Acute Effects of a Session with The EXOPULSE Mollii Suit in a Fibromyalgia Patient: A Case Report

Alejandro Rubio-Zarapuz, María Dolores Apolo-Arenas, Vicente Javier Clemente-Suárez, Ana Rodrigues Costa, David Pardo-Caballero, Jose A Parraca, Alejandro Rubio-Zarapuz, María Dolores Apolo-Arenas, Vicente Javier Clemente-Suárez, Ana Rodrigues Costa, David Pardo-Caballero, Jose A Parraca

Abstract

Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain and associated fatigue, sleep disturbances, and other cognitive and somatic symptoms. A multidisciplinary approach including pharmacological therapies along with behavioral therapy, exercise, patient education, and pain management is a possible solution for the treatment of this disease. The EXOPULSE Mollii® method (EXONEURAL NETWORK AB, Danderyd, Sweden) is an innovative approach for non-invasive and self-administered electrical stimulation with multiple electrodes incorporated in a full-body suit, with already proven benefits for other diseases. Therefore, the present case report study aims to evaluate the effects that a 60 min session with the EXOPULSE Mollii suit has on a female fibromyalgia patient. After the intervention, we can conclude that a 60 min session with the EXOPULSE Mollii suit has beneficial effects on pain perception, muscle oxygenation, parasympathetic modulation, and function in a female fibromyalgia patient.

Keywords: EXOPULSE mollii suit; autonomic modulation; electrostimulation; fibromyalgia; function; muscle oxygenation; pain.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
EXOPULSE Mollii Suit [30].
Figure 2
Figure 2
Mollii Control Unit [30].

