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Electrical stimulation is a method of therapeutic treatment with pulsed currents, including intermittent galvanic current, with the aim of stimulating or enhancing the activity of certain organs or systems.

Electrical stimulation of motor nerves and muscles is most often used and successfully developed.

However, electrical stimulation of internal organs is also widely used.

Indications for electrostimulation include the prevention of muscle atrophy, as well as blood clots and embolism during forced inactivity (limb immobilization); reflex atrophy with muscle damage without damage to the motor nerve; peripheral motor neuron paresis (intoxication); expulsion of ureteral stones; weakness of labor, as well as in the postpartum period in order to expel the placenta; fight against atonic bleeding; weakened bowel function; weakened gallbladder function; weakened rectal sphincter function; weakened bladder muscle function; paresis of the laryngeal muscles; paresis of the facial nerve and facial muscles with flaccid paresis and paralysis; stimulation of the respiratory muscles; obliteration of atherosclerotic vessels; consequences of cerebral palsy; vasospasms; impotence; genital infantilism; obesity; figure correction; peripheral paresis; in order to eliminate the consequences of hypokinesia in athletes; to stimulate reparative osteogenesis, etc.

Before performing electrical stimulation of muscles with impaired innervation, it is necessary to conduct electrodiagnostics (classical and advanced) to establish a diagnosis (taking into account the degree of degeneration of the neuromuscular system) and the possibility of doing so, i.e. determine the optimal parameters of electrical stimulation (type of current, frequency, pulse duration in milliseconds, pause between pulses). These tests are carried out by a doctor.

For moderate and severe degeneration of the neuromuscular system, paresis of the facial seal and facial muscles with flaccid paresis and paralysis, electrical stimulation is a medical procedure.

Electrical stimulation is carried out on the devices “Stimul-1”, “Amp-lipulse-4, 5”, “Neuropulse”, “Diagnostim”, “NET”, “NSitron-626, 627, etc.”, “TUR-RS” , “Stersodnnator”, “Vector-automatic” (see below).

"Stimulus-1" is a source of alternating and rectified sinusoidal current with a frequency of 1-2.5 kHz, used in continuous and pulsed mode (Fig. 95). On the device panel there are: 1 - milliammeter; 2 - signal light for connecting the device to the network; 3 - indicator light for parcel delivery; 4 - potentiometer knob “Patient current”; 5 - button to turn the network on and off; 6 - operating mode switch buttons (continuous and pulse); 7 - buttons for switching types of current - alternating (“Psrsm.”) and rectified (“Ryp.”); 8 - knob for adjusting the duration and cut of bursts.

Rice. 95. Diagram of the control panel of the Stimul-1 device (explanation in the text)

Turning on the device during rhythmic stimulation. 1. The patient should be placed comfortably, electrodes should be applied according to the prescribed technique and securely fixed. 2. Before connecting the wires, make sure that the “Patient Current” knob (4) is moved to the left extreme position and the power button is in the “Off” position. 3. Connect the wires and move the power button to the “On” position, and the signal lamp (2) lights up. Warm up the device for 1-2 minutes.

4. While the device is warming up, set the panel handles according to the prescribed method. Set the mode by pressing one of the buttons (6) (for continuous mode, press the “Continuous” button, for pulse mode, press one of the four buttons indicating the ratio of the duration of bursts and pauses), set the current type switch (7) to the “Variable” position. or "Exit." The light (3) lights up constantly when the continuous mode is turned on, and goes out during pauses in the pulse mode. When using the pulse mode, set the handle (8) to the extreme left position, and then the bursts will be rectangular in shape, or to the right middle or extreme position, and then the front and cut of the bursts will lengthen, and the current in them will increase gradually.

After setting all parameters of the procedure, turn on the current by turning the “Patient Current” knob (4) from left to right. The current intensity is increased with a glowing lamp (3) until a muscle contraction is obtained. If it is impossible to cause muscle contraction with alternating current, switch to the rectified current mode (“Rectified”), having previously moved the handle (4) to the extreme left position. The sockets for connecting the cable are located on the side of the device, and the red socket on the patient cable will have a positive polarity.

Turning off the device. 1. At the end of the procedure, handle (4) “Patient current” is smoothly moved to the left extreme position until it clicks. In this case, the instrument needle is set to zero, the signal lights go out. 2. The “Network” knob (5) is set to the “Off” position. 3. Remove the wires from the terminals and remove the electrodes.

