1. Types of Electrical Stimulators that can be used to cuase muscle contraction
    • High Voltage
    • Low Voltage
    • Alternating Current
    • Hybrid current
    • TENS
  2. Therapeutic Uses of Electrically Induced Muscle Contraction
    • Muscle re-ed
    • Muscle Pump contractions for edema control
    • Retardation of muscle atrophy
    • Meucle conditioning through strengthening or endurance training
    • Increased ROM
  3. Contraindication of E. Stim
    • Arrhymia
    • Cardiac condition
    • musculotendinous lesion
    • insecure bony attachment of the muscle
    • compromised bone integrity
  4. Precautions of NMES
    • Improper use may result in burns or skin irritation
    • Intense or prolonged stimulation may rsult in muscle spasm and or mucle soreness
    • An electrically induced conraction can generate too much tension within the muscle becuase natural protection is eliminated
    • Decrease response to exercise (CHF, recent MI, need monitorin during sessions
    • Superficial meta
    • Open skin
    • Obesity (may no be able to reach muscle)
    • Osteoporosis (could cuase fractures)
    • Peripheral Neuropathy
    • Autonomic Dysreflexia
  5. Type 1 Muscle fibers
    • do no generate muc force but are able to sustain the contraction for a prolonged period
    • Fire first during voluntary contractions
  6. Type 2 Muscle fibers
    • Generate mroe force but fatigue quickly
    • Electrical Stimulation cuases large diameter type 2 motor nerves to evoke a contraction before type 1 fibers
    • because type 2 fibers are capable of producing more force the strength of the contraction is increased
    • Fire first during ESTIM contractions
  7. Physiologically Induced Contractions vs. EStim Induced Contractions
    • Physiologically: Smaller diameter, slow twitch muscle fibers are recruited first. Contracions and Recruitement are asynchronous. Golgi tendon organs protect the muscles from too much force production
    • EStim: Large diameter, fast twitch muscle fibers recruited first. Contractions and recruitment are synchronous and based on the number of pulses per second. Golgi tendon organs can't override.
  8. Muscle Force
    • Muscle force is varied by changeing the intensity to recruit more or less motor units
    • Muscles force can also be varied to a certain degree by increasing the summation quality of the contraction with high burst or pulse rates
    • the greater teh force the greater the fatigue
  9. Symmetrica Biphasic Wave Forms
    • Used with larger muscle groups
    • large active area
    • Bipolar setup with electrodes
  10. Asymmetric Balanced Waveforms
    • Used with smaller muscle groups
    • Discrete activation
    • Over motor point
    • Monopolar set up with electrodes
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