SOFT TISSUE INJURIES

"...Several studies have shown positive correlations between muscle strength, flexibility, and the frequency of low-back pain. Weak trunk musculature and decreased endurance have thereby come to be identified as significant risk factors in the development of occupational hack problems ..." ¹

"... electrical stimulation has been shown to increase the muscle strength of the lower extremities"¹

"... electrical stimulation may be a valuable treatment in the early care of low-back pain patients in maintaining and increasing strength and endurance of back muscles when a more active exercise program is too painful to perform." ¹

"... Electrical stimulation, a passive modality of muscle strengthening, may be better tolerated than exercise for a patient with acute or subacute low-back pain. Electrical stimulation also has the added advantage of providing an anesthetic effect from the stimulation, which may also decrease pain while treatment is being administered. (see modality comparisons) It must be recognized that selective training with electrical stimulation or exercise, or a combination of both, can be used to obtain optimal clinical results. Electrical stimulation may, therefore, become a valuable treatment modality for patients with acute and subacute back pain before begi ng an exercise and conditioning program ..."²

". . . a positive correlation between strength capacity and the frequency of low-back pain ..."²

" ... subjects with recurrent back pain had weaker trunk muscles and diminished flexibility ... "²

"... The goal of most rehabilitative programs is aimed at improving the trunk strength and the endurance of the low-back pain patient. Electrical stimulation has be shown to be effective in increasing the strength of the muscles of the lower extremities ... " ²

" ... Electrical stimulation has been shown to be superior to exercise in postsurgical knee patients, ...abates muscular atrophy ..." ² (see FDA indications)

" It appears that for electrical stimulation to be effective, the intensity of the stimulation must be close to a maximum voluntary contraction.. ." ¹ (see the modality comparison)

"The necessity for the intensity of stimulation to be high indicates that for electrical stimulation to be beneficial, subjects must have substantial pain tolerance." ¹ (see the modality comparison)

"... The patients who received neuromuscular electrical stimulation had stronger quadriceps muscles and more normal gait patterns.. ."³

"... it is extremely difficult to teach a patient to perform co-contraction at an intensity sufficient to provide overload to the muscles ..." ³

"... Neuromuscular electrical stimulation has been shown to improve the torque-generating capability of the quadriceps femoris after operations on the knee ligaments ..." ³

".. . neuromuscular electrical stimulation may be more effective in increasing isometric strength of these muscles than volitional co-contraction ..." ³

"... Electrically elicited co-contraction has been shown to decrease strain on the graft and to increase strength of the periarticular muscles ..." ³

"... increases in muscle strength caused by electrically elicited contractions will similarly improve gait ..." ³

"... Treatment with neuromuscular electrical stimulation is clinic based, more labor intensive, and therefore more costly ..." ³ (The Neuro Care™ is portable and can be used in the patient's home).

". .. neuromuscular stimulation was only used three times a week ..." ³

"... Neuromuscular electrical stimulation may prevent what some investigators have termed 'reamed disuse' ..."³

"... Electrically elicited muscle contraction may be better able to augment muscle strength in patients who have weakness ..."³

"... Overall, the patients in the neuromuscular electrical stimulation group had a more normal gait pattern than did the patients in the volitional exercise group. The quadriceps femoris muscles were stronger, the temporal gait patterns were nearly normal, and the kinematics were more like those of the uninvolved knee. The knees of these patients were stronger in the eighth post-operative week than reported averages for such patients years after the operation. Our results suggest that the use of neuromuscular electrical stimulation translates, at least in the immediate postoperative period, not only into an increase in muscle strength but also into an improvement in the functional use of the muscles..." ³

" Electrical stimulation can be used to assist in gaining the initial degrees of motion for patients with frozen shoulder or shoulder-hand syndrome... ⁴

"... Because electrical stimulation generally is limited to one or two muscle groups, stimulation of muscles to achieve shoulder flexion or abduction beyond the 90-degree horizontal plane is specially difficult ..." ⁴ (see FDA letter)

"...Electrical stimulation to increase the strength and power output of the posterior deltoid muscle can be used to augment traditional muscle strengthening programs.. ." ⁴

"...Electrical stimulation for the reduction of shoulder subluxation not only may prevent further joint separation, but also can provide normal glenohumeral alignment for the patient when assuming the upright position. Thus, maintaining normal joint alignment and counteracting the stretching of the shoulder capsule that is caused by gravity are advantages of such stimulation..." ⁴