References

    1. Bair M.J., Krebs E.E. Fibromyalgia. Ann. Intern. Med. 2020;172:ITC33–ITC48. doi: 10.7326/AITC202003030.
    1. National Institute of Arthritis and Musculoskeletal and Skin Disease Fibromyalgia. [(accessed on 2 January 2023)]; Available online: .
    1. Blanco I., Béritze N., Argüelles M., Cárcaba V., Fernández F., Janciauskiene S., Oikonomopoulou K., de Serres F.J., Fernández-Bustillo E., Hollenberg M.D. Abnormal Overexpression of Mastocytes in Skin Biopsies of Fibromyalgia Patients. Clin. Rheumatol. 2010;29:1403–1412. doi: 10.1007/s10067-010-1474-7.
    1. Moore R.A., Straube S., Aldington D. Pain Measures and Cut-Offs—“No Worse than Mild Pain” as a Simple, Universal Outcome. Anaesthesia. 2013;68:400–412. doi: 10.1111/anae.12148.
    1. Maffei M.E. Fibromyalgia: Recent Advances in Diagnosis, Classification, Pharmacotherapy and Alternative Remedies. Int. J. Mol. Sci. 2020;21:7877. doi: 10.3390/ijms21217877.
    1. Scaturro D., Guggino G., Tumminelli L.G., Ciccia F., Letizia Mauro G. An Intense Physical Rehabilitation Programme Determines Pain Relief and Improves the Global Quality of Life in Patients with Fibromyalgia. Clin. Exp. Rheumatol. 2019;37:670–675.
    1. Scaturro D., Vitagliani F., Tomasello S., Filippetti M., Picelli A., Smania N., Mauro G.L. Can the Combination of Rehabilitation and Vitamin D Supplementation Improve Fibromyalgia Symptoms at All Ages? J. Funct. Morphol. Kinesiol. 2022;7:51. doi: 10.3390/jfmk7020051.
    1. Lin S., Sun Q., Wang H., Xie G. Influence of Transcutaneous Electrical Nerve Stimulation on Spasticity, Balance, and Walking Speed in Stroke Patients: A Systematic Review and Meta-Analysis. J. Rehabil. Med. 2018;50:3–7. doi: 10.2340/16501977-2266.
    1. Dailey D.L., Vance C.G.T., Chimenti R., Rakel B.A., Zimmerman M.B., Williams J.M., Sluka K.A., Crofford L.J. The Influence of Opioids on Transcutaneous Electrical Nerve Stimulation Effects in Women With Fibromyalgia. J. Pain. 2022;23:1268–1281. doi: 10.1016/j.jpain.2022.02.008.
    1. DeSantana J.M., Da Silva L.F.S., De Resende M.A., Sluka K.A. Transcutaneous Electrical Nerve Stimulation at Both High and Low Frequencies Activates Ventrolateral Periaqueductal Grey to Decrease Mechanical Hyperalgesia in Arthritic Rats. Neuroscience. 2009;163:1233–1241. doi: 10.1016/j.neuroscience.2009.06.056.
    1. Kalra A., Urban M.O., Sluka K.A. Blockade of Opioid Receptors in Rostral Ventral Medulla Prevents Antihyperalgesia Produced by Transcutaneous Electrical Nerve Stimulation (TENS) J. Pharmacol. Exp. Ther. 2001;298:257–263.
    1. Maeda Y., Lisi T.L., Vance C.G.T., Sluka K.A. Release of GABA and Activation of GABA(A) in the Spinal Cord Mediates the Effects of TENS in Rats. Brain Res. 2007;1136:43–50. doi: 10.1016/j.brainres.2006.11.061.
    1. Sluka K.A. Blockade of N- and P/Q-Type Calcium Channels Reduces the Secondary Heat Hyperalgesia Induced by Acute Inflammation. J. Pharmacol. Exp. Ther. 1998;287:232–237.
    1. Lisi T.L., Sluka K.A. A New Electrochemical HPLC Method for Analysis of Enkephalins and Endomorphins. J. Neurosci. Methods. 2006;150:74–79. doi: 10.1016/j.jneumeth.2005.06.001.
    1. Ma Y.T., Sluka K.A. Reduction in Inflammation-Induced Sensitization of Dorsal Horn Neurons by Transcutaneous Electrical Nerve Stimulation in Anesthetized Rats. Exp. Brain Res. 2001;137:94–102. doi: 10.1007/s002210000629.
    1. Sluka K.A., Vance C.G.T., Lisi T.L. High-Frequency, but Not Low-Frequency, Transcutaneous Electrical Nerve Stimulation Reduces Aspartate and Glutamate Release in the Spinal Cord Dorsal Horn. J. Neurochem. 2005;95:1794–1801. doi: 10.1111/j.1471-4159.2005.03511.x.
    1. Dailey D.L., Rakel B.A., Vance C.G.T., Liebano R.E., Amrit A.S., Bush H.M., Lee K.S., Lee J.E., Sluka K.A. Transcutaneous Electrical Nerve Stimulation Reduces Pain, Fatigue and Hyperalgesia While Restoring Central Inhibition in Primary Fibromyalgia. Pain. 2013;154:2554–2562. doi: 10.1016/j.pain.2013.07.043.
    1. Pennati G.V., Bergling H., Carment L., Borg J., Lindberg P.G., Palmcrantz S. Effects of 60 min Electrostimulation With the EXOPULSE Mollii Suit on Objective Signs of Spasticity. Front. Neurol. 2021;12:706610. doi: 10.3389/fneur.2021.706610.
    1. Perez M.A., Field-Fote E.C., Floeter M.K. Patterned Sensory Stimulation Induces Plasticity in Reciprocal Ia Inhibition in Humans. J. Neurosci. Off. J. Soc. Neurosci. 2003;23:2014–2018. doi: 10.1523/JNEUROSCI.23-06-02014.2003.
