After paralysis of lower motor neurons, muscles lose control of nerves and atrophy and degeneration. In order to slow down this change, according to different situations, different pulse currents are selected to stimulate muscles or muscle groups to make them passively contract rhythmically. Through exercise, the function of muscles can be maintained, and the development of atrophy and degeneration can be delayed.
Therapeutic effect on spastic muscles
At present, the principle of this treatment method is still in the hypothetical stage. Electrical stimulation of spastic muscles is mainly to relax spastic muscles by stimulating the reflex inhibition caused by Golgi apparatus in spastic tendons and the mutual inhibition caused by stimulating its anti-muscle abdomen. Electrode technology
Bipolar therapy is generally advocated because it can concentrate the current on the diseased muscle without affecting the treatment because it stimulates the adjacent muscles. However, when the muscles are too small (such as the hand minor) or the whole muscle group needs to be stimulated, the bipolar method is not suitable. At this time, the unipolar method should be adopted, and a small main electrode should be placed at the movement point of the small muscle, and another large electrode should be placed between the lumbosacral or scapula.
Timing of electrical stimulation therapy
1. Muscle atrophy is the fastest in the first month after denervation, so electrical stimulation should be carried out as soon as possible. This treatment should also be carried out as soon as possible when it is uncertain but suspected that the muscle is innervated.
2. After several months of denervation, electrical stimulation therapy is still needed, but the effect is uncertain. At this time, although it may not delay the process of atrophy, it is still effective in preventing fibrosis. However, before electrical stimulation, it should be determined whether the muscle has the possibility of restoring innervation.
Selection of current waveform
Conditions of ideal current:
1, which can selectively stimulate only the diseased muscles and not the adjacent normal muscles.
2, it can only stimulate the sick muscles without causing sensory reactions.
Selection of current polarity
Generally, the cathode is selected for unipolar method. If bipolar method is used, the cathode is usually placed at the distal end.
The number of muscle contractions per treatment.
At the beginning of treatment, each diseased muscle should contract 10- 15 times at a time and rest for ten minutes. If it is unconditional, it can shrink the same number of times after 3-5 minutes, and so on for four times. During the whole treatment period, each diseased muscle contracted at least 80- 120 times. But it can't be decided by numbers alone. Appropriate stimulation should meet the following requirements:
1, the contraction of the diseased muscle should be strong enough, otherwise it is difficult to delay the occurrence of atrophy.
2. There is no pain or mild pain during contraction.
3. The response of adjacent muscles is very small.
4. The contraction range is similar every time.
Daily treatment times
Experiments show that 4-6 times a day is better than 1-3 times. If you have no illness, you should be treated at least 1 time every day, and if you get better, you should be treated three times a week.
Estimation of the duration of electrical stimulation therapy
1, apraxia is a disease in which muscle function is temporarily lost but nerve has no organic pathological changes. There was no denervation in electric diagnosis, and it is estimated that it will recover in 3-4 weeks or a little longer. At this time, the electrical stimulation should last for more than 6 weeks until the nerve function is restored.
2. When the peripheral nerve is injured by trauma, extrusion, surgery, etc. If the location is definite, limited and regeneration is possible, it can be estimated according to the regeneration speed of peripheral nerves.
3. If the damaged part is uncertain, it can't be calculated according to the above formula, and it can only be estimated generally. That is, it takes about 6- 12 weeks to recover from partial degeneration or partial denervation; It takes about 6- 12 months to recover from complete degeneration or complete denervation. Indications: mild hemiplegia after cerebrovascular accident (neuromuscular electrical stimulation can improve the upper limb function of stroke patients, especially in training wrist and finger back extension function), cerebral palsy in children, spastic paralysis caused by birth injury, multiple sclerosis paralysis, spastic paralysis caused by spinal cord injury, Parkinson's disease.
Contraindications: amyotrophic lateral sclerosis and multiple sclerosis.