Stimulation - Find out more

What is Stimulation?

Neuromuscular Stimulation has been used for many years to stimulate muscle and nerve fibres to treat a number of muscle and nerve related conditions.  

Over the last 30 years numerous clinical trials and papers have been written.
The NeuroTrac™ STIM products are a new breed of modern Neuromuscular Stimulators which Verity Medical have developed with the Therapist and Patient in mind. Our principle aim is to design products that have high levels of functional use, are sensibly priced, compact and user friendly.

The NeuroTrac™ stimulation products combine several treatment programmes into one unit. Neuromuscular Stimulation is increasingly understood by Therapists and Doctors. There is a better understanding of the mechanisms which exist between nerves and muscles that makes it possible to stimulate the neuromuscular system with precise electrical signals. NeuroTrac™ stimulation products offers precision giving full control of Pulse Widths, Rates, Ramp up times, Work / Rest cycles as well as alternating or synchronous application if two channels are being applied.

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Background ?
Historical Development
Applications
Contra Indications

Background

Neuromuscular Stimulation of kind has been used for many years to stimulate muscle and nerve fibers to treat a number of muscle and nerve related conditions.  
Over the last 30 years numerous clinical trials and papers have been written.

Neuro physiologists have paved the way for new horizons in the re-education of the neuromuscular system.  A clearer understanding of the normal mechanism of control which exists between nerves and muscle makes it possible to take over this control of muscle metabolism by the appropriate application of precise electronic signals.  It has been shown that nerves control muscle by transmitting a neurological code. This code occurs in two frequency bands according to the type of muscle five required.  Postural fibers require a tonic feeding at the rate of 10 pps, if given for periods of one hour or more per day, it is possible to maintain all their essential characteristics.  This treatment for muscles can act as a life support system until normal function can be resumed.  Muscles treated in this way, are able to preserve bulk, capillary bed density, and their essential ability to utilise oxygen.

The second frequency band occurs at 30 pps, and feed information to the fast contracting muscle fibers which give power to a movement.  This feeding  occurs naturally in a physic way, and therefore, treatment protocols to promote these fibers are given for shorter periods of time.

This physiology approach to neuromuscular stimulation, also requires pulses, which are shaped like the naturally occurring nerve signals and have very brief pulse widths.  By mimicking nature as accurately as possible, electrical stimulation has been used for prolonged periods, when required, without causing any single side effects.

Advances in technology have led to the production of neuromuscular stimulators, which are able to meet all of these expectations.

Historical Development

The word trophic applies to feeding, development and growth. It represents the repair process and when applied to a muscle it means that the muscle is always in a state to make the next contraction.  The relationship between nerve and muscle is seen then to be two fold in that the nerve signals the muscle for movement and it also supplies information to maintain its metabolic properties.

Electrical stimulation previously has addressed the contractile mechanism and was inappropriate to deal with the very real problem of preventing atrophy - atrophy being the state of malnutrition in a muscle as a direct consequence of the lack of neural information.

A breakthrough in the understanding of trophic neuromuscular simulation influence and of the ability of muscle to change from one metabolic form to another occurred with the publication of a paper by Buller, AJ, Eccles, JC, and JC Eccles, Journal of Physiology(1960) "Interactions between neurons and muscles in respect of the characteristics speeds of their motor responses".  Prior to this paper the hypothesis was that within the motor unit (the anterior horn cell, the motor neurons and the muscle supplied) there was a metabolic influence.  All muscles supplied in the motor unit were of the same type, this specifically indicated neural control of metabolism which was confirmed in the 1960 paper.   The authors showed that when fast and slow muscle assumes the physical.  Biochemical and histochemical characteristics of the previously innervated muscle i.e. the metabolic profile of the muscle is nerve determined.

Each skeletal muscle clearly has the capacity to synthesis both forms of myosin.  When muscle fiber changes from one form to the other the final adapting process is this switching in myosin type which takes place after 110 days.  The switching of fast to slow myosin has been achieved by copying the slow nerve signals and feeding it to the fast motor unit for periods of 3 hours + per day.  These studies were the background to trophic neuromuscular stimulation and the use of electrical signaling to prevent or reverse the changes of atrophy.

Applications

• To prevent disuse atrophy e.g. rheumatoid arthritis
• Atrophy associated with painful inhibition of muscle e.g. knee injuries
• To prevent the changes of muscle following nerve injury
• To increase endurance and resistance to fatigue
• To increase muscle tone as appropriate in muscle spasm and spasticity
• To promote continence in females and males
• To re-educate muscle following transplantation or circumstances of chronic disuse
• To increase muscle strength
• To maintain or improve range of movement
• To increase and improve the blood supply to the muscle in cases of intermittent caudication.  As a warm up prior to exercising

Conditions known to respond to NS

• Urinary and rectal incontinence
• Chronic neurological conditions to decrease spasticity, to strengthen muscle and promote higher levels of activity
• Peripheral nerve lesions including brachial plexus and Bell's Palsy
• Arthritis for muscle atrophy and pain relief
• Peripheral nerve lesions including brachial plexus and Bell's Palsy.
• Paraplegics to increase muscle bulk.
• Anal rectal and urinary incontinence.
• In the prevention of certain sports injuries which can be attributed to muscle imbalance.
• Muscle re-education, flat feet, vastus medialis.

Contra Indications and Precautions

• It is inadvisable to use neuromuscular stimulation if  demand type pacemaker is fitted.
• It is not advisable to drive a vehicle or operate dangerous machinery whilst receiving treatment.
• The safety of neuromuscular stimulation during pregnancy has not been established.
• Care must be used when treating to avoid the immediate vicinity of the richly innervated cartoid sinus.
• The user should only use the device as prescribed.
• Skin irritation from the treatment itself does not occur.  However, certain skin types do react to the glue on the electrodes and, therefore, users should use hypoallergenic brands.