Biomedical subjects

D M Walsh

Publications and source records attributed to D M Walsh.

At least 19 recordsLinked to original sources

PubMed2007

Rapid assessment of severe cognitive impairment in individuals with developmental disabilities.

BACKGROUND: Most standardized intelligence tests require more than 1 hour for administration, which is problematic when evaluating individuals with intellectual disabilities and developmental disabilities (IDDD), because a significant proportion of these individuals can not tolerate lengthy evaluations. Furthermore, most standardized intelligence tests are of limited usefulness for individuals with severe cognitive deficits because of floor effects. METHODS: A number of low-difficulty items were selected from standardized tests. A total of 271 participants with profound, severe, moderate and mild levels of cognitive impairment took part in this study. In the formative phase, 68 participants were evaluated with the selected items, and those items that differentiated between levels of cognitive impairment were retained in the battery. The instrument was then modified and standardized with an additional 203 participants. RESULTS: The instrument, referred to as the Rapid Assessment for Developmental Disabilities (RADD), required 10-25 min for administration. Internal reliability estimates from the RADD total score and from individual subtests satisfied conventional and rigorous statistical criteria (median alpha r = 0.93). The RADD total score was strongly correlated with the level of cognitive impairment (rho = 0.86). The RADD total score and individual subtests differentiated between all levels of cognitive impairment ( Wilks Lambda = 0.135, F(42,525.832) = 12.075, P < 0.001). Receiver operating characteristic curves indicated the instrument was particularly sensitive to the cognitive abilities of the most seriously impaired participants. CONCLUSIONS: The RADD, composed of low-difficulty items from published tests, is rapidly administered, assesses a wide range of cognitive skills and differentiates among all levels of cognitive impairment. The battery has clinical utility with populations exhibiting short attention spans because of its ability to quickly assess a wide range of cognitive abilities. The RADD also has research potential for the documentation of cognitive function in studies of individuals with IDDD.

Adolescent↗

PubMed2006

Organisms as natural purposes: the contemporary evolutionary perspective.

Kant's conception of organisms as natural purposes raises a challenge to the adequacy of mechanistic explanation in biology. Certain features of organisms appear to be inexplicable by appeal to mechanical law alone. Some biological phenomena, it seems, can only be accounted for teleologically. Contemporary evolutionary biology has by and large ignored this challenge. It is widely held that Darwin's theory of natural selection gives us an adequate, wholly mechanical account of the nature of organisms. In contemporary biology, the category of the organism plays virtually no explanatory role. Contemporary evolutionary biology is a science of sub-organismal entities-replicators. I argue that recent advances in developmental biology demonstrate the inadequacy of sub-organismal mechanism. The category of the organism, construed as a 'natural purpose' should play an ineliminable role in explaining ontogenetic development and adaptive evolution. According to Kant the natural purposiveness of organisms cannot be demonstrated to be an objective principle in nature, nor can purposiveness figure in genuine explain. I attempt to argue, by appeal to recent work on self-organization, that the purposiveness of organisms is a natural phenomenon, and, by appeal to the apparatus of invariance explanation, that biological purposiveness provides genuine, ineliminable biological explanations.

Biological Evolution↗

PubMed2006

Mitochondrial-related gene expression changes are sensitive to agonal-pH state: implications for brain disorders.

Mitochondrial defects in gene expression have been implicated in the pathophysiology of bipolar disorder and schizophrenia. We have now contrasted control brains with low pH versus high pH and showed that 28% of genes in mitochondrial-related pathways meet criteria for differential expression. A majority of genes in the mitochondrial, chaperone and proteasome pathways of nuclear DNA-encoded gene expression were decreased with decreased brain pH, whereas a majority of genes in the apoptotic and reactive oxygen stress pathways showed an increased gene expression with a decreased brain pH. There was a significant increase in mitochondrial DNA copy number and mitochondrial DNA gene expression with increased agonal duration. To minimize effects of agonal-pH state on mood disorder comparisons, two classic approaches were used, removing all subjects with low pH and agonal factors from analysis, or grouping low and high pH as a separate variable. Three groups of potential candidate genes emerged that may be mood disorder related: (a) genes that showed no sensitivity to pH but were differentially expressed in bipolar disorder or major depressive disorder; (b) genes that were altered by agonal-pH in one direction but altered in mood disorder in the opposite direction to agonal-pH and (c) genes with agonal-pH sensitivity that displayed the same direction of changes in mood disorder. Genes from these categories such as NR4A1 and HSPA2 were confirmed with Q-PCR. The interpretation of postmortem brain studies involving broad mitochondrial gene expression and related pathway alterations must be monitored against the strong effect of agonal-pH state. Genes with the least sensitivity to agonal-pH could present a starting point for candidate gene search in neuropsychiatric disorders.

