7
4.1.2.1 Indications Muscle Stimulation
• Relaxation of muscle spasms
• Prevention or retardation of disuse atrophy
• Increasing local blood circulation
• Muscle re-education
• Immediate post-surgical stimulation of calf muscles to prevent venous thrombosis
• Maintaining or increasing range of motion
• Dysphagia
4.1.2.2 Contra-indications Muscle Stimulation
• This device should not be used on patients with demand-type cardiac pacemakers
• This device should not be used over cancerous lesions
• Electrode placements that apply current to the sinus carotid region (anterior neck) must be
avoided
(1
• Electrode placements that apply current transcerebrally (through the head) must be avoided.
• Electrode placements that apply current transthoracically (the introduction of electrical current
into the heart may cause cardiac arrhythmias) must be avoided.
Note
(1)
However the application area for the treatment of Dysphagia is distant enough from the sinus
carotis area, when the therapist follows the guidelines as described in the therapybook
"Dysphagia (by H.C.A. Bogaardt SLP, PhD)"
4.1.2.3 Warnings Muscle Stimulation
• The long-term effects of chronic electrical stimulation are unknown.
• Safety has not been established for the use of therapeutic electrical stimulation during pregnancy.
• Stimulation should not be applied over swollen, infected, or inflamed areas of skin eruptions e.g.,
phlebitis, thrombophlebitis, varicose veins, etc.
• See also chapter 3, Precautionary Instructions, for general Warnings and Precautions.
4.1.2.4 Precautions Muscle Stimulation
• Adequate precautions should be taken when treating individuals with suspected or diagnosed
heart problems, or epilepsy.
• Caution should be used when there is a tendency to hemorrhage following acute trauma or
fracture.
• Caution should be used following recent surgical procedures when muscle contraction may
disrupt the healing process.
• Caution should be used over the menstruating uterus.
• Caution should be used over areas of the skin which lack normal sensation.
• Some patients may experience skin irritation or hypersensitivity due to electrical stimulation or
electrical conductive medium. The irritation can usually be reduced by using an alternative
conductive medium, or alternate electrode placement.
• See also chapter 3, Precautionary Instructions, for general Warnings and Precautions.
4.1.2.5 Adverse Effects Muscle Stimulation
• Skin irritation and burns beneath the electrodes have been reported with the use of therapeutic
electrical stimulation.
4.1.2.6 Current Waveforms Muscle Stimulation
• For muscle stimulation the following current waveforms are recommended.
4.1.3.2.1, 4.1.3.2.3, 4.1.3.3, 4.1.3.4, 4.1.3.6, 4.1.3.9.1
These waveforms are often applied in combination with a surge program, which consists of a
sequence of exercise and rest periods. Two options are available here:
• Reciprocal application, where stimulation alternates between agonists and antagonists. This is
accomplished through asynchronous stimulation over two current channels with an appropriate
delay between the two channels.
• Co-contract application, where two channels operate synchronously to co-contract agonist and
antagonist or different sections of a larger muscle group.
See paragraph 8.2.5.6 for the available parameters
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