1.Chronic Pain and Erectile Dysfunction: Mechanism, Treatment, and Future Perspective
I Putu Eka Widyadharma ; Eric Hartono Tedyanto ; I Made Oka Adnyana ; Ida Ayu Sri Wijayanti
Malaysian Journal of Medicine and Health Sciences 2024;20(No.1):304-311
Erectile dysfunction is a problem with multiple causes and is challenging to diagnose. Chronic pain has been associated with erectile dysfunction in some studies. Chronic pain can be a potential direct or indirect cause of sexual
dysfunction. A decreased sexual desire due to restricted sexual activity in chronic pain can result in erectile dysfunction. Erectile dysfunction has been linked to migraines, chronic pain, and psychological factors. Multiple neurotransmitters may contribute to the pathophysiology of erectile dysfunction. Depression and anxiety, as well as painkillers
like pregabalin and opioids, can be indirect causes of erectile dysfunction. Numerous factors affect the occurrence
of erectile dysfunction; therefore, erectile dysfunction must be treated holistically.
2.EMG-TRIGGERED NEUROMUSCULAR ELECTRICAL STIMULATION FOR MUSCULOSKELETAL REHABILITATION OF STROKE
Ni Made Dwita Pratiwi ; Eric Hartono Tedyanto ; I Komang Arimbawa ; Jessica Amelinda Mintarjo ; I Putu Eka Widyadharma
Journal of University of Malaya Medical Centre 2024;27(1):106-112
EMG-TRIGGERED NEUROMUSCULAR ELECTRICAL STIMULATION FOR MUSCULOSKELETAL REHABILITATION OF STROKE
A decline in stroke-related mortality has led to an increased prevalence of post-stroke complications, globally. One of the most significant clinical effects of stroke are musculoskeletal problems. Musculoskeletal issues are typically induced by hemiplegia and they occur on the affected side. They also may not appear for weeks or months after a stroke. The most frequent musculoskeletal complications of stroke include motor loss, spasticity, shoulder discomfort, and wrist flexion contracture. Neuromuscular electrical stimulation (NMES) is a rehabilitation technique advised for stroke patients. NMES contracts muscles innervated by an external electrical stimulus, with or without patient participation (active or passive). There is evidence that NMES can strengthen muscles, reduce spasticity, increase corticospinal neural circuit excitability, and improve neuroplasticity. Electromyogram (EMG)-triggered NMES is a device that identifies subtle electrical EMG signals that remain discernible in paralyzed muscles after a stroke and utilizes these signals to trigger electrical stimulation impulses to the same paralyzed muscles, resulting in muscle movement. A study found that EMG-triggered NMES was superior to cyclic-NMES for increasing wrist extension and grip strength following the intervention.


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