Using Electrical Muscular Stimulation (EMS) for CVA patient

[sdkashif]

Hey every body,
In fact I understand physiologically how inhibition could be possible for the spastic muscles by applying EMS or other stimulatory techniques on the antagonist( the non-spastic group) by reciprocal inhibition. But I don't get how the reverse could be possible. I mean physiologically what happened when you apply specific type of EMS on the spastic muscle to end with relaxation.
many thanks....

I think that I have already explained it. So I'm repeating it again here.

The NEMS of spastic muscles with a frequency of 100 to 350 Hz result in a fair reduction of spastic tone that lasted for hour. The neurophysiological rationale for the effectiveness of NEMS activation of the spastic muscles may be two fold. First it could lead to fatigue of the peripheral system. It is theorized that either neuromuscular junction fatigue or a possible depletion of Ca++ release at post synaptic binding sites might have been responsible for the reduction in muscle tension.

A second neurophysiological mechanism by which NEMS of the spastic muscle might affect a reduction of muscle tone rests in antidromic activation of alpha motor neuron axon. Antidromic propogation may provide a spinal level response that could lead to longer lasting modulation of spastic tone. With each voluntary and stimulated action potential, the alpha motor neurone activates the motor unit and excites a pool of Renshaw cells through recurrent collaterals. The Renshaw cells inhibit the alpha motor neurons of the activated pool and motor neurons of synergistic muscles.

Procedure used has the following settings(Motor Nerve Inhibition).

1-Parameter Setting:

a-Waveform: Symmetrical Biphasic preferred, but monophasic or polyphasic can also be used.

b-Phase duration: depends upon the type of current used.

c-Pulse rate: 100 to 350 Hz

d-Polarity: Makes no difference

e-Amplitude: Motor Nerve Stimulation

2-Current Modulation Mode: Continuous Pulses

3-Electrode Placement: Bipolar over target muscles

4-Treatment Time: No clinical data to suggest the treatment time.


An other procedure (contract relax Method) has the following setting.

1-Parameter Setting

a-Wavew forrm: Symmetrical Biphasic is preferred but monophasic and polyphasic (Burst) can also be used.

b-Phase Duration: 20 to 200 micro seconds

c-Pulse rate: 40 to 50 pps

d-Polarity make sno difference

e-Amplitude: Motor Nerve stimulation

Current Modulation Mode: Interrupted pulses

a-On time: 5 to 10 seconds

b-Off time: 60 to 120 second

3-Electrode placement: Bipolar over target muscles

4-Treatment Time: No clinical data to suggest treatment time.


If you want further detail information, you have a look over the electrotherapy and electrophysiology texbooks for detail which are:

Clinical Electrotherapy, 2nd Edition by Roger M.Nelson & Dean P. Currier

Clinical Electrophysiology, Electrophysiology and Electrophysiological testing By Lynn Snyder Mackler & Andrew J.Robinson

[ramywhite]

Thanks sdkashif

[Dee]

Thankyou for an informative dialogue.

Does anyone know where I can get a definitive answer as to whether E-stim can be used safely with patients who have medication-controlled post stroke epilepsy?

Can anyone recommend the best type of unit to purchase for use with neurological patients to maintain muscle condition, promote activity by allowing the patient to join in with the movement and to reduce spasticity?

[uma1383]

hey the information quoted is really good.
my only concern is, the books u have stated are not available here, so it would be kind of u, if u please forward me any related articles or studies u have regarding electrical stimulation & spasticity.