Antidepressive Agents↗

PubMed2005

The role of cell-derived oligomers of Abeta in Alzheimer's disease and avenues for therapeutic intervention.

Burgeoning evidence suggests that soluble oligomers of Abeta (amyloid beta-protein) are the earliest effectors of synaptic compromise in Alzheimer's disease. Whereas most other investigators have employed synthetic Abeta peptides, we have taken advantage of a beta-amyloid precursor protein-overexpressing cell line (referred to as 7PA2) that secretes sub-nanomolar levels of low-n oligomers of Abeta. These are composed of heterogeneous Abeta peptides that migrate on SDS/PAGE as dimers, trimers and tetramers. When injected into the lateral ventricle of rats in vivo, these soluble oligomers inhibit hippocampal long-term potentiation and alter the memory of a complex learned behaviour. Biochemical manipulation of 7PA2 medium including immunodepletion with Abeta-specific antibodies and fractionation by size-exclusion chromatography allowed us to unambiguously attribute these effects to low-n oligomers. Using this paradigm we have tested compounds directed at three prominent amyloid-based therapeutic targets: inhibition of the secretases responsible for Abeta production, inhibition of Abeta aggregation and immunization against Abeta. In each case, compounds capable of reducing oligomer production or antibodies that avidly bind Abeta oligomers also ameliorate the synaptotoxic effects of these natural, cell-derived oligomers.

Alzheimer Disease↗

PubMed2005

An investigation of the impact of the Force Sensing Array pressure mapping system on the clinical judgement of occupational therapists.

OBJECTIVES: To examine the impact of pressure mapping technology on the clinical decisions of occupational therapists and to examine the role of the Braden Scale in assisting with the selection of pressure-reducing cushions. DESIGN: Case studies. SETTING: Community. SUBJECTS: Forty clients. INTERVENTIONS: Clients were pressure mapped on their current seating surface and on four pre-selected cushions by the principal researcher. An occupational therapist completed the Braden Scale and a decision tree to assist in recommending a suitable pressure-reducing cushion. MAIN OUTCOME MEASURES: Interface pressure maps, Braden Scale, and the cushion recommended, using a decision tree to guide clinical judgement. RESULTS: Thirty per cent (12) of the 40 cushions recommended were changed when the pressure maps from the Force Sensing Array (FSA) system were viewed. In 70% (26) of cases, the maps supported the cushion recommended. In 25% (10) of the cases, the maps showed that the client's current seating surface was unsuitable. After viewing the pressure maps, a surface other than the client's current surface was recommended in 47% (19) of the cases. There was a lack of agreement between the risk level of the clients as identified by the Braden Scale score, and the risk level of the clients as identified by the occupational therapist using a decision tree and the FSA maps. CONCLUSION: Pressure mapping technology has a positive impact on clinical decisions regarding the provision of pressure-reducing cushions. Future research should examine the predictive validity of this technology. The Braden Scale may underpredict the risk level of the clients.

Activities of Daily Living↗

PubMed2004

Dysregulation of the fibroblast growth factor system in major depression.

In this report we describe findings that imply dysregulation of several fibroblast growth factor (FGF) system transcripts in frontal cortical regions of brains from human subjects with major depressive disorder (MDD). This altered gene expression was discovered by microarray analysis of frontal cortical tissue from MDD, bipolar, and nonpsychiatric control subjects and was verified by quantitative real-time PCR analysis and, importantly, in a separate cohort of MDD subjects. Furthermore, we show, through a separate analysis of specific serotonin reuptake inhibitor (SSRI)-treated and non-SSRI-treated MDD subjects that the observed changes in expression of FGF transcripts are not secondary to drug treatment. Rather, changes in specific FGF transcripts are attenuated by SSRIs and may thus be partially responsible for the mechanism of action of these drugs. We also make available the gene-expression profile of all of the other growth factors and growth factor receptors detected in these postmortem samples.

Adult↗

PubMed2003

A pilot investigation of the hypoalgesic effects of transcutaneous electrical nerve stimulation upon low back pain in people with multiple sclerosis.

