Electrical stimulation: indications, contraindications,side effects

Update: October 2018

Electrical stimulation (physical stimulation, electromyostimulation,
miostimulyation, miolifting) is a physiotherapeutic method,
related to restorative treatment, based on
is electrical stimulation of muscle and nervous tissue.
It is carried out by transfer of current with certain characteristics.
от миостимулятора к определенной области тела через electrodes.

Electrostimulation technique is widely used to restore
patients after injuries, with pathologies of the nervous system
(peripheral and central), muscle hypotonia, in cosmetology and
professional sport.

Under myostimulation implies the use of stationary,
fixed electrodes and current, the intensity of which allows
get visible muscle contractions. Miolifting involves
impact on the skin of moving electrodes that do not lead to
visible contractions of muscle fibers, but are felt as passing
current.

Mechanism of action

The action of the pulse current is mainly directed to the tone and
muscle tissue responsiveness.

When electric current is applied to muscles or nerves
there is a change in their bioactivity and the formation of spike
replies. So, electrostimulation with a frequency of more than 10 imp-1, leads
to 2m effects: depolarization and strong, long-lasting
muscle contraction or dentate tetanus. With increasing frequency
due to very frequent impulses the muscle tissue does not relax and
there is a full tetanus, which at a subsequent increase
frequency changes to complete non-excitability of muscle tissue.

The most intense excitement is realized by coincidence in
nerve conductors of the frequency ranges of impulses and
electrostimulation. Against the background of electrostimulation of the nerve impulses more
50 imp-1 motor neural conductor excitation is formed and
passive contraction of muscle fibers.

Besides:

  • In the cytoplasm of cells increases the number of high-energy
    compounds (creatine phosphate, ATP), their enzymatic
    activity, accelerated oxygen utilization and reduced costs
    energy for stimulated muscle contraction compared to
    arbitrary;
  • Blood supply and lymphatic drainage are activated, which leads to
    trophic enhancement;
  • Expansion of peripheral vessels occurring in parallel
    пассивному сокращению мышц, приводит к активации кровоcurrent.

Nerve cells are known to regulate the activity of others.
cells. Signals from nerve endings cause contractions
myocytes. When both muscle and muscle are active
nerve cells, ions move rapidly through the cell membrane.
The current generated during this is called the “action potential”, and
you can register it using intracellular
electrodes.

Impulses that are as close as possible to the “potentials
actions of muscle and nerve cells are called neuropulses.
Drugs that generate neuroimpulses are especially popular in
cosmetology, because the procedures are the most comfortable,
and the result is more efficient and noticeable.

Indications for electrostimulation and effects of procedures

Procedures allow:

  • Prevent muscle atrophy due to special
    �”Training” the muscles during stimulation, namely, the reduction and
    relaxation;
  • Restore the nervous regulation of muscle contraction;
  • Increase muscle volume and strength without shortening muscle
    fibers;
  • Increase the adaptation and fatigue limit of muscle tissue;
  • Reduce the pain of any localization;
  • Dispose of energy reserves (thereby activating
    lipolysis);
  • Provide lymphatic drainage and accelerate the excretion of products
    matabolism.

The most popular indications for stimulation:

  • Weakening of muscle tone;
  • Weakening of skin turgor;
  • Simulation of the oval face and neck, the restoration of muscle tone in
    this area.

Electromyostimulation devices

Modern computerized equipment allows you to set
required parameters of the procedure that will be most effective in
in each case:

  • pulse shape;
  • pulse repetition rate. Mostly use low frequency
    импульсов, от 10 до  1000 Гц.

Low frequency range used in physiotherapy
practice is preferable due to the fact that the skeletal muscle fibers
may react with a reduction in current stimulation with a frequency not
more than 1000 Hz. Higher current frequencies are no longer perceived.
nervous and muscle tissue as separate stimuli, and this
приводит к резкому снижению эффективности impact.

For effects on skeletal, smooth muscle and nerve guides.
it is necessary to use different pulse frequencies. If the apparatus
allows you to change the frequency of the generated pulses, it is significantly
expands the scope of its application. Different classes of devices
operate at a different pulse frequency:

  • Devices for high-grade electrostimulation –
    high-frequency pulse filling with the recommended frequency in
    range of 400-600 Hz.
  • Devices of the middle class – low-frequency pulse filling
    with the recommended frequency of myostimulation in range of 10-230 Hz.

Also, devices are classified into professional, which
installed in physical cabinets and beauty salons
beauty, and low-power home (belts, butterflies, shorts, etc.),
which can be used independently.

The pulse duration is 0.1-1000 ms. Close to
natural neuropulses and most preferred for
myostimulation are short pulses, from 0.1 to 0.5 ms.

The current strength of the equipment varies depending on the area of ​​the body:
for effects on the face – up to 10 mA, for effects on the body – up to 50
mA. During the procedures, the intensity of the current varies in
depending on the person’s sensations: muscle contractions should be
strong but not painful.

