(Figure 2) Figura 2 Positioning of patient for pendulum test The

(Figure 2) Figura 2 Positioning of patient for pendulum test. The measurements were performed in the right leg of the patient and repeated three times. Prior to each experiment, another Nutlin-3a Sigma researcher evaluated spasticity through the modified Ashworth scale. We conducted a subjective scale before and after the NMES session. A scale from 0 to 10 where 0 represents no spasticity and 10 high spasticity was shown to the patients. They were asked to rank their perception of spasticity before performing pre -training evaluation with neuromuscular electrical stimulation and before the post-training assessment. 2nd Step Neuromuscular electrical stimulation (NMES): At this stage the patients performed NMES through a 4-channel electrical stimulator that features a 25Hz signal with 300��s duration and maximum intensity 100mV (1K�� load) monophasic rectangular pulses.

NMES was held in the quadriceps muscles and fibular nerve for 20 and 15 min, respectively. 3rd Step Pendulum test: Reassessment was performed after NMES session. Once again, another researcher evaluated spasticity using the Asworth’s scale, and then the pendulum test was performed through the PST device. DATA ANALYSIS The software was developed for the operation of the program, which consists in the analysis of the pendulum test, data collection and projection of graphs. In the data analysis and projection graphs it was possible to check the values of the variation between the peak maximum and minimum of each oscillation peak of the graph. The differences between these peaks were measured curves obtained from each patient before and after the session of NMES.

Figures 3 and and44 show the graphs of the pendulum test of a patient with spinal cord injury. Measurements were made before and after NMES. Figure 3 Curve of the pendulum test before NMES (Right leg). Figure 4 Curve of the pendulum test after NMES (Right leg). In addition to these data, and adopting Stillman’s et al. nomenclature, 11 we calculated the onset angle of the test (onset angle=On Ang ), final angle of the response test (Rest end angle=Rest Ang), the angle at the end of the first flexion movement (F1 Ang), the angle at the end of the first extension movement (Ang E1), the initial flexion amplitude (F1Amp=F1 Ang-On Ang), initial extension amplitude (E1 Amp=F1 ang- E1 Ang), total movement amplitude (Plat Amp=Rest Ang-On Ang), relaxation index (RI=F1 Amp/Plat Amp), and relaxation extension index (REI=E1 Amp/Plat Amp).

RESULTS In Figure 3 it can be seen that the range of motion is reduced and disorganized oscillatory motions are present. This is because there is neither muscle control nor constant oscillation frequency. The start of the movement is marked by an angular position which is generally lower than expected. Typically, the end of the movement is a result of energy loss due to friction caused by the oscillation of the leg with Carfilzomib the air as well as muscle relaxation.

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