Using Neuromuscular Electrical Stimulation

Electrical neurostimulators and Using Neuromuscular Electrical Stimulation

What is Electrical Muscle Stimulation or Neuromuscular Stimulation?

Electrical muscle stimulation is a method of using electrical currents to stimulate and rehabilitate muscles .  This process helps with circulation of your body’s fluids.

Part of having a healthy home environment is having a healthy lifestyle. While it can be difficult to maintain a healthy lifestyle in today’s hectic world, it is important to exercise, eat right, and recover quickly from injuries. Part of that recovery process may include NMES or “Neuromuscular Electrical Stimulation”

Neuromuscular Electrical Stimulation (also known as Electrical Muscle Stimulation) has been used in sports medicine for many year. It has been used for muscle strengthening, maintenance of muscle mass and strength during prolonged periods of immobilization, selective muscle retraining, and the control fluid retention in the body. (1)

Neuromuscular Electrical Stimulation (NMES) involves the use of a device which transmits an electrical impulse to the skin over selected muscle groups by way of electrodes. Also known as an electronic shock unit, this therapeutic electrical stimulator is designed for home use. The NMES causes muscles to contract as a form of exercise or physical therapy.

Luigi Galvani provided the first scientific evidence that current can activate muscle in the 17oo’s. During the 19th and 20th centuries, researchers studied and documented the exact electrical properties that generate muscle movement. It was discovered that the body functions induced by electrical stimulation caused long-term changes in the muscles. In the 1960s, Soviet sport scientists applied EMS in the training of elite athletes, claiming 40% force gains. In the 1970s, these studies were shared during conferences with the Western sport establishments. The Soviet studies actually suggested that regular electrical activation of muscle was more effective than exercise in strengthening skeletal muscle in elite athletes.

The Soviet researchers originally used a 2500-Hz current with specific wave-forms. This form of stimulation has been promoted commercially as “Russian Stimulation”. No single waveform has been found to be superior for all NMES applications. While both portable battery operated and line-powered stimulators are available, generally NMES units that are battery operated have lower maximum power output than those that are line-powered.

Recent medical physiology research pinpointed the mechanisms by which electrical stimulation causes adaptation of cells of muscles, blood vessels and nerves.

As an adjunct to traditional physical therapy, NMES of healthy muscle is intended to strengthen or maintain muscle mass during or following periods of enforced inactivity, maintain or gain range of motion, facilitate voluntary muscle control, and temporaily reduce spasticity. This is often the result of chronic neuromuscular disorders such as cerebral palsy, spina bifida, club foot and some nonprogressive myopathies.

  1. Sports Med. 1992 May;13(5):320-36.
    Neuromuscular electrical stimulation. An overview and its application in the treatment of sports injuries. – Department of Physical Therapy, Northeastern University, Boston, Massachusetts.

Abstract
In sports medicine, neuromuscular electrical stimulation (NMES) has been used for muscle strengthening, maintenance of muscle mass and strength during prolonged periods of immobilisation, selective muscle retraining, and the control of oedema. A wide variety of stimulators, including the burst-modulated alternating current (‘Russian stimulator’), twin-spiked monophasic pulsed current and biphasic pulsed current stimulators, have been used to produce these effects. Several investigators have reported increased isometric muscle strength in both NMES-stimulated and exercise-trained healthy, young adults when compared to un-exercised controls, and also no significant differences between the NMES and voluntary exercise groups. It appears that when NMES and voluntary exercise are combined there is no significant difference in muscle strength after training when compared to either NMES or voluntary exercise alone. There is also evidence that NMES can improve functional performance in a variety of strength tasks. Two mechanisms have been suggested to explain the training effects seen with NMES. The first mechanism proposes that augmentation of muscle strength with NMES occurs in a similar manner to augmentation of muscle strength with voluntary exercise. This mechanism would require NMES strengthening protocols to follow standard strengthening protocols which call for a low number of repetitions with high external loads and a high intensity of muscle contraction. The second mechanism proposes that the muscle strengthening seen following NMES training results from a reversal of voluntary recruitment order with a selective augmentation of type II muscle fibres. Because type II fibres have a higher specific force than type I fibres, selective augmentation of type II muscle fibres will increase the overall strength of the muscle. The use of neuromuscular electrical stimulation to prevent muscle atrophy associated with prolonged knee immobilisation following ligament reconstruction surgery or injury has been extensively studied. NMES has been shown to be effective in preventing the decreases in muscle strength, muscle mass and the oxidative capacity of thigh muscles following knee immobilization. In all but one of the studies, NMES was shown to be superior in preventing the atrophic changes of knee immobilization when compared to no exercise, isometric exercise of the quadriceps femoris muscle group, isometric co-contraction of both the hamstrings and quadriceps femoris muscle groups, and combined NMES-isometric exercise. It has also been reported that NMES applied to the thigh musculature during knee immobilization improves the performance on functional tasks

 

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