Technique and general principles of procedures

To carry out electrical stimulation, small (3-8 cm) or large (50-400 cm2) plate electrodes with hydrophilic gaskets, cavity electrodes of a special design, as well as electrodes on a handle with a push-button breaker are used.

The choice of electrode depends on the area of ​​influence. Thus, plate electrodes are more often used to stimulate the muscles of a limb or torso. To stimulate the muscles of internal organs, both plate and cavity electrodes are used, and to stimulate the muscles of the face, electrodes on a handle with a push-button breaker are used.

When striated muscles are stimulated, electrodes are placed on certain areas - motor points of nerves or motor muscles (Erb's table). The motor point of a nerve represents the area where the nerve is most superficially located under the skin and accessible to action. The motor point of the muscle represents the place corresponding to the level of entry of the motor nerve into the muscle - the zone of greatest excitability of the muscle. To determine the location of motor points, use the table. Erba.

However, taking into account the variability of their location in each specific case, the physiotherapist determines the location of these points; the first procedure is carried out in his presence. The found motor points are outlined so that during subsequent procedures you do not have to look for them again. When electrically stimulating the muscles of internal organs, the effect is carried out on the projection zone of the organ and on the segmental area, using large electrodes and placing them transversely.

The method of influencing skeletal muscles can be one- or two-polar. With the unipolar (unipolar) technique, one electrode (active) of a small area (4-6 cm2) is placed on the motor point of a muscle or nerve, the second - a larger area (100-150 cm2) - in the region of the corresponding segment along the midline of the body. With the bipolar (bipolar) technique, both electrodes of a small area (4-10 cm2) are placed along the stimulated muscle, one of them is at the motor point, the second is in the distal section in the area of ​​​​the transition of the muscle to the tendon.

The gasket is moistened with warm tap water, and the electrodes are fixed. The affected part of the body must be in a free and comfortable position so that muscle contraction occurs unhindered and is clearly visible. The current strength is dosed until a clear muscle contraction occurs. Lack of contraction, differential contraction of many muscles at the same time, severe pain indicate that the procedure was performed incorrectly.

In the presence of voluntary muscle contractions, it is advisable to carry out the procedure with the participation of the patient (active electrical stimulation). At the same time, his voluntary movements in a certain rhythm are amplified by an electrical impulse supplied using manual modulation.

Treatment methods

Electrical stimulation of nerves and muscles of the limbs and torso (for flaccid paresis and paralysis, for the prevention of atrophy, thrombus formation during prolonged forced inactivity of the limbs). The impact is carried out using a single-pole (Fig. 96, a, b) or two-pole (Fig. 96, c, d) method.

The type of current depends on the state of electrical excitability of the neuromuscular system. With normal excitability and mildly expressed quantitative disorders, diadynamic currents are used (syncopation rhythm; single-cycle, rhythmic, push-pull wave current - “Tone-1”, “Tone-2”), sinusoidal modulated currents in the first mode, the second (PP) type of work with frequency 50-100 Hz, modulation depth 100% with half-cycle duration 2-3 s (“Amplipulse-4, 5”). Apply current until a pronounced muscle contraction occurs. The duration of impact on the muscle is 5-10 minutes. 8-12 procedures are prescribed per course.

Rice. 96. Methods of electrical stimulation: a - unipolar method of stimulation of the right radial nerve; b - unipolar technique of stimulation of the left peroneal nerve; c - bipolar technique for stimulating the flexor carpi ulnaris; d - bipolar method of stimulation of the long peroneal flexor of the right foot

The following pulse mode is used on the “Stimul” device: 10 s - send, 50 s - pause, the total number of cycles in one workout is 10. The maximum tolerated current strength is prescribed, causing maximum contraction of the irritated muscle. Procedures are carried out daily (once or twice a day). 15-20 impacts are applied per course.

In case of a mild partial degeneration reaction (according to electrodiagnostics), exponential pulses are used with a frequency of 80-10 Hz, a pulse duration of 30-12 ms, a pause duration of 2000 ms on the devices “Net”, “Neuropulse”, “Neuroton”, “Diagnostim”.

Single-cycle wave current is used in constant or alternating burst form: period - from 15 to 20 s, leading edge - 3 s, trailing edge - 2 s (“Tone”). Sinusoidal modulated currents are prescribed in the first or second mode, the second type of work (PP), at a frequency of 80 to 10 Hz, modulation depth 100%, pause duration 4-6 s (“Amplipulse”). The current intensity is adjusted until the muscle contracts; the duration of exposure is 3-7 minutes per muscle. Procedures are prescribed daily. The course is 12-20 exposures when using a one- or two-pole technique.