OBJECTIVE: To investigate the hypoalgesic effects of transcutaneous electrical nerve stimulation (TENS) upon low back pain (LBP) in people with multiple sclerosis (MS). DESIGN: A randomized double-blind placebo controlled clinical pilot study. SUBJECTS AND SETTING: Fifteen people with MS were recruited and randomly allocated to one of the following groups under double blind conditions (n = 5 per group): TENS 1 (4 Hz, 200 micros), TENS 2 (110 Hz, 200 micros), placebo TENS. INTERVENTIONS: Treatment was applied for 45 minutes three times a week for six weeks with a four-week follow-up. OUTCOME MEASURES: The following outcome measures were taken at weeks 1, 6, and 10: visual analogue scale (VAS) (for current LBP, right leg pain, left leg pain); Leeds Multiple Sclerosis Quality of Life Questionnaire; Roland Morris Disability Questionnaire; Short Form-36 (SF-36) Version 1; and the McGill Pain Questionnaire (MPQ). VAS for current LBP, right and left leg pain were also taken before and after treatment, and once a week during the follow-up period. RESULTS: Analysis showed no statistically significant effects for any of the data. However, both active treatment groups showed a trend of improvement in the majority of the outcome measures. CONCLUSION: Active TENS was more effective than placebo TENS in decreasing VAS scores following each treatment although results were not statistically significant. Further work in this area is warranted and should include a larger number of participants in the form of a randomized controlled clinical trial to determine the efficacy of this modality.

Adult↗

PubMed2002

Amyloid-beta oligomers: their production, toxicity and therapeutic inhibition.

Despite extensive genetic and animal modelling data that support a central role for the amyloid beta-protein (A beta) in the genesis of Alzheimer's disease, the specific form(s) of A beta which causes injury to neurons in vivo has not been identified. In the present study, we examine the importance of soluble, pre-fibrillar assemblies of A beta as mediators of neurotoxicity. Specifically, we review the role of cell-derived SDS-stable oligomers, their blocking of hippocampal long-term potentiation in vivo and the finding that this blocking can be prevented by prior treatment of oligomer-producing cells with gamma-secretase inhibitors.

Alzheimer Disease↗

PubMed2002

Interferential therapy: lack of effect upon experimentally induced delayed onset muscle soreness.

This study was designed to assess the analgesic effects of interferential therapy (IFT) on experimentally induced muscular pain under randomized, double-blind, placebo-controlled conditions. After ethical approval and written consent were obtained, 40 healthy human volunteers (20 males: 20 females) aged 18-25 years were recruited and randomly assigned to one of four experimental groups (n = 10 per group: male = female): IFT 1, IFT 2, control or placebo. Delayed onset muscle soreness (DOMS) was induced in the elbow flexors of the non-dominant arm of each subject using a single bout of eccentric exercises to exhaustion. Measurements of isometric peak torque, resting angle, mechanical pain threshold and visual analogue scales were performed at set time points. Treatment was applied for 30 min daily over the biceps brachii muscle, for five consecutive days, according to group allocation. IFT 1 received 10-20 Hz, whilst subjects in IFT 2 were treated with 80-100 Hz (bi-pole; carrier frequency: 4 kHz; pulse duration: 125 microseconds). For the placebo group, the procedure was identical to that in the active treatment groups; however, no interferential current was delivered. The control group received no treatment. No significant between group difference was identified at any time point (P > or = 0.14). However, some inconsistent, yet significant differences in daily treatment effects, interactive effects and effects over time were detected. Based on the results of this study it can be concluded that application of IFT at the parameters used here, had no overall beneficial effect on DOMS.

Adolescent↗

PubMed2002

The effect of a first vaginal delivery on the integrity of the pelvic floor musculature.

