study hypothesis can not be confirmed. On the other hand, four out of ten patients in control group had their VEGF levels increased but no electrical current was applied. What is interesting though is the fact that all three patients that had their VEGF levels increased in study group had at the same time an increase in pCO2, increase in lactic acid and decrease in pH measurement, all those factors revealing increase in muscle workload, which was not observed in the control group. From our findings we can conclude that either EMS does not significantly affect PAD patients or that EMS application parameters were not properly designed and applied. Although the study used a small number of patients and so a significant statistical conlusion can not be extracted, there is a hint that when EMS produces significant muscle workload, then this is going to lead to VEGF increase. New studies have to focus in increased time of EMS application and stimulation as to reveal possible benefits for PAD patients.
Main subject category:
Health Sciences
Other subject categories:
Medicine
Surgical specialties
Keywords:
TENS, EMS, VEGF, PAD
