In presence of a traumatic lesion of the peripheral nerves, the measure of the chronaxy fosters to
establish whether the denervation is insufficient, partial or total. The aim of an excitomotor
treatment is the preservation of the trophism and the limitation of the muscular sclerosis in order to
foster the muscle to be as functional as possible by the end of the reinnervation process that can
sometimes last some months. The effectiveness of this type of treatment depends on the correct
setting of the stimulation parameters; these must be defined in a specific way for every patient and
must evolve with time.
In the programs for denervated muscles three types of currents are mainly used.
Rectangular currents
The rectangular current is characterized by single rectangular impulses, than varies quickly from the
null value to the maximum value of the set up intensity. The duration of the impulse causes a
selective contraction of the denervated fibers and the null medium value of the impulses (alternated
polarity) avoids whichever phenomenon of ionization of the dermis. The rectangular impulses are
mainly use on totally denervated muscles.
Triangular currents
The triangular current reaches the maximum value of the set intensity through a linear ramp up,
bound together to impulses of pretty long duration, it determines a valid contractile answer of
denervated fibers (controlled by damaged nerves) without stimulating the adjacent and normally
innervate ones (healthy ones). Naturally, being this stimulating current (the triangular impulse) in
charge of the contraction of denervated fibers, it will be followed by a period of pause in which the
current has a null value. The polarity of the impulses is alternated in order to avoid the phenomenon
of ionization of the dermis. Because of the adaptation ability of the nervous fibers to the slow
increase of intensity of the stimulus and the absence of annoyances to the patient, the triangular
current is used to stimulate totally and partially denervated muscles. The selective stimulation of
fibers happens without involving the already normal innervated fibers, a problematic sometimes
found with the alternated rectangular one because of the fast rise of the impulse.
Trapezoidal current
Trapezoidal impulses are mainly used on partially denervated muscles.
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