OBJECTIVE: To assess the specific effect of delivery of the first child on the integrity of the pelvic floor musculature. DESIGN: A prospective study of two groups of females with no symptoms of urinary incontinence. SETTING: Physiotherapy Department, Rotunda Lying In Hospital, Dublin. SUBJECTS: Two groups of healthy female physiotherapists (age range 20-28 years) were recruited for the study: group 1 consisted of nulliparous females (n = 10) and group 2 consisted of primiparous females who were 9-10 months post delivery (n = 10). INTERVENTION AND MAIN OUTCOME MEASURES: Assessment of the pelvic floor musculature was performed by digital assessment, electromyography and perineometry. RESULTS: For all data, the nulliparous group showed evidence of greater pelvic floor strength and endurance. Analysis of anterior and posterior electromyography data showed significantly stronger contractions in the nulliparous group (p = 0.0001 and 0.044). During a maximum contraction of the pelvic floor muscles, the anterior resting EMG activity increased by 9 +/- 6 microV (mean +/- SD) in the primiparous group compared with an increment of 22.3 +/- 4.74 microV in the nulliparous group. Posterior EMG resting activity increased by 19.7 +/- 7.65 microV (mean +/- SD) in the nulliparous group compared with 13.8 +/- 8.19 microV in the primiparous group. There were significant differences between the two groups for the four types of digital muscle assessment (p < 0.0013). In addition, there was a greater increase in perineometry readings in the nulliparous group (increment = 5.6 +/- 2.5, mean +/- SD) compared with the primiparous group (increment = 3.1 +/- 0.9; mean +/- SD). CONCLUSIONS: This study suggests that irrespective of lack of symptoms of urinary incontinence, it would appear advisable that all women should undertake a prescribed programme of pelvic floor rehabilitation exercises after childbirth.

Adult↗

PubMed2001

In vitro studies of amyloid beta-protein fibril assembly and toxicity provide clues to the aetiology of Flemish variant (Ala692-->Gly) Alzheimer's disease.

In a Flemish kindred, an Ala(692)-->Gly amino acid substitution in the amyloid beta-protein precursor (AbetaPP) causes a form of early-onset Alzheimer's disease (AD) which displays prominent amyloid angiopathy and unusually large senile plaque cores. The mechanistic basis of this Flemish form of AD is unknown. Previous in vitro studies of amyloid beta-protein (Abeta) production in HEK-293 cells transfected with cDNA encoding Flemish AbetaPP have shown that full-length [Abeta(1-40)] and truncated [Abeta(5-40) and Abeta(11-40)] forms of Abeta are produced. In an effort to determine how these peptides might contribute to the pathogenesis of the Flemish disease, comparative biophysical and neurotoxicity studies were performed on wild-type and Flemish Abeta(1-40), Abeta(5-40) and Abeta(11-40). The results revealed that the Flemish amino acid substitution increased the solubility of each form of peptide, decreased the rate of formation of thioflavin-T-positive assemblies, and increased the SDS-stability of peptide oligomers. Although the kinetics of peptide assembly were altered by the Ala(21)-->Gly substitution, all three Flemish variants formed fibrils, as did the wild-type peptides. Importantly, toxicity studies using cultured primary rat cortical cells showed that the Flemish assemblies were as potent a neurotoxin as were the wild-type assemblies. Our results are consistent with a pathogenetic process in which conformational changes in Abeta induced by the Ala(21)-->Gly substitution would facilitate peptide adherence to the vascular endothelium, creating nidi for amyloid growth. Increased peptide solubility and assembly stability would favour formation of larger deposits and inhibit their elimination. In addition, increased concentrations of neurotoxic assemblies would accelerate neuronal injury and death.

Alanine↗

PubMed2001

The effect of three electrotherapeutic modalities upon peripheral nerve conduction and mechanical pain threshold.

The current study was designed to examine the neurophysiological and hypoalgesic effects of three types of electrical stimulation. Following approval by the University's Research Ethical Committee, healthy volunteers (n=40; 20 males and 20 females; age 20-40 years; mean age 26.18 years) were recruited and screened for contraindications. Subjects were randomly allocated in equal numbers to the following groups: control, transcutaneous electrical nerve stimulation (TENS; 150 Hz, 125 micros), interferential therapy (IFT; 150 Hz, 125 micros) or action potential stimulation therapy (APS; 153 Hz, 6.4 ms). All treatments were applied under double-blind conditions for 15 min over the course of the median nerve in the subject's right forearm. Antidromic median nerve compound action potentials (CAPs) were recorded pretreatment, immediately post-treatment (i.e. at 15 min) and then at 25, 35 and 45 min. Immediately following CAP recording, mechanical pain threshold (MPT) was recorded from two sites on the palmar surface of the right hand. Statistical analysis showed significant differences between groups for peak to peak amplitude (PPA) at 25, 35 and 45 min (Kruskal-Wallis: P=0.01, 0.01 and 0.02). Mann-Whitney U-tests indicated a significant increase in PPA in the IFT group compared with all other groups at 25 and 35 min and compared with the TENS and APS groups at 45 min. No significant differences were found for the MPT data. This study has therefore demonstrated that none of the aforementioned modalities produced a significant hypoalgesic effect; however, IFT produced a significant change in PPA compared with TENS and APS.