In case of partial degeneration of the neuromuscular structure of a moderate degree, manual electrical stimulation with an exponential current waveform is possible with a pulse duration of 50-30 ms, a pause duration of 2000 ms on the devices “NET”, “Neuropulse”, “Neuroton”, “Diagnostic”.

In case of partial degeneration of the neuromuscular structure of a severe degree, the doctor performs manual electrical stimulation (unipolar). Optimal parameters of electrical stimulation: exponential current shape, pulse duration - 100-60 ms, pause duration - 2000 ms, current strength is adjusted to muscle contraction, duration of exposure - from 1 to 5 minutes per muscle.

Procedures are most often prescribed twice a day using the NET, Neuropulse, Neuroton, and Diagnostim devices. If the neuromuscular structure is completely degenerated, electrical stimulation is not performed.

Bogolyubov V.M., Vasilyeva M.F., Vorobyov M.G.

Source: www.ooo-tit.spb.ruAuthor: V.P.Bersnev, R.D.Kasumov, G.S.Kokin, O.N.Izvekov, R.G.Daminov, M.R.Daminov Russian Research Neurosurgical Institute named after Prof. A.L. .Polenova, St. Petersburg

How can I say in a nutshell what electrical stimulation is?

Electrical stimulation is the use of pulsed currents to rehabilitate tissues, organs and systems, especially nerves and muscles, that have lost their normal function as a result of disease or injury.

What is the essence of electrical stimulation?

Electrical stimulation is crucial in the complex of rehabilitative treatment of damage and diseases of the nervous system, leading to limitation of active movements, decreased strength and muscle wasting (weight loss).

Electrical stimulation, causing motor excitation and muscle contraction, simultaneously reflexively enhances the entire complex of metabolic and trophic processes aimed at providing energy to working muscles, and also increases the activity of regulatory systems, including cells of the cerebral cortex. When a stimulating electric current passes along the nerve trunks, the conductivity of nervous excitation through them increases, and the regeneration of damaged nerves is accelerated. Muscle contraction caused by a stimulating electric current, even with complete disruption of nerve conduction, due to the above processes, inhibits the development of muscle atrophy and sclerotic changes (degeneration of muscle tissue into connective tissue, i.e. into tissue incapable of active contraction) in them.

Electrical stimulation improves blood circulation by dilating blood vessels and accelerating blood flow in them, for example, on the skin this is manifested by hyperemia (redness) and an increase in skin temperature under the electrodes. Activation of blood and lymph circulation also occurs in the deeper tissues of the interelectrode space, the permeability of the vascular walls increases, and reserve capillaries open. Hyperemia occurs not only as a result of the reflex effects of electrical stimulation, but also due to the direct effect on the walls of blood vessels of biologically active substances formed in the stimulated tissues, for example: histamine, acetylcholine, adrenaline and others. Activation of blood circulation under the influence of electrical stimulation is a factor that provides many components of the healing process. This is an improvement in the trophism (nutrition) of tissues, removal of products of impaired metabolism from pathological foci, resorption of edema, softening and resorption of scars, regeneration (restoration) of damaged tissues, normalization of impaired functions. Along with improving blood circulation in the stimulated area, the processes of synthesis of nucleic acids, including RNA, are activated.

What therapeutic effect does electrical stimulation have?

Electrical stimulation regulates the activity of the central nervous system (brain and spinal cord), restores the activity of the neuromuscular system, restores muscle tone and volume of muscle mass, increases the vascular bed of arterial and venous blood that nourishes the nerves and muscles, and also has an analgesic effect.

Which patients need electrical stimulation? In medical terms, who is electrical stimulation indicated for?

There are peripheral (flaccid) paresis and paralysis (limitation of active movements) that occur due to injuries or diseases of the nerves, nerve plexuses, and nerve roots. Peripheral paresis and paralysis are characterized by flabbiness (flatness) of the affected muscles. Another group is central (spastic) paresis and paralysis (limitation of active movements) arising from injuries and diseases of the brain and spinal cord. Central paresis and paralysis are characterized by the density (spasticity) of the affected muscles.

