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MA531_EN
EN 13
Impulsive currents
Pulses having a constant growth of the intensity versus time, that is the right form to reduce the accommodation, are
generally used for the stimulation of denervated or partially denervated muscles due to neuroplasia, axontomesis, or
neurotomesis . Generally the use of this current should be suspended in case of an evident reappearance of an active
contraction.
Time of applications varies from 10 to 30 minutes, with a number of settings that varies in relation to the therapeutic pro-
gram.
To avoid the muscular weariness the pauses among the single impulses should be at least ten times longer than time’s
stimulation.
To obtain a good contraction the stimulus’ intensity should be superior to the rheobase (the least-necessary intensity to
obtain the contraction) and a very short time (100 – 500 msec).
Anyway it is better, placing caution to the cutaneous zones with a high sensibility, to use the largest intensity tolerated by
the patient.
Avoiding to subject normally innervated muscles to the treatments it is important to be careful with the positioning of the
electrodes, trying to use small electrodes.
It is advisable to carry out a curve intensity-time (answer to the stimulation).
Generally the techniques of applications are two:
Monopolar technique applying the negative in the muscular stomach where it is more evident the motor answer and the
positive proximally.
Bipolar technique applying the electrodes to the extremity of the muscle.
Antalgic Effect
Tens
The Tens is an electric transcutaneous selective stimulation of peripheral nerves with consequent reduction of the symp-
tomatology of pain.
The tens is used in all the pathologies where we need a reduction of pain.
The antalgic effect of transcutaneous stimulation have other factors:
▪ Selective stimulation of the nervous fibers with consequent inhibition of spinal neurons involved in the nocicep-
tival transmission (theory of Gate Control);
▪ Liberation of endorphin that activate the cerebral circuits the transmission of pain to the level of the spinal mar-
row;
▪ Increasing of pain caused by the variation of the peripheral excitability to the level of receptor and nervous fi-
bers. The receptors, for the pain caused by the stimulation settle themselves to a higher level, to be excited by
stimulus only with a larger intensity than to the starting, so this effect increase the pain.
The antalgic effect of Tens current last for a long time also after the end of treatment, for some indirect effects, the varia-
tion of the neuronal conductibility caused by the same impulses and the neuronal excitability that causes the interruption
of pain circuits. Obviously, it is a therapeutic treatment, so we have to be careful with the placebo effect.
The wave form can be monophasic or rectangular biphasic, symmetric, asymmetric or Spike with time that varies from 20
to 500 msec and the frequency from 2 to 200 Hz.
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