    1. Karakoyun A., Boyraz İ., Gunduz R., Karamercan A., Ozgirgin N. Electrophysiological and Clinical Evaluation of the Effects of Transcutaneous Electrical Nerve Stimulation on the Spasticity in the Hemiplegic Stroke Patients. J. Phys. Ther. Sci. 2015;27:3407–3411. doi: 10.1589/jpts.27.3407.
    1. Mahmood A., Veluswamy S.K., Hombali A., Mullick A., Manikandan N., Solomon J.M. Effect of Transcutaneous Electrical Nerve Stimulation on Spasticity in Adults with Stroke: A Systematic Review and Meta-Analysis. Arch. Phys. Med. Rehabil. 2019;100:751–768. doi: 10.1016/j.apmr.2018.10.016.
    1. Flodström C., Axelsson S.-A.V., Nordström B. A Pilot Study of the Impact of the Electro-Suit Mollii® on Body Functions, Activity, and Participation in Children with Cerebral Palsy. Assist. Technol. 2022;34:411–417. doi: 10.1080/10400435.2020.1837288.
    1. Palmcrantz S., Pennati G.V., Bergling H., Borg J. Feasibility and Potential Effects of Using the Electro-Dress Mollii on Spasticity and Functioning in Chronic Stroke. J. Neuroeng. Rehabil. 2020;17:109. doi: 10.1186/s12984-020-00740-z.
    1. Arkkukangas M., Graff J.H., Denison E. Evaluation of the Electro-Dress Mollii® to Affect Spasticity and Motor Function in Children with Cerebral Palsy: Seven Experimental Single-Case Studies with an ABAB Design. Cogent Eng. 2022;9:2064587. doi: 10.1080/23311916.2022.2064587.
    1. Uszynski M., McCarron C. Benefits of Innovative Exopulse Mollii Full-Body Electric Garment Intervention on Lower Limb Strength, Gait Speed, Lower Back Pain, Quality of Life, and Fatigue in a Female with Multiple Sclerosis—A Case Study. Physiother. Rev. 2022;26:49–55. doi: 10.5114/phr.2022.123158.
    1. Wong C., Torabi T.P., Mortensen K.R.L., Michelsen J.S. The Mollii-Suit®—A Novel Method Using Reciprocal Inhibition in Children with Cerebral Palsy, Gross Motor Function Classification System IV–V: A 6-Month Prospective Study. Toxicon. 2018;156:S116. doi: 10.1016/j.toxicon.2018.11.279.
    1. Sandell J. A Case Study to Assess the Effects of the Exo-Pulse Neuromodulation Suit on Pain, Fatigue and Sleep Patterns of an Individual Diagnosed with CFS/ME. World J. Adv. Res. Rev. 2022;14:634–636. doi: 10.30574/wjarr.2022.14.3.0612.
    1. Jonasson L.-L., Sörbo A., Ertzgaard P., Sandsjö L. Patients’ Experiences of Self-Administered Electrotherapy for Spasticity in Stroke and Cerebral Palsy: A Qualitative Study. J. Rehabil. Med. 2022;54:jrm00263. doi: 10.2340/jrm.v53.1131.
    1. Raffalt P.C., Bencke J., Mortensen K., Torabi T.P., Wong C., Speedtsberg M.B. Electro-Suit Treatment of Children with Unilateral Cerebral Palsy Alters Nonlinear Dynamics of Walking. Clin. Biomech. 2022;98:105714. doi: 10.1016/j.clinbiomech.2022.105714.
    1. Ottobock Exopulse Molli Suit. [(accessed on 2 January 2023)]. Available online: .
    1. Clamente-Suárez V., Parraca J., Silva V., Batalha N., Costa A., Tomas-Carus P. Differences in Peripheral Vascular Response of a Fibromyalgia Patient in a Physical Fatigue Situation. A Case Control Report. Perspect. Online Biológicas Saúde. 2021;11:1–10.
    1. Meier T., Rummey C., Leinonen M., Voit T., Schara U., Straathof C., D’Angelo M., Bernert G., Cuisset J.-M., Finkel R., et al. The Use of a Hand-Held Device (ASMA-1) for Home-Based Monitoring of Respiratory Function Changes in Pediatric and Adolescent Patients with Duchenne Muscular Dystrophy. Neuromuscul. Disord. 2015;25:S201. doi: 10.1016/j.nmd.2015.06.064.
    1. S Sener U., Ucok K., Ulasli A.M., Genc A., Karabacak H., Coban N.F., Simsek H., Cevik H. Evaluation of Health-Related Physical Fitness Parameters and Association Analysis with Depression, Anxiety, and Quality of Life in Patients with Fibromyalgia. Int. J. Rheum. Dis. 2016;19:763–772. doi: 10.1111/1756-185X.12237.
    1. Forti M., Zamunér A.R., Andrade C.P., Silva E. Lung Function, Respiratory Muscle Strength, and Thoracoabdominal Mobility in Women With Fibromyalgia Syndrome. Respir. Care. 2016;61:1384–1390. doi: 10.4187/respcare.04401.
    1. Nugent S.M., Lovejoy T.I., Shull S., Dobscha S.K., Morasco B.J. Associations of Pain Numeric Rating Scale Scores Collected during Usual Care with Research Administered Patient Reported Pain Outcomes. Pain Med. 2021;22:2235–2241. doi: 10.1093/pm/pnab110.
    1. Crum E.M., O’Connor W.J., Van Loo L., Valckx M., Stannard S.R. Validity and Reliability of the Moxy Oxygen Monitor during Incremental Cycling Exercise. Eur. J. Sport Sci. 2017;17:1037–1043. doi: 10.1080/17461391.2017.1330899.