Electrical stimulation is indicated for the following manifestations of the disease:

• peripheral (flaccid) paresis and paralysis (limitation of active movements) due to injury and diseases of the nerves (neuritis), nerve plexuses (plexitis), nerve roots (radiculitis),
• disorders of the sensitivity of the skin due to injuries and diseases of the nerves (neuritis), nerve plexuses (plexitis), nerve roots (radiculitis),
• central (spastic) paresis and paralysis (limitation of active movements) due to trauma and diseases of the brain and spinal cord,
• disorders of the sensitivity of the skin due to injuries and diseases of the brain and spinal cord,
• muscle wasting (weight loss) due to prolonged physical inactivity, prolonged immobilization with a plaster cast or other bandage.

Who should not undergo electrical stimulation?

Contraindications to electrical stimulation:

• feverish conditions,
• sepsis,
• acute purulent inflammatory processes,
• thrombophlebitis,
• thromboembolic disease,
• malignant neoplasms,
• epilepsy,
• dermatoses,
• bleeding, tendency to bleed,
• high arterial hypertension,
• atrial fibrillation,
• implanted pacemaker,
• acute period of myocardial infarction,
• acute period of stroke,
• bone fractures before their consolidation (fusion),
• condition after suture of a nerve, tendon, or vessel within three weeks after surgery.

Contraindications should be treated, like indications, philosophically: the more competent and skillful the doctor, the fewer contraindications and the more indications for electrical stimulation. For example, epilepsy is a contraindication to electrical stimulation according to some sources of information, and at the same time, other scientists write that electrical stimulation reduces the frequency of epileptic attacks and has a beneficial effect on the course of the disease. In this regard, ancient philosophers said that the difference between medicine and poison lies in the dose.

What electrical stimulators are used for rehabilitation treatment?

For electrical stimulation procedures in the rehabilitation treatment of peripheral (flaccid) paresis and paralysis (limitation of active movements), as well as muscle wasting (weight loss) due to prolonged physical inactivity, prolonged immobilization with a plaster cast or other bandage, devices that deliver pulses with high irritating ability and long pulse duration are suitable and amplitude, pulse repetition rate from 1 pulse per 2 seconds to 30-150 pulses per second.

Such devices include:

• domestic devices: ASM-2, ASM-3, UEI-1, ISE-01, ESL-2, Electrical stimulator ES-50-1, Neuropulse, Electroneurostimulator ENS-01, Neuron-1, EDAS-01. This same group of devices includes those developed at the Russian Research Neurosurgical Institute named after prof. A.L. Polenov electrical stimulators ES-D, for which the Federal Institute of Industrial Property issued a RF Patent. Patent holders: Russian Research Neurosurgical Institute named after Prof. A.L. Polenov and Daminov Marat Rafailovich.
  Electrostimulator ES-D1 is intended for patients who wish to independently, at home, supplement the rehabilitation treatment prescribed by their attending physician for injuries and diseases of the nervous system, leading to restrictions on active movements. ES-D1 requires periodic adjustment to the patient by a specialist (physiotherapist, neurologist, etc.).
  Electrostimulator ES-D2 is intended both for patients who wish to independently, at home, supplement the rehabilitation treatment prescribed by their attending physician for injuries and diseases of the nervous system, leading to restrictions on active movements, and for specialists. ES-D2 can be adjusted for the patient independently in accordance with the “Instructions for Use”.
  Electrostimulator ES-D3 is intended for specialists wishing to carry out comprehensive rehabilitation treatment of: 1) injuries and diseases of the nervous system leading to limitation of active movements; 2) pain syndromes: trigeminal neuralgia, spondylogenic radicular, autonomic, phantom pain; 3) functional disorders of the nervous system: neurocirculatory dystonia of all forms, neurasthenia, reactive and asthenic conditions, alcohol withdrawal syndrome, neuro-emotional stress, sleep disturbances, logoneurosis, meteotropic reactions, enuresis, etc.; 4) diseases of the cardiovascular system in the initial stages: cerebral atherosclerosis, coronary heart disease, hypertension stages I-II, obliterating diseases of the vessels of the extremities; 5) diseases of the gastrointestinal tract: peptic ulcer of the stomach and duodenum; 6) respiratory diseases: bronchial asthma; 7) skin diseases: neurodermatitis, itchy dermatoses, eczema, seborrhea, atopic dermatitis.
• foreign devices: TUR RS-10, TUR RS-12, TUR RS-21 (GDR), Universal Neuroton-726S (Siemens), Denatron 438, Endomed-CV405 from Enraf ​​Nonius).

Devices delivering diadynamic currents (DCT) of the type: Tonus-1, Tonus-2, Bipulsator, Diadinamic DD-5A, Dinamed, Neuroton, Sonodynator, etc., as well as sinusoidal modulated currents (SMC) of the Amplipulse type are not suitable for electrical stimulation of muscles for damage and diseases of the nerves with such manifestations as muscle wasting (weight loss).

