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Neuro Re-Education
PROTOCOL / CLINICAL
INDICATION
STIMULATION PARAMETERS
MECHANISM OF ACTION
APPLICATION TECHNIQUE
OPERATIONAL SEQUENCE
UE TRIPHASIC PENS
Neuro-re-education
FX
2
before Therex
70 µS phase duration
Triphasic EMG Pattern
Treatment time of 15 minutes
Patterned Electrical Neuromuscular Stimulation
(PENS) is a precise reproduction of EMG firing
patterns of muscle agonist and antagonist pairs. The
stimulation helps to re-establish proper firing
sequence in the spinal and supraspinal central
pattern generators, re-educating neuromuscular
function. PENS helps re-boot the sense position
system and neuromuscular junction to improve
recruitment and muscle function. It should be used
prior to Therex to improve recruitment and motor
performance. It’s also used to decrease spasticity
and muscle tone.
This program is used to re-educate U.E. agonist
and antagonist muscle pairs where fine motor
control and positioning is required. Place the (+)
and (-) electrodes as indicated in the clinical
treatment charts over the agonist and antagonist
muscle pair to be treated. In patients with severe
disuse atrophy, decreased sensation or
inflammation use a sensory level of stimulation for
the first two weeks of treatment. This can be
increased to a moderate muscle twitch during the
next 4-6 weeks of treatment.
Press NEURO RE-ED button until screen reads "UE TRIPHASIC
PENS".
Set Outputs A and B until the patient feels the desired sensation.
Press START / STOP and T15 will display in upper right corner.
Adjust treatment time if necessary using the TIME/PARAMETER button.
The treatment will end at the end of the preset time or if the patient
safety switch is pressed.
UE BIPHASIC PENS
Neuro-re-education
FX
2
before Therex
70 µS phase duration
Biphasic EMG pattern
Cycle time of 0.75 seconds
Treatment time of 15 minutes
This program is used to re-educate U.E. agonist -
antagonist muscle pairs for reciprocal movement such
as pursing the lips, chewing, and for the treatment of
torticollis. Place the (+) and (-) electrodes as indicated
in the treatment clinical charts over the agonist and
antagonist muscle pair to be treated. In patients with
severe disuse atrophy, decreased sensation or
inflammation use a sensory level of stimulation for the
first two weeks of treatment. This can be followed
increased to a moderate muscle twitch during the next
4-6 weeks of treatment.
Press NEURO RE-ED button until screen reads "UE BIPHASIC PENS".
Set Outputs A and B until the patient feels the desired sensation.
Press START / STOP and T15 will display in upper right corner.
Adjust treatment time if necessary using the TIME/PARAMETER button.
The treatment will end at the end of the preset time or if the patient
safety switch is pressed.
LE TRIPHASIC PENS
Neuro-re-education
FX
2
before Therex
70 µS phase duration
L.E. Triphasic EMG Pattern
Treatment time of 15 minutes
This program is used to re-educate L.E. agonist and
antagonist muscle pairs where fine motor control
and positioning is required. Place the (+) and (-)
electrodes as indicated in the clinical treatment
charts over the agonist and antagonist muscle pair to
be treated. In patients with severe disuse atrophy,
decreased sensation or inflammation use a sensory
level of stimulation for the first two weeks of
treatment. This can then be increased to a moderate
muscle twitch during the next 4-6 weeks of
treatment.
Press NEURO RE-ED button until screen reads "LE TRIPHASIC
PENS".
Set Outputs A and B until the patient feels the desired sensation.
Press START / STOP and T15 will display in upper right corner.
Adjust treatment time if necessary using the TIME/PARAMETER button.
The treatment will end at the end of the preset time or if the patient
safety switch is pressed.
TENS-LVPC MOTOR
Neuro-re-education Post stroke.
4Hz - 200uSec PD Continuous
Treatment time of 15 minutes.
Motor level stimulation activates recovery of
function in post ischemic stroke patients based
on clinical trial evidence.
Target tissue-superficial. Bipolar placement over
local and distal acu points. Set intensity to elicit
a moderate muscle twitch.
Press NEURO RE-ED button until screen reads "TENS-LVPC MOTOR".
Set Outputs A and B until the patient feels the desired sensation.
Press START / STOP and T15 will display in upper right corner.
Adjust treatment time if necessary using the TIME/PARAMETER button.
The treatment will end at the end of the preset time or if the patient
safety switch is pressed.
MFAC RECIPROCAL
INHIBITION
Reduces muscle tone (spasm) of
spastic muscle
50 BPS - 2500 Hz
12Sec “ON” and 18Sec “OFF” time
Channels fire simultaneously
Ramps are 6Sec “ON” and 4Sec “OFF”
Treatment time of 15 minutes
Stimulation of the spastic muscle's antagonists
activates reciprocal inhibition of the spastic muscle
reducing tone. Slow ramps decrease the potential
to trigger spasticity of the agonist.
A single channel (A or B) is used over the spastic
muscle's antagonist. Set intensity to elicit a grade 2-
3 muscle contraction. Ensure the intensity is not too
high to induce overflow activation of the spastic
muscle. Reduce treatment time based on muscle
fatigue and inhibition of spasticity.
Press NEURO RE-ED button until screen reads "MFAC RECIPROCAL
INHIBITION".
Set Outputs A and B until the desired contraction level is obtained.
Press START / STOP and T15 will display in upper right corner.
Adjust treatment time if necessary using the TIME/PARAMETER button.
The treatment will end at the end of the preset time or if the patient
safety switch is pressed.
