2- Electrical Currents for Muscle Contraction

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24 Terms

1

Neuromuscular Electrical Stimulation (NMES)

  • The use of electrical currents to produce muscle contraction in innervated muscles

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2

Does NMES require an intact and functioning nervous system?

Yes it does to work properly

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3

What is NMES used for?

  • Muscle strengthening

  • Muscle education and reeducation

  • Edema

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4

Slow Twitch Type 1

  • Innervated by small nerve fibers

  • Activated first in physiological contractions

  • Produce lower-force contractions

  • Fatigue and atrophy resistant (for endurance)

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5

Fast Twitch Type 2

  • Innervated by larger diameter nerve fibers

  • Activated first when muscle is stimulated electrically

  • Produce strongest contractions

  • Fatigue rapidly and atrophy rapidly with disuse (for explosive power)

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6

Overload principle

A principle of strengthening muscle that states the greater the load placed on a muscle and the higher the force contraction it produces, the more strength that muscle will gain

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7

Specificity Theory

Muscle contractions specifically strengthen the muscle fibers that contract

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8

What is the best way to increase strength through electrical currents?

Higher force contractions should be used

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9

What is the best way to increase endurance through electrical currents?

Lower-force contractions should be used

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10

Orthopedic conditions treated by ES

  • ACL reconstruction

  • TKA

  • Nonsurgical management of other orthopedic conditions

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11

Neurological conditions treated with ES

Occurs via direct muscle strengthening or inc excitability of the motor neuron produced by motor level ES

  • SCI - counteracts muscle atrophy and improves circulation

  • Stroke - improves voluntary recruitment of motor units, proves gait, reduce agonist/antagonist co-contraction

  • MS

  • CP

  • TBI

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12

Functional electrical stimulation (FES)

  • Application of an electrical current to produce muscle contraction during a functional activity

  • Ex. stimulation of the anterior tibialis to cause DF during swing phase of gait

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13

Contraindications for ES for Muscle Contraction

  • Pacemaker or unstable arrhythmias

  • Over the carotid sinus

  • Venous or arterial thrombosis or thrombophlebitis

  • Pelvis abdomen, trunk or low back during pregnancy

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14

Precautions for Electrical Stimulation for Muscle Contraction

  • Cardiac disease

  • Impaired sensation or mentation

  • Malignant tumors

  • Skin irritation or open wounds

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15

Parameters for ES for Muscle Contraction

  • Waveform

  • Electrode placement

  • Pulse duration

  • Pulse frequency

  • On:off ratio

  • Ramp up/down

  • Amplitude

  • Duration of treatment (10-20 min)

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16

What is the MOST appropriate position for a patient using NMES?

  • A position that allows the pt to contract their muscle in the direction of the contraction being created by the NMES

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17

How should the electrodes be placed when using NMES

Parallel to the muscle fibers with one on the motor point

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18

As the pulse duration (width) is shortened, how will the amplitude need to be adjusted to achieve the same strength of contraction?

The amplitude will need to be raised

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19

What is MVIC?

maximum voluntary isometric contraction

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20

What MVIC should be used when using ESTIM on a muscle without injury?

50%

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21

What MVIC should be used when using ESTIM on muscles after post-op?

10%

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22

What is the ratio used for beginning muscle contraction ESTIM?

1:5 with 6-10 seconds on and 50-120 seconds

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23

What is the ratio for muscle contraction ESTIM to relieve muscle spasms (or to make them relax)?

1:1

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24

How long does the pulse width need to be to stimulate a contraction in denervated muscle?

10 ms or longer

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