    1. Belinchon-deMiguel P., Clemente-Suárez V.J. Psychophysiological, Body Composition, Biomechanical and Autonomic Modulation Analysis Procedures in an Ultraendurance Mountain Race. J. Med. Syst. 2018;42:32. doi: 10.1007/s10916-017-0889-y.
    1. Clemente-Suarez V.J., Robles-Pérez J.J. Acute Effects of Caffeine Supplementation on Cortical Arousal, Anxiety, Physiological Response and Marksmanship in Close Quarter Combat. Ergonomics. 2015;58:1842–1850. doi: 10.1080/00140139.2015.1036790.
    1. Carbonell-Baeza A., Álvarez-Gallardo I.C., Segura-Jiménez V., Castro-Piñero J., Ruiz J.R., Delgado-Fernández M., Aparicio V.A. Reliability and Feasibility of Physical Fitness Tests in Female Fibromyalgia Patients. Int. J. Sports Med. 2015;36:157–162. doi: 10.1055/s-0034-1390497.
    1. Petzke F., Khine A., Williams D., Groner K., Clauw D.J., Gracely R.H. Dolorimetry Performed at 3 Paired Tender Points Highly Predicts Overall Tenderness. J. Rheumatol. 2001;28:2568–2569.
    1. Kinser A.M., Sands W.A., Stone M.H. Reliability and Validity of a Pressure Algometer. J. Strength Cond. Res. 2009;23:312–314. doi: 10.1519/JSC.0b013e31818f051c.
    1. Ernberg M., Christidis N., Ghafouri B., Bileviciute-Ljungar I., Löfgren M., Bjersing J., Palstam A., Larsson A., Mannerkorpi K., Gerdle B., et al. Plasma Cytokine Levels in Fibromyalgia and Their Response to 15 Weeks of Progressive Resistance Exercise or Relaxation Therapy. Mediat. Inflamm. 2018;2018:3985154. doi: 10.1155/2018/3985154.
    1. Buranruk O. A Randomized Clinical Trial of Self-Stretching with and without Mindful Breathing—Immediate Effect on Pressure Pain and Range of Motion in Myofascial Pain Syndrome. J. Bodyw. Mov. Ther. 2022;32:29–35. doi: 10.1016/j.jbmt.2022.05.016.
    1. Lamy E., Simões C., Rodrigues L., Costa A.R., Vitorino R., Amado F., Antunes C., do Carmo I. Changes in the Salivary Protein Profile of Morbidly Obese Women Either Previously Subjected to Bariatric Surgery or Not. J. Physiol. Biochem. 2015;71:691–702. doi: 10.1007/s13105-015-0434-8.
    1. Bradford M.M. A Rapid and Sensitive Method for the Quantitation of Microgram Quantities of Protein Utilizing the Principle of Protein-Dye Binding. Anal. Biochem. 1976;72:248–254. doi: 10.1016/0003-2697(76)90527-3.
    1. Association W.M. World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA. 2013;310:2191–2194. doi: 10.1001/jama.2013.281053.
    1. Shang Y., Gurley K., Symons B., Long D., Srikuea R., Crofford L.J., Peterson C.A., Yu G. Noninvasive Optical Characterization of Muscle Blood Flow, Oxygenation, and Metabolism in Women with Fibromyalgia. Arthritis Res. Ther. 2012;14:R236. doi: 10.1186/ar4079.
    1. Cordero M.D., De Miguel M., Fernández A.M.M., López I.M.C., Maraver J.G., Cotán D., Izquierdo L.G., Bonal P., Campa F., Bullon P., et al. Mitochondrial Dysfunction and Mitophagy Activation in Blood Mononuclear Cells of Fibromyalgia Patients: Implications in the Pathogenesis of the Disease. Arthritis Res. Ther. 2010;12:R17. doi: 10.1186/ar2918.
    1. Miranda-Fuentes C., Chirosa-Ríos L.J., Guisado-Requena I.M., Delgado-Floody P., Jerez-Mayorga D. Changes in Muscle Oxygen Saturation Measured Using Wireless Near-Infrared Spectroscopy in Resistance Training: A Systematic Review. Int. J. Environ. Res. Public Health. 2021;18:4293. doi: 10.3390/ijerph18084293.
    1. Katz D.L., Greene L., Ali A., Faridi Z. The Pain of Fibromyalgia Syndrome Is Due to Muscle Hypoperfusion Induced by Regional Vasomotor Dysregulation. Med. Hypotheses. 2007;69:517–525. doi: 10.1016/j.mehy.2005.10.037.
    1. Martínez-Lavín M., Hermosillo A.G. Autonomic Nervous System Dysfunction May Explain the Multisystem Features of Fibromyalgia. Semin. Arthritis Rheum. 2000;29:197–199. doi: 10.1016/S0049-0172(00)80008-6.
    1. Costa A.R., Freire A., Parraca J.A., Silva V., Tomas-Carus P., Villafaina S. Heart Rate Variability and Salivary Biomarkers Differences between Fibromyalgia and Healthy Participants after an Exercise Fatigue Protocol: An Experimental Study. Diagnostics. 2022;12:2220. doi: 10.3390/diagnostics12092220.
    1. Koep J.L., Taylor C.E., Coombes J.S., Bond B., Ainslie P.N., Bailey T.G. Autonomic Control of Cerebral Blood Flow: Fundamental Comparisons between Peripheral and Cerebrovascular Circulations in Humans. J. Physiol. 2022;600:15–39. doi: 10.1113/JP281058.

Source: PubMed

3
Subscribe