WORK
WORK
REST
PERIODIC TIME
PULSE WIDE
MONOPHASE PULSES
INTENSITY
PULSE INTENSITY
RA
MP
RA
MP
BIPHASIC PULSES
WORK
WORK
REST
PERIODIC TIME
PULSE WIDE
MONOPHASE PULSES
INTENSITY
PULSE INTENSITY
RA
MP
RA
MP
BIPHASIC PULSES
7
8
Muscle wastage: EMS is used in the treatment of medical conditions involving muscle
wastage including: Neuromuscular facilitation - Muscle re-education - Muscle training -
Prevention/slowing of atrophy/hypotrophy - Preventing postoperative muscle weakness
- Reduction of spasticity - Maintaining or increasing range of motion - Training of partial
peripheral nerve damage with signs of re-innervation - Treatment of scoliosis.
4.1 Mode of operation
EMS uses external electrical impulses that act through the skin to stimulate the nerves
supplying a specific muscle group.
The muscle reacts in different ways depending on the strength of current and duration
and frequency of the electrical impulse.
Muscles are made up of two different types of fibre:
- Red fibre is slower contracting and aerobic working.
- White fibre is faster acting and capable of anaerobic working.
The proportions of red and white fibres depend on the way the muscle is used.
Fibre can be converted from one type to the other, depending on the signals it receives.
This is known as the Trophic effect.
Different frequencies have different effects: Low (1-10 Hz) frequencies coupled with
long impulse times have a purifying and relaxing effect through individual contractions,
whereby the circulation in the treated muscle is simultaneously improved and removal
of metabolic end products is supported (lymphatic drainage). The oxygen supply to the
muscle is improved.
In contrast, medium (20-50 Hz) frequencies can put a high level of strain on the muscle,
thus promoting the muscular structure.
Very high frequencies (60-90 Hz) can be used to promote muscle definition and bulk.
The body maps at the back of this guide show pad positioning in order to stimulate
specific muscle groups.
4.2 Treatment time and treatment interval
Treatment by EMS can vary between 15–60 minutes stimulation twice a week to treatment
several times per day.
4.3 Choosing the right strength
The object of EMS treatment is to produce powerful muscle contractions.
The strength of the current should be increased to about three times the level at which
you can first feel the tingling, or to as high as you can stand without causing pain. You
will probably feel that electrical contraction is being more powerful than a voluntary
contraction, because the current also stimulates your sensory nerves. The signals have
a pain-relieving effect.
You may find the sensation uncomfortable to start with, therefore you may not get up
to therapeutic strength at the start of treatment. The strength can be increased during
the course of the treatment, as you become accustomed to the sensation. Voluntary
muscular activity is more effective than stimulation, and it may improve progress if you
combine voluntary contraction with stimulation.
The powerful muscle contractions caused by electrical stimulation give rise to training
aches, which usually disappear within a week.
After treatment tingling sensations may continue or your skin may feel numb, this
is normal.
5. TENS and EMS STIMULATION PARAMETERS:
The effect of electrical stimulation on the body depends on the following current settings:
5.1 Pulse Waveform
This describes the time function of the excitation current which may be either monophasic
or biphasic.
With monophasic pulse trains, the current flows in one direction. With biphasic pulses,
the excitation current alternates its direction.
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