Action Potentials↗

PubMed2001

Interferential therapy electrode placement technique in acute low back pain: a preliminary investigation.

OBJECTIVE: To determine the efficacy of interferential therapy (IFT) electrode placement technique compared with a control treatment in subjects with acute low back pain (LBP). DESIGN: Single-blind, randomized, controlled trial with a 3-month follow-up. SETTING: Outpatient physiotherapy departments in hospital and university settings. PATIENTS: A random sample of 60 eligible patients with back pain (28 men, 32 women) were recruited by general practitioners and self-referral for physiotherapy treatment and randomly assigned to 1 of 3 groups. INTERVENTIONS: (1) "IFT painful area" and The Back Book, (2) "IFT spinal nerve" and The Back Book, and (3) "Control," The Back Book only. Standardized IFT stimulation parameters were used: carrier frequency 3.85 kHz; 140 Hz constant; pulse duration 130 micros; 30 minutes' duration. MAIN OUTCOME MEASURES: Pain Rating Index, Roland-Morris Disability Questionnaire (RMDQ), and EuroQol were completed by subjects pretreatment, at discharge, and 3-month follow-up. RESULTS: All groups had significant improvements in all outcomes at follow-up. Subjects managed by IFT spinal nerve and The Back Book displayed both a statistically significant (p = .030) and clinically meaningful reduction in functional disability (RMDQ), compared with management via IFT painful area and The Back Book combined or The Back Book alone. CONCLUSIONS: The findings showed that IFT electrode placement technique affects LBP-specific functional disability, providing preliminary implications for future clinical studies.

Acute Disease↗

PubMed2001

A study of the use of acupuncture in physiotherapy.

OBJECTIVES: This two-phase study was designed to establish the current use of acupuncture within physiotherapy and to determine the opinions of those who received acupuncture therapy. DESIGN: Retrospective study and questionnaire survey. PATIENTS: Patients who attended an outpatient physiotherapy department over a 2-year period (phase 1, retrospective study of clinical records; n = 599). Patients who had received acupuncture treatment from outpatient physiotherapy (phase 2, patient survey; n = 200). MAIN OUTCOME MEASURE: Patient records and questionnaire. RESULTS: The patients who attended for outpatient physiotherapy were categorized into three main groups: low back pain, cervical/thoracic spine problems and soft-tissue injuries of peripheral joints. Acupuncture appeared to be used as a secondary form of treatment for these conditions, where other modalities failed rather than being used for best effect. The response rate to the questionnaire was 78%, of whom 60% stated that they had experienced pain relief following their acupuncture therapy, and 31% were still experiencing pain relief. The majority had achieved sufficient relief to carry out daily activities at home (80%) and at work (57%). Ninety-four per cent of respondents were either 'satisfied' or 'very satisfied' with their treatment. CONCLUSION: Further investigation is required to adequately assess the efficacy of acupuncture as a pain-relieving modality.

Acupuncture Therapy↗

PubMed2001

Transcutaneous electrical nerve stimulation (TENS): the effect of electrode placement upon cutaneous blood flow and skin temperature.

In the current study the effect of electrode placement on cutaneous blood flow and skin temperature were assessed using laser Doppler flowmetry. Following approval from the University's ethical committee, 30 subjects were recruited (15 male: 15 female) and randomly assigned to a control or one of two treatment groups (n=10 all groups). TENS was applied either over the median nerve or to the Hegyu acupuncture point (L.I.4) for 15 minutes. Blood flow and skin temperature data were recorded during TENS and for 15 minutes post TENS. Analysis of results showed significant differences between groups for cutaneous blood flow (p=0.0001; repeated measures ANOVA). There was a significant increase in blood flow in the TENS median nerve group compared with the other two groups during TENS application. No significant changes in skin temperature were observed between groups. This study demonstrates that the effect of TENS upon cutaneous blood flow is dependent upon electrode placement sites.

Acupuncture Points↗

PubMed2000

The oligomerization of amyloid beta-protein begins intracellularly in cells derived from human brain.