"...We have found that chronic use of neuromuscular stimulation for shoulder subluxation management has been most successful for patients in supervised care settings where supportive individuals can assist the patient in maintaining appropriate electrode placement and skin care..."⁴

"...Electrical stimulation has been shown to be effective in aiding the recovery of quadriceps femoris muscle force production after anterior cruciate ligament reconstruction..."⁹

"...Portable stimulators are appealing because they are easy to use and are presumably less costly than the use of stimulators in clinics..." ⁹

"...Advantage of cost-effectiveness of home-based regimens using portable electrical stimulators..."⁹

"...Subjects were able to achieve contractile forces averaging approximately 50% of the involved muscles..."⁹

"...Perhaps there are portable stimulators that are capable of evoking more electrically elicited force..."⁹

"...Recovery is positively correlated to contraction intensity when using electrical stimulation to strengthen the quadriceps femoris muscles..." ⁹

". . .Mechanical difficulty is demonstrated by a patient's inability to actively extend the knee to the point of passive extension...resulting diminished range of motion (ROM) at the knee..."¹⁰

"...Patients are indeed incapable of volitionally increasing their knee extensor output..."¹⁰

"...Electrical stimulation has been used successfully in increasing bath static and dynamic muscle torque. Thus, it offers a means by which patients can improve their muscle force output without having to perform volitional muscular contractions..." ¹⁰

"...The introduction of electrical stimulation therapy during the rehabilitative phase may in fact accelerate functional rehabilitation, resulting in an earlier patient discharge. This, in effect, returns the patient more quickly to normal active status at potentially reduced costs. . . "(10)

"...Clearly,..., electrical stimulation is effective in expediting recovery from surgery, as evidenced by a more rapid patient return to active daily living. Secondarily, reduced hospital stay may decrease the overall cost of patient care, contributing further benefit to the patient. .."¹⁰

". . The newest hope for aching backs, flabby stomachs and weak knees does sound like something out of science fiction. It's called electrical stimulation (EMS), and it entails zapping a muscle with electricity to strengthen it. Once reserved for rehabilitating atrophied muscles. EMS is now being used to treat more subtle structural problems as well, since a therapist can direct the electrical current to areas of weakened muscle-such as the lower back-that ordinary exercise can 't reach..."¹¹

"...lt takes an experienced hand to apply the right amount of current...Effective treatment with EMS takes some trial and error..."¹¹

"...Scientists have shown that applying EMS several times a week will make a muscle stronger, even if the patient can no longer move it voluntarily..." ¹¹

"...This strengthening technique is now standard treatment in rehabilitating weakened muscles after surgery.- It's also being used to prevent muscle atrophy in arthritis patients, as well as those paralyzed from spinal cord injuries..."¹¹

"...EMS can speed recovery from a variety of orthopedic injuries..." (11 )

"...dramatic improvement in paralyzed patients. EMS builds muscle mass, and that helps with circulation to the extremities, which in turn may prevent blood-clotting problems..." ¹¹

"...Patients often get a psychological boost from the added muscle, too, because they feel stronger and look better..."¹¹

"...More intriguing still is the prospect of using EMS to shore up postural weakness-an approach that may offer fresh hope to the 16 million Americans suffering from chronic back pain..." ¹¹

".. .very useful in helping patients improve their trunk muscle strength and endurance. .."¹¹

"...EMS can help elite athletes get past their training plateaus... " ¹¹

"...sessions are expensive, usually between $50 and $100 an hour..." ¹¹ NOT the Neuro Care™!

"...EMS induced contractions can be painful..." ¹¹

"... Lab studies have shown that electrical stimulation actually strengthens muscles more than an equivalent workout with weights. This suggests that EMS reaches muscle fibers that aren't being contracted in normal exercise movements..." ¹¹

"...Over the past eight years the field has come a long way, both in research and clinical applications...We're still looking for the ideal stimulator-one that can strengthen without discomfort..."¹¹

"... Electricity does more than just build muscles...EMS can even heal skin sores and bone fractures..."¹¹

"...Most cuts, sores and broken bones heal by themselves. But certain chronic problems, such as bed sores and "nonunion" fractures, can linger for years..." ¹¹

"...electric currents seem to speed up protein synthesis in damaged cells..." ¹¹

"...many athletes also have some misconceptions regarding therapeutic modalities. Even amongst clinicians, it is difficult to find a consensus regarding treatment protocols. This can be frustrating for the clinicians, coach and athlete trying to accelerate a return to play..." ¹²

Circulatory | Neuro Care 1000TEMS/EMS Comparison | Bibliography

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