MTR DoloBravo - IV. Transcutaneous Electrical Nerve Stimulation (TENS); Gate-Control-Effect; Treatment Modes

DoloBravo Bedienungsanleitung / Operators Manual
40
TENS
(Transcutaneous Electrical Nerve Stimulation)
The rst treatment using electrical current was carried out around 2500 BC in Egypt. At that
time they used electric sheatsh for the treatment of pain relief. The results obtained from this
treatment were quite astounding bearing in mind that science concluded the physiological basis
for this treatment in the 19
th
century. The Gate-Control Theory which was rst published by
Melzack and Wall in the 20
th
century formed the basis for the neurophysiological understanding
and the rst treatment of pain relief with the aid of highly frequenced TENS as is applied today.
TENS as a scientically recognised method for pain relief therapy is a suitable aid for pain
for many doctors. The stimulating electrical current impulses being produced by the nerve
stimulator DoloBravo is transferred from the electrodes to the skins nerve bres. The effect of
pain relief begins at the start of the application and is normally effective for an amount of time
after the stimulation period. This is achieved due to two different mechanisms:
Gate-Control-Effect:
The pain is transferred over the nerve bres of the body to the brain which perceives the pain.
Through stimulus of the nerves the DoloBravo nerve stimulator prevents further transmission of
the pain signals to the brain. The pain sensation is therefore eased or inhibited.
Beta-endorphins-release:
TENS-therapy stimulates the synthesis and release of beta-endorphins. Beta-endorphins as
bodily synthesised peptides, which have a similar effect as morphine for pain relief, but without
the side effects that morphine carries (e.g. breathing depression).
TENS is available in three different treatment modes.
1. Continuous Tens (CONT): Electrical impulses are exchanged between the electrodes in
a continuous ongoing mode back and forth. They block the transmitting nerve bands. It is
possible that the body gets used rather quickly to this traditional treatment. The effects can
subside with prolonged treatment.
1a A special kind of continuous mode is named Dense-Disperse-Stimulation (CONT +
BURST) according to Prof. Han. The permanent alternation of frequency between
2 Hz and 100 Hz within a few seconds (2-4 secs.) raises the output of different analgesic
substances.
2. Modulated Tens (MOD): By changing the parameters (frequency, pulse width and/or
intensity) regularly and automatically, the sensation of an increasing and decreasing current
is produced. Therefore the body will adapt distinctly delayed to the electrical impulses.
For example: Modulating time 10 seconds at a pulse range of 250 – 150 µs means:
Start at 250 µs – exponential decrease (rst fast then slow) down to 150 µs in ve seconds,
then increase (rst slow then fast) back to 250 µs. This complete cycle lasts for 10 seconds.
3. Burst (BST): 9 impulses with a set frequency and pulse range, twice per second are
emitted. This articially produced frequency of 2 Hz is able to increase the production of
the bodies own endorphins and therefore relieve pain in a more natural way.