For the rehabilitation treatment of central (spastic) paresis and paralysis (limitation of active movements), both the above-mentioned electrical stimulators and devices that generate diadynamic currents (DCT), sinusoidal modulated currents (SMC), etc. are suitable.

How to carry out electrical stimulation with greater benefit?

How to carry out electrical stimulation is indicated in the instructions for using each specific device. Here we will tell you the useful tips that we have received from our practice and creative activity.

Electrical stimulation for peripheral (flaccid) paresis and paralysis (limitations of active movements), as well as in case of muscle wasting (weight loss) due to prolonged physical inactivity, prolonged immobilization with a plaster or other bandage, it is useful to carry out immediately after a thermal procedure (applications of paraffin, ozokerite, electric heating pad, etc.). If constantly following this advice is burdensome, then periodically it is simply necessary.

When forming a stimulating impulse, it should be remembered that the deeper the muscle wasting, the longer the impulse duration is required for its contraction, and vice versa. This pattern explains the reason why devices using diadynamic currents (DCT), sinusoidal modulated currents (SMC), as well as analgesic electrical stimulators do not produce contractions of the stimulated muscles. The duration of the pulses of these devices is not sufficient to contract the stimulated muscles.

With a very weakened muscle, there is no need to achieve distinct contractions. However, as the muscle strengthens and adapts to the current, the intensity of the current should be sufficient to produce distinct contractions.

When performing electrical stimulation of weakened muscles, it is necessary during the procedure to periodically combine the action of the current with volitional efforts aimed at performing muscle contractions. It is advisable to perform movements with the participation of symmetrical healthy muscles. If necessary, at first, weakened muscles should be helped by facilitating contraction by positioning the body or limb. As the range of motion and strength of the muscle increases, additional load should be introduced in the form of overcoming gravity.

The duration of continuous electrical stimulation at one point should not exceed 3 minutes.

One nerve or one muscle can have multiple points of stimulation.

The duration of stimulation of one nerve with deep conduction disturbances or one weakened muscle is up to 1-3 minutes, after which it is necessary to give this nerve or muscle a 9-12-minute rest break and then repeat electrical stimulation of this nerve or muscle 2-3 times. During the break, you can stimulate other nerves or muscles in the same way.

The duration of stimulation of one nerve with restored conductivity or one strengthened muscle is 3-6 minutes, after which it is necessary to give this nerve or muscle a 6-9-minute rest break and then repeat electrical stimulation of this nerve or muscle 2-3 times. During the break, you can stimulate other nerves or muscles in the same way.

The duration of one electrical stimulation procedure should be within 45 minutes. Procedures are carried out daily 2-3 times a day.

Treatment is carried out in courses of 2-4 weeks with an intercourse break of 2-3 weeks.

Electrical stimulation for central (spastic) paresis and paralysis (limitations of active movements) has the following features. Thermal procedures (ozokerite, paraffin, warm sand, heated coarse table salt, medical heating pad, etc.) should be applied to spastic muscle groups while simultaneously electrically stimulating antagonist muscles. For example, if there is a central (spastic) paresis of the posterior group of muscles of the lower leg, then the anterior group of muscles of the lower leg is stimulated while simultaneously warming up the posterior group of muscles of the lower leg.

Taking into account the fact that a healthy muscle group is stimulated, it is necessary to use a short duration of the stimulating pulse, as well as a small pulse amplitude. The small strength of the stimulating current allows you to increase the duration of stimulation at one point to 6 minutes. Stimulation of one healthy muscle can be increased to 6-12 minutes, after which it is necessary to give this nerve or muscle a 6-12-minute rest break and then repeat electrical stimulation of this nerve or muscle 2-3 times. During the break, you can stimulate other nerves or muscles in the same way.

The duration of one electrical stimulation procedure can be increased to 15-30 minutes. Procedures are carried out daily.

Treatment is carried out in courses of 2-4 weeks with an intercourse break of 3-4 weeks.

In contrast to stimulation for peripheral (flaccid) paresis and paralysis (limitation of active movements), for central (spastic) paresis and paralysis, electrical stimulation with tetanizing current can be performed from the very beginning of the treatment course, i.e. short electrical impulses with a frequency of up to 150 impulses per second, grouped into packets lasting 1-2 seconds and a pause of 2-4 seconds.