Impulses are classified as mono- and bipolar.

  • Monopolar pulses separate substances into ions and can
    promote particles with an electric charge into the tissue.
    Monopolar pulse current can also be used for
    electrophoresis. Use the same substances as for electrophoresis with
    galvanic current.
  • Bipolar pulses lead to oscillatory motions of particles with
    electric charge on biological membranes. Impulses on
    symmetric zones compensate for electrolysis, and under the electrodes do not
    skin irritation occurs. Such impulses more effectively overcome
    skin resistance and procedures are more comfortable for
    patients.

Treatment by electrostimulation is carried out 2-3 times in 7 days (it is possible and
every other day), for 20-40 minutes per session. The course includes 15-20 procedures.
The minimum break between courses is 1 month.

Procedure scheme

  1. Electrodes, well soaked in water, are installed on active
    muscle points of muscle tissue in the area of ​​impact and fix
    bandages.
  2. Connect the wires, observing the polarity.
  3. Run the appropriate program on the machine.
  4. The strength of the current is increased gradually, 3-4 minutes after the start.
    effects, until there is active muscle
    cuts. There should be no pain during contraction
    muscle Impact intensity is best increased
    simultaneously in symmetric zones.
  5. After the procedure, turn off the device and remove
    electrodes.
  6. The skin at the site of the procedure is treated with a moisturizing tonic or
    milk.

Contraindications

Contraindications к электростимуляции довольно обширны и
must be taken into account when prescribing treatment. The fact,
that electric current can accelerate the progression of a series
diseases and lead to the most undesirable effects.

  • Oncological diseases (however, some
    electrostimulation is used to relieve pain).
  • Blood pathology.
  • Pregnancy (in exceptional cases it can be used for
    toxicosis).
  • Diseases of the infectious nature.
  • Hyperthermia.
  • Artificial pacemaker.
  • Pulmonary, heart failure higher than 2 degrees.
  • Severe heart rhythm disorders.
  • Hyperthyroidism.
  • Arterial hypertension (upper pressure more than 180).
  • Epilepsy.
  • Parkinson’s disease.
  • Individual intolerance to electric current.

There are also local contraindications that concern
procedure areas:

  • injuries, attritions, cuts, and other infringements of integrity
    dermis;
  • metal implants, for example, “golden threads” on the face,
    intrauterine device with metal elements if electrodes
    superimposed on the lower abdomen;
  • benign neoplasms, including nevi;
  • phlebitis, thrombophlebitis;
  • phlebeurysm.

Electrostimulation methods

Neuromuscular electrostimulation

It is successfully used in medical rehabilitation, as well as
supplement athletic vocational training, and is suitable for
stimulation of all muscles of the body.

Procedures help eliminate muscle and skin slackness, fight with
the phenomena of cellulitis, help with excess weight, violation
peripheral circulation (venous and arterial) and
venous lymphatic insufficiency. Shown for recovery
muscle strength after surgeries, fractures, for
improve mobility. Recommended after a stroke because
help to restore fine movements of the hands and gait.

We must not forget about the individual sensitivity of patients to
current, and start the procedure at the lowest rates
increasing them gradually. With prolonged electrotherapy can
develop addictive. Therefore, it is very important to make
treatment program, include other methods for the greatest
effect. If we are talking about trained people, athletes, then
It should be borne in mind that this group of patients initially has more
strong muscles, so the electrical load should be more intense.

Electrostimulation of muscles goes well with lymphatic drainage,
deep heat, electrophoresis, ultrasound
therapy, pressure therapy, endermology.

Transcutaneous Electrical Nerve Stimulation (TENS)

In other words, the effect on the lesion through the skin. Effective with
acute and chronic pain of various origins and is applied in
everyday physiotherapy practice.

High frequency exposure activates inhibition mechanisms
pains: impulses of electric current lead to blockade of pain
signals that go along the nerves from the focus of pain to the brain.
Low frequency exposure activates the release of endorphins, which
act as natural pain inhibitors.

Unlike anesthetic drug therapy, TENS does not
has side effects. Can be used as monotherapy, and as
addition to other methods.

Transcranial electrostimulation

Implies the effects of pulsed bipolar currents with
given characteristics of the brain. Main indications for
electrostimulation of the brain: post-stroke and post-infarction
condition, idiopathic hypertension, 1-2 st., rehabilitation after
lesions of the peripheral nervous system, pain syndrome
cancer patients, neurological patients, after injuries, depression,
anxiety, toxicosis of pregnant women in 1-2 trimesters, menopause, disturbances
sleep, pruritic dermatitis.

