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1 4 . H O W T O U S E T H E W I R E L E S S P R O F E S S I O N A L O N S P E C I F I C
I N D I C AT I O N S
267 EN WIRELESS PROFESSIONAL
14.11.2.5 Stimulation energy
Always work with an energy that is too low to produce muscle fibre stimulation in the spastic muscles.
The stimulation energy must however be adjusted manually so that the isotonic contraction of the
antagonist muscle causes movement to the maximum range of motion, thus creating maximum stretch of
the spastic muscle.
This action cannot be carried out if the agonist-antagonist imbalance is too great; this occurs when
spasticity of a muscle exceeds the contraction strength of its atrophied antagonist. Stimulation then only
allows for more or less reduced movement or even no movement at all.
However, the treatment should be carried out even in this situation, because stimulation, even subliminal,
has a beneficial effect on the reduction of spasticity.
14.11.2.6 Manual activation of stimulation
When the mi-SCAN is activated, the stimulation session starts automatically with a measurement of
the chronaxy. This is a short test lasting around ten seconds, which allows the optimum duration of
the stimulation pulse to be adjusted, ensuring maximum comfort. The energy should then be gradually
increased to cause the first contraction of the antagonist muscle.
Each contraction is followed by a five-second rest period. Once this rest period has finished, press any
button on any channel to trigger the next contraction.
By doing so, each contraction is triggered and therefore controlled by a manual action. This technique
provides a clear psychological benefit for the patient, who can trigger contractions with his/her good
hand, and it also makes it possible to work synchronously with the associated movements.
14.11.2.7 associated actions
Passive mobilisation:
When the severity of spasticity causes a marked imbalance between the spastic muscle and its antagonist,
and there is a risk of joint stiffness, the therapist can complete the movement induced by stimulation using
passive mobilisation or gravity assisted posture