Due to known circumstances, electrical stimulation in medical institutions is carried out according to a truncated version and naturally cannot give the maximum possible result. To achieve the best results from electrical stimulation, it is recommended to use a home electrical stimulator and supplement both the procedures and the course of treatment at home. Such a home Electrical Stimulator (ES-D) was developed at the Russian Research Institute of Neurosurgery named after. prof. A.L. Polenova. This development was presented to the Scientific and Technical Council under the Governor of St. Petersburg in 1999 for inclusion in the scientific and technical program “Science to the City”. It implements the following ideas:

• ease of use of the electrical stimulator,
• safety, since the device can be powered by batteries,
• the cheapest of its kind,
• personal use device,
• The period of stable operation corresponds to the period of rehabilitation treatment of the patient.

What complications are possible with electrical stimulation and what is their prevention?

The most common complications from electrical stimulation are electrical burns, which can occur when overly intense stimulation currents are used.

To prevent this complication, you should avoid electrical stimulation due to pain, stimulation at one point for more than three minutes, and at the end of the procedure, lubricate the places where the electrodes come into contact with the skin with a nourishing cream.

How to improve treatment results and avoid complications?

One of the conditions for improving the quality of treatment is your active position, a positive relationship with your attending physician and constructive consultations with a specialist in the field of physiotherapy.

Also of interest to specialists is the Electrostimulator ES-D3, which has a lot of additional capabilities for providing qualified medical care.

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Electrical muscle stimulation in neurology is one of the best methods of physiotherapy, which is aimed at restoring the function of muscle tissue and nerves after damage. During the procedure, currents of very different frequencies and strengths are used.

At the same time, the patient’s trophic functions of the nerve fiber improve or are completely restored, the process of their innervation and contractility improves.

Indications

There are quite a few indications for the use of electrical muscle stimulation. These are all diseases in which, for one reason or another, the speed of nerve impulses changes, diseases characterized by paresis and paralysis, traumatic damage to nervous tissue. More detailed list:

1. Spastic paralysis, which can be a symptom of various diseases, including polyneuropathy,.
2. Impaired skin sensitivity, which is associated with various traumatic injuries.
3. Paralysis and paresis due to cerebrovascular accident.
4. Muscle wasting, which is associated with the fact that a person, for one reason or another, lacked movement, for example, due to fractures.

The procedure should not be the only one in the treatment of a particular disease, but should be only part of a comprehensive course. In this case, electrical muscle stimulation will bring much more benefits.

This procedure also gives an excellent effect during long-term bed rest. Moreover, electrical stimulation is indicated for almost all patients who are forced to constantly stay in bed, be it due to injury, the period after surgery or any neurological disorder, as well as old age.

Contraindications

Electrical muscle stimulation in neurology, despite all its usefulness, has some contraindications. Firstly, this is the acute period of heart attack and stroke. Secondly, fever, fever and sepsis. Thirdly, all neoplasms, both malignant and benign.

Contraindications also include skin diseases, especially in the area where the electrodes will be applied, and pathologies of the heart and blood vessels. And finally, this is epilepsy, since such use of current can provoke the development of an attack.

In case of traumatic damage to nerve tissue, muscles or tendons, electrical stimulation is indicated only one month after surgery. If this time is significantly reduced, then there will be no complete healing of the rupture site.

As for pregnancy, during this period of a woman’s life electrical stimulation is completely contraindicated, as it can provoke the onset of premature birth.

Duration of treatment

The duration of treatment will depend entirely on the patient’s health status, his diagnosis, and the desire to achieve a good result. However, whether it will be 10 or 20 procedures can only be decided by the attending physician.

The duration of one procedure, as a rule, does not exceed 40 minutes, but there are some peculiarities here. One muscle or one nerve can be stimulated for no more than a couple of minutes, after which a break of up to 10 minutes must be taken.

This treatment should be carried out every day, and in the most difficult cases, several times a day. The general course can range from 10 days to one month, after which a mandatory break and resumption of treatment using the same method is required.

The procedure will not relieve a person from the cause of the pathology, since the main effect is only on muscle and nervous tissue, thus causing it to contract. In the most severe cases, even long-term treatment may not give the expected positive effect.

At home

Carrying out the procedure in a hospital setting may not give a noticeable result, which is due to the minimum number of prescribed procedures. Therefore, after discharge, it is advisable to have an electrical stimulation device at home in order to continue the treatment started. The home device is easy to use, safe, intended for individual use and gives good results with regular and correct use.

