Mel:

Your thoughts on the below?

Sports Med 1992 May;13(5):320-36 Related Articles, Books, LinkOut


Neuromuscular electrical stimulation. An overview and its application in the
treatment of sports injuries.

Lake DA.

Department of Physical Therapy, Northeastern University, Boston,
Massachusetts.

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 unexercised 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 immobilisation. In all but one of the studies,
NMES was shown to be superior in preventing the atrophic changes of knee
immobilisation 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 immobilisation improves the performance on
functional tasks.(ABSTRACT TRUNCATED AT 400 WORDS)

Phys Ther 1994 Mar;74(3):201-13; discussion 213-8 Related Articles, Books,
LinkOut


Erratum in:
Phys Ther 1994 Jun;74(6):595

Pulsed microamperage stimulation: a controlled study of healing of
surgically induced wounds in Yucatan pigs.

Byl NN, McKenzie AL, West JM, Whitney JD, Hunt TK, Hopf HW, Scheuenstuhl H.

Graduate Program in Physical Therapy, University of California School of
Medicine, San Francisco 94143-0736.

BACKGROUND AND PURPOSE. Microamperage direct current and microamperage
electromagnetic stimulation are used to accelerate healing in bone. Although
many clinicians are using microamperage stimulation to relieve pain and
facilitate wound healing, there is significant question regarding whether
this low-intensity direct current significantly accelerates soft tissue
wound repair. The purpose of this study was to determine whether low-voltage
pulsed microamperage current (100 microA, 60 V, 0.1 Hz) enhances the healing
of superficial, full-thickness, or incisional wounds created to simulate
acute abrasions, ulcers, and lacerations. SUBJECTS. Ten adult Yucatan mini
pigs served as the subjects for this study. METHODS. Variables associated
with healing were measured in 60 matched pairs of surgically induced
partial-thickness, full-thickness, and incisional wounds after either sham
or anodal (positive-polarity) stimulation with pulsed microamperage current
(100 microA) was administered for 1 hour per day for 5 days. Sterile,
disposable electrodes (2 x 4 cm) were placed over each wound, which was kept
wrapped and protected throughout the study. RESULTS. At 7 days postinjury,
all wounds were healing well with no signs of infection. There were no
differences in tensile strength, collagen density, maturity, or deposition
(hydroxyproline), wound size, or visual appearance between the sham
treatment and treatment lesions. No changes in local subcutaneous oxygen or
temperature were found in the swine during or after microamperage
stimulation. CONCLUSION AND DISCUSSION. This study did not provide any
evidence to support the use of microamperage stimulation to accelerate wound
healing. No negative effects, however, were found. Further research is
needed to determine whether there is a critical interaction between the size
of the electrode relative to the wound, the density of the current, the
duration of the treatment, the polarity of the treatment electrode, and the
acuity or chronicity of wounding and the effectiveness of microcurrent
stimulation for wound healing.

PMID: 8115454 [PubMed - indexed for MEDLINE]

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2: Phys Ther 1994 Mar;74(3):195-200; discussion 213-8 Related Articles,
Books


Effect of microamperage stimulation on the rate of wound healing in rats: a
histological study.

Leffmann DJ, Arnall DA, Holmgren PR, Cornwall MW.

Group Health Co-operative-Central Hospital, Seattle, WA 98112.

BACKGROUND AND PURPOSE. This study examined cutaneous wound healing after
microamperage stimulation (MS). SUBJECTS. Twelve female Sprague-Dawley rats
were studied. METHODS. The treatment (wound reduction) group (n = 6)
received 100 microA of current at 0.3 Hz on a 50% duty cycle for 2 hours a
day for 14 days. The control group (n = 6) received the same handling and
electrode placement, but no current was applied. Wound size was measured
daily following each treatment. Histological analysis included measurement
of epithelial thickness, vascularity, and fibroblast density from tissue
sections taken at the end of the experiment. RESULTS. An analysis of
variance showed no significant difference between the two groups with
respect to the change in wound size over the 14 treatment days. A series of
t tests showed no significant differences between the groups for any of the
histological measurements. CONCLUSION AND DISCUSSION. The results of this
study do not support the hypothesis that MS accelerates acute cutaneous
wound healing.



> Periodically, some coaches and athletes ask about the possible use of
> electrostimulation for bodybuilding and other athletic conditioning, so
this
> recent discussion on the Supertraining list may also be of interest here.
>
> It was asked:
>
> <Dr. Siff,  You recently mentioned the use of Electrostimulation (ES) in
the
> context of a training session (not simply as a restorative measure). What
> kind of results have you seen in your experience? Is this something the
> layman can learn? >
>
> *** Virtually anyone can learn almost anything fairly competently, given
> enough effort and motivation, but the legitimate use of a modality whose
use
> is often regulated by medical laws is quite another thing.  First of all,
ES
> is not a substitute for standard strength training and, like plyometrics
and
> other 'shock' methods, needs to be carefully integrated into an overall
> training program.
>
> In fact, the use of certain ES procedures will offer more explosive and
> stronger muscle recruitment than the weight catching methods that Jay Sch
> roeder has been using.  Before we discuss this issue further, I would
suggest
> that you read through the article and especially some of the references in
an
> article that I wrote for one of the NSCA publications.
>
> Siff MC (1990) Application of Electrostimulation in Physical Conditioning.
J
> of Applied Sports Science Res,  4(1): 20-26
>
> Incidentally, Charlie Francis regularly used ES in training Ben Johnson,
so
> that it is not only Russians who have used this modality successfully.  In
> one controlled study that some of my physio students carried out over 4
> months, it emerged that a combination of a specific training scheme
> (Autoregulating Progressive Resistance Exercise - APRE) and ES produced
> significantly greater thigh hypertrophy than simply the APRE method alone
> (even with adjustments made to APRE to take into account the extra
training
> offered by the ES).  Its use for no more than 5 minutes per muscle group
> every second day also significantly increased the Totals of several
Olympic
> lifters who trained in our gym back in the 1970s.  However, it must be
> stressed that the restorative role played by microcurrent ES can also be
very
> useful in enhancing any training program.
>
> There are videos of workshops that I offered at one NSCA conference on ES
and
> at the Australian Institute of Sport in 1988, but I believe that they are
no
> longer in stock.  At one stage I worked for a company in designing and
> producing various types of clinical, training and cosmetic ES devices and
> still have some of the many prototypes that we manufactured.  I generally
> display these at my educational Strength Camps - possibly I now need to
show
> people how they are used in practice.   Maybe I need to investigate having
> copies made for anyone who may be interested, even though the material is
now
> over 13 years old.  Then again, all the material that I offered during a
> similar period (1982-1989) on "Functional  Conditioning" seems to have hit
> the market all these years later, so who knows - maybe older material is
> sometimes still very much up to date?
>
> Since there are often enquiries on this topic, I will post a long article
> later today on the Supertraining list (URL below) on the use of ES in
sport.
>
> Dr Mel C Siff
> Denver, USA
> http://groups.yahoo.com/group/Supertraining/