  • Activation of opioid structures and the release of beta-endorphin,
    relieves pain, reduces drug load when
    the need for pain relief;
  • Beta-endorphin relieves anxiety and has antidepressant
    effect, improves stress tolerance and mood, which in itself
    helps in the treatment of any disease;
  • Impact on the vasomotor center of the medulla oblongata
    normalizes blood pressure;
  • Lymphocyte activation by beta-endorphin leads to an increase in
    body defenses;

The method is used in the treatment of addictions and removes
manifestations of withdrawal symptoms. Thirst for alcohol and drugs
drugs are reduced by stimulating the opiate system.
It helps in the recovery period for severe burn patients.
It has an analgesic effect, relieves stress spasm
vascular wall and improves blood flow.

Interstitial electrostimulation

The second name is Gerasimov’s electrical stimulation, because
The method was developed under the guidance of this scientist. Main
Indications: spinal osteochondrosis, herniated intervertebral, painful
syndrome after spinal surgery for hernia truncation,
scoliosis, deforming arthrosis, IRR, peripheral dysfunction
nerves, asthma, migraine, tension headache,
dizziness, heel spur.

For the procedure using special disposable needles, which
with the help of wires connected to the apparatus, producing
pulsed low frequency current. Needles are installed directly.
in painful areas.

As a result of the procedure, microcirculation improves,
decreases swelling, eliminates muscle spasm and improves nutrition
in the area where the needles are installed. After the first procedure
there is a significant improvement and reduction of pain.

Very often practiced with osteochondrosis, localized in
any part of the spine. Improves blood circulation, helps
stop the breakdown of cartilage tissue, restores innervation and
most important for patients – eliminates pain in 95%
cases.

Electrostimulation of the eye

It is implemented during the impact of pulsed current on the muscular
eye apparatus, optic nerve, retina. Main показания: птоз,
strabismus, dystrophy of the retina, optic nerve, myopia,
amblyopia, paresis, and paralysis of the oculomotor musculature.

Impact on the motor muscles of the eyelid and eyes leads to
improve neuromuscular transmission, normalize muscle tone and
their more efficient functioning. After the course of procedures
friendly movements of the eyes, raising the eyelids. Action on
sensory apparatus (optic nerve, retina) allows you to increase
the number of connections with the central nervous system and form a large feedback, and
It means – to improve vision.

Electrical stimulation of the pelvic nerves

Is an alternative, official method of treatment.
incontinence of feces and urine. Works as with stress incontinence, so
and dysfunction due to a decrease in the tone of the muscles of the pelvic floor and
anal sphincter.

  • When treating stress incontinence, the goal of treatment is
    elimination of pelvic floor dysfunction.
  • In case of incontinence, the procedure is aimed at inhibiting
    involuntary contraction of the bladder walls by stimulation
    nerves of the pelvic floor.

Electrical stimulation in children

In pediatrics, this method of treatment is used quite widely, with
birth, with the following pathologies: intestinal atony, violations
functions of the pelvis, hypotonia of the muscles of the anterior abdominal wall, organic
lesion of central nervous system, cerebral palsy, flat feet, scoliosis, hip dysplasia
joints, the consequences of head injury, including in children with
medication sleep, the effects of spinal infection
and brain, autism, hyperactivity, speech and hearing impairment,
pathology of the joints.

In children, all methods of electrostimulation are used, including
interstitial, transcranial. Individually
current strength, pulse shape and frequency, and duration are selected
impact. In any case, the stimulation is carried out on gentle
modes and with a shorter duration of exposure than
adults.

In cosmetology

The procedure is actively used in cosmetology for the correction
figures, cellulite, giving the face a clearer contours,
reduce flabbiness skin and wrinkles, strengthen and improve tone
neck and face muscles, abdominals (especially after childbirth), reducing
weight, accelerate lymphatic drainage (elimination of edema).

During the procedure, conduct an impact on different muscular
groups of pulsed current of different frequencies. Myostimulation allows
use even deep muscles.

Improves the condition of small blood vessels, speeds up the exchange
substances, activates the outflow of lymph, makes the muscles actively
shrink, levels stagnant processes in the skin and intensely
removes excess moisture (precisely because of this, even after the first
procedures you can see a decrease in the volume of the body).

  • When changing the shape of the face, the muscles that are localized
    in the cheek area
  • When flabbiness of the neck is stimulated by a wide subcutaneous muscle –
    platism, by applying self-adhesive skin electrodes.
  • To reduce the severity of the second chin use
    pulse current.
  • It is possible to achieve noticeable positive results when omitting
    upper eyelid using mobile electrodes on gel
    basis.

Side effects and complications

Muscle can be felt during and after the procedure.
the discomfort. At the site of contact of the skin and electrodes may develop
inflammatory reaction.

To prevent these unwanted effects, during the procedure
the patient must keep track of his health and when
discomfort or pain report to the doctor.

Among the possible complications include:

  • skin flushing up to burns. Perhaps with the wrong
    setting electrodes;
  • increased menstrual flow, especially if the procedure
    held in the first days of menstruation. Therefore, during menstruation
    it is recommended to refuse treatment;
  • Nausea, indigestion. This is possible if the procedure is
    abdominal area was carried out immediately after eating.

Автор: врач-гигиенист, эпидемиолог

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