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The keratinized cells of the epidermis (the top layer of skin) make it difficult to conduct electrical impulses. Therefore, it is quite advisable to exfoliate the skin before starting treatment and then repeat it once or twice a week.

Electrodes superimposed on the so-called motor points - the points of penetration of the motor nerve into the muscle sheath. By placing electrodes at these points, muscle fibers can be activated as much as possible.

In most cases, electrodes are secured to the body using special belts - bandages. Sometimes disposable electrodes are used, which can simply be glued on like a band-aid. Fabric, rubber and sticky electrodes perform the same functions, differing only in convenience, processing features and appearance.

In the bipolar stimulation mode, one electrode, regardless of polarity, is applied to the motor point of the muscle, and the other in the area of ​​its attachment. If the device operates in monopolar mode, then a negative electrode is placed in the area of ​​the motor point.

The main frequency range for electrical stimulation is 30-150 Hz. Do not increase the current immediately in hopes of getting better results. The current strength is initially set to a minimum and the effect on the muscles is gradually increased. There should be no feeling of pain or discomfort.

During the first procedures, you should not increase the current to maximum. In some salons, patients are immediately given high current, in which case a visible effect can be achieved even after one session. Such an immediate result only shows that your muscles are able to contract, but has nothing to do with the therapeutic effect. You, as in advertising, will lose 1-2 cm in weight, but what happens to your muscles? Having received a powerful charge of current, they contract convulsively and can remain in this tension for half a day. Normal muscle tone is somewhere between spasm and relaxation.

The muscles gradually become accustomed to the load, so you can slightly increase the current strength, change the duration of the series of impulses or the polarity (for bipolar impulses). Two to four sessions are enough for the muscles to get used to effective contractions without pain.

Over time, adaptation to the effects of pulsed current is developed. Fewer and fewer muscle fibers are involved in work. This is due to the “accustoming” of the motor and sensory centers of the brain to the flow of stimuli. To effectively carry out a course of procedures, adaptation to current should be reduced. Well-designed professional devices have ways to eliminate this drawback.

The figures below show diagrams with the most effective placement of electrodes in the area of ​​motor points. Electrodes belonging to the same channel are marked with the same numbers; these numbers have no relation to a specific channel number. Nerve endings are located symmetrically on the left and right sides of the body and on both sides of the spinal column. It is also very important to correctly place the electrodes belonging to one channel on one side of the body. In people with a puny (fragile) build, the electrodes may overlap each other by 1/4 or 1/3 of the area. The following figures show approximate stimulation settings and electrode placement depending on the desired effect. After a stroke, limb stimulation can only be indicated as prescribed by the attending physician. In most cases, it may be the only way to maintain muscle tone until the functioning of the nervous system is restored.

So, some general rules for conducting electrical stimulation, recommended by the manufacturer of professional myostimulators ESMA.

• Make sure there are no contraindications to electrical stimulation.
• Apply a conductive medium to the electrodes.
• Install the electrodes correctly (according to the diagram).
• Ensure good contact between skin and electrodes. The exception is ESMA conductive electrode gloves, which can be torn off painlessly during the procedure.
• Antagonist muscle groups (eg, external and internal thigh muscles, abdominal muscles and buttocks) cannot be stimulated simultaneously. It is possible to install electrodes on antagonistic muscles at the same time only when the device has a group mode of operation.
• The procedure should not be prolonged beyond 30 minutes. In some cases 45 minutes.
• Procedures should not be carried out daily, optimally 3 procedures per week, with breaks of 2 days.
• To build muscle mass, it is advisable to immediately after the procedure get protein foods (nuts, cottage cheese, special cocktails).
• If you want to reduce body fat and cellulite, you should refrain from eating dense foods for a couple of hours after the procedure. Juices and fruits are not contraindicated.

Abdominal muscle stimulation

Where will we make the waist? This question could be asked to most of our visitors, because there is often simply no waist

Loose skin and weak muscles of the anterior abdominal wall (abs), especially in women who have given birth, are a big problem that is difficult to cope with even with time and great willpower. In this case, electrical stimulation gives good results. Literally after the first procedure you can feel the restoration of muscle tone. Typically, women immediately notice that the stomach is easier to retract and the abdominal wall begins to participate in breathing movements. And after a few (3-4) procedures, the count is already counting in centimeters. Measurements are taken not daily, but once every five days.