The progressive aggregation and deposition of amyloid beta-protein (Abeta) in brain regions subserving memory and cognition is an early and invariant feature of Alzheimer's disease, the most common cause of cognitive failure in aged humans. Inhibiting Abeta aggregation is therapeutically attractive because this process is believed to be an exclusively pathological event. Whereas many studies have examined the aggregation of synthetic Abeta peptides under nonphysiological conditions and concentrations, we have detected and characterized the oligomerization of naturally secreted Abeta at nanomolar levels in cultures of APP-expressing CHO cells [Podlisny, M. B., Ostaszewski, B. L., Squazzo, S. L., Koo, E. H., Rydell, R. E., Teplow, D. B., and Selkoe, D. J. (1995) J. Biol. Chem. 270, 9564-9570 (1); Podlisny, M. B., Walsh, D. M., Amarante, P., Ostaszewski, B. L., Stimson, E. R., Maggio, J. E., Teplow, D. B., and Selkoe, D. J. (1998) Biochemistry 37, 3602-3611 (2)]. To determine whether similar species occur in vivo, we probed samples of human cerebrospinal fluid (CSF) and detected SDS-stable dimers of Abeta in some subjects. Incubation of CSF or of CHO conditioned medium at 37 degrees C did not lead to new oligomer formation. This inability to induce oligomers extracellularly as well as the detection of oligomers in cell medium very early during the course of pulse-chase experiments suggested that natural Abeta oligomers might first form intracellularly. We therefore searched for and detected intracellular Abeta oligomers, principally dimers, in primary human neurons and in neuronal and nonneural cell lines. These dimers arose intracellularly rather than being derived from the medium by reuptake. The dimers were particularly detectable in neural cells: the ratio of intracellular to extracellular oligomers was much higher in brain-derived than nonbrain cells. We conclude that the pathogenically critical process of Abeta oligomerization begins intraneuronally.

Amyloid beta-Peptides↗

PubMed2000

Lack of effect of pulsed low-intensity infrared (820 nm) laser irradiation on nerve conduction in the human superficial radial nerve.

BACKGROUND AND OBJECTIVE: To investigate the effect of pulsed low-intensity laser irradiation on nerve conduction in the human superficial radial nerve and on temperature in the skin overlying the nerve. STUDY DESIGN/MATERIALS AND METHODS: Thirty-two healthy human volunteers were recruited and randomly assigned to either placebo, laser 1 (9.12 Hz), laser 2 (73 Hz), or control groups (n = 8 all groups). A GaAlAs laser diode (820 nm, 50 mW peak) was used to irradiate the skin overlying the right superficial radial nerve at three points (1.2 J per point; energy density, 9.55 J/cm(2)). Antidromic action potentials were recorded from the superficial radial nerve preirradiation and at 5, 10, and 15 minutes after irradiation. Skin temperature was monitored concomitantly by using two surface thermistor probes attached to the skin overlying the nerve. RESULTS: Repeated measures analysis of variance showed no significant differences between groups for negative peak latency nor skin temperature data after laser irradiation. CONCLUSION: This study has demonstrated that laser irradiation at the radiant exposure and pulsing parameters indicated did not produce any specific neurophysiologic effects in this model of nerve function.

Action Potentials↗

PubMed2000

A controlled study on the effects of transcutaneous electrical nerve stimulation and interferential therapy upon the RIII nociceptive and H-reflexes in humans.

OBJECTIVE: To study the effect of transcutaneous electrical nerve stimulation (TENS) and interferential therapy (IFT) upon the RIII nociceptive reflex and H-reflex. DESIGN: Double-blind conditions. PARTICIPANTS: Seventy healthy subjects were randomly allocated to one of seven groups (n = 10 per group): Control, TENS 1 (5 Hz), TENS 2 (100 Hz), TENS 3 (200 Hz), IFT 1 (5 Hz), IFT 2 (100 Hz), IFT 3 (200 Hz). INTERVENTION: In the treatment groups, stimulation was applied over the right sural nerve for 15 minutes. MAIN OUTCOME MEASURES: Ipsilateral RIII and H-reflexes were recorded before treatment, immediately after treatment, and subsequently at 25, 35, and 45 minutes. Subjects rated the pain associated with the RIII reflex using a computerized visual analogue scale (VAS). RESULTS: Statistical analysis using ANOVA showed no significant differences between baseline and posttreatment measurement for RIII reflex, H-reflex, or VAS data. CONCLUSION: These results suggest that neither type of electrical stimulation (TENS or IFT) affects the RIII or H-reflexes, at least using the parameters and application time in this study.

Adolescent↗