I would also like to clarify that even with such wonderful results, it is necessary to carry out supporting procedures, for example, the same gymnastics. Only in this case will it be possible to maintain your waist size. In general, it is easier to remove fat deposits in the abdominal area using myostimulation than in the thighs. But maintaining the result is more difficult.

The first or just a one-time myostimulation procedure almost always increases muscle tone. If you measure volumes before and after the procedure, there will definitely be a decrease of 1-2 cm, especially on the abdomen. This change indicates that the muscles are indeed weakened and need to be exercised. And also about their readiness to restore tone. But if you decide on a course of procedures, you don’t need to make tempting calculations: for one procedure - 2 cm, which means for ten procedures - 20 cm. After a single myostimulation procedure, the tone does not last long, and real changes accumulate gradually, training and some reorganization of work occurs muscles. A significant reduction in volume is the difference in waist circumference before the first and before the last procedure. How many centimeters will it take? The results depend not only on the equipment and the correct implementation of the technique. But in many ways - from the state of health, the presence of excess weight and additional measures - diet, physical activity, additional procedures.

On average, you can expect that 4-6 cm will go away. Ideally, myostimulation should be combined with other anti-cellulite methods - wraps, massage.

The electrodes are fixed taking into account the motor points. The superficially located rectus and external oblique abdominal muscles are stimulated.

Scheme 1. MODE OF STIMULATION OF THE ABDOMINAL AND WAIST MUSCLES

Back muscle stimulation

Stimulation of the back muscles not only gives an aesthetic result, but also has a therapeutic effect for osteochondrosis and scoliosis. The activity of segmentally located internal organs is stimulated. In addition, electrical stimulation at a certain frequency leads to relaxation of muscle tension.

Scheme 2. WORKING WITH THE MUSCLES OF THE FOREARM AND BACK

Chest muscle stimulation

Breast skin care may include myostimulation, but this method should be used with extreme caution. In modern women, unfortunately, neoplasms, cysts and mastopathy quite often occur in the mammary glands. In this case, the use of electric current is contraindicated, and before carrying out any procedures, you must discuss them with your doctor.

Stimulation of the pectoral muscles can slightly improve the shape of the breast, but make no mistake - it is impossible to achieve the ideal shape and increase the volume of the breast with the help of myostimulation.

Electrical stimulation of the pectoral muscles is a more rewarding task for men. With sufficient protein nutrition and patience, you can achieve good results.

Scheme 3. TRAINING THE CHEST MUSCLES

Thigh muscle stimulation

Those with too large hips and large buttocks suffer extremely. Most often, these are representatives of the so-called ganoid type of fat distribution (pear-type). Simply limiting your food intake or taking weight loss medications is not an option for them. Such women usually have a rather thin waist, narrow shoulders and modest-sized breasts, which are the first to lose weight due to diets and physical activity. In this case, myostimulation gives noticeable results - the volume of the hips and the appearance of cellulite are reduced, while at the same time the upper body remains the same as it was. Myostimulation in most cases is alternated or combined with lymphatic drainage. The use of massage and wraps significantly speeds up the process of figure correction.

Myostimulation can be used not only to increase the tone of flabby muscles or reduce the volume of fat deposits, but also to relax overtrained muscles.

It is possible to apply electrodes to the internal and external muscles of the thigh at the same time only if the device has a group (asynchronous) method of channel operation.)

Scheme 4. HIPS - FRONT AND OUTER SURFACES

We work with the buttocks and breeches and calf muscles

The basis of the gluteal muscles is made up of the gluteus maximus, medius and minimus muscles. The stimulation parameters and the application of electrodes are determined in accordance with Scheme 5. To combat the “breeches,” the electrode arrangement shown in the right figure and the “Fat Breakdown” mode are used. The left picture shows work with the gluteal muscles.

Working with the "breeches" consists of a combination of stimulation of the femoral and gluteal areas, and it is advisable to use a hyperemic belt or its substitute

Scheme 5. HIPS - BACK AND INNER SURFACES, BUTTON, breeches

Scheme 6. WORKING WITH THE MUSCLES OF THE UPPER AND LOWER PARTS OF THE BUTTOCKS AND LIN

Shoulder muscle stimulation

The shoulder muscles, especially the back, often give away a woman's age, as do the neck and hands. The triceps muscle of the shoulder - triceps - quickly becomes flabby and is very difficult to respond to various physical influences. Even with the help of exercise equipment, it is difficult to restore her good tone, much less increase her weight. Electrical stimulation in this case gives good results.

Scheme 7. WORKING WITH THE MUSCLES OF THE SHOULDER AND FOREARM