Abstract
BackgroundTo counteract denervation atrophy long-term electrical stimulation with a high number of muscle contractions has to be applied. This may lead to discomfort of the patient and negative side effects like burns. A functional effective muscle contraction induced by the lowest possible stimulation intensity is desirable. In clinical practice a selective stimulation of denervated muscles with triangular pulses is used.The aim of the study was to evaluate the influence of polarity and pulse duration on the stimulation intensity of triangular pulses in denervated muscles in patients with peripheral nerve lesions.MethodsTwenty-four patients with denervated extensor digitorum communis muscle and twenty-four patients with denervated tibialis anterior muscle due to peripheral nerve lesions were included. Four different combinations of triangular pulses with various duration and polarity were delivered randomly to the denervated muscles. The threshold intensity to induce a functional effective muscle contraction was noted. One-way within subject ANOVA was used to assess changes in intensity. An alpha level of p less than or equal to 0.05 was the criterion for statistical significance.ResultsPatients with a denervated tibialis anterior muscle presented significant lower intensities inducing a functional effective muscle contraction in favor of the stimulation with a duration of 200 ms and a polarity with the cathode proximally applied. No significant differences could be shown between the different stimulation protocols in case of denervated extensor digitorum communis muscle.ConclusionsWe recommend electrical stimulation of the denervated tibialis anterior muscle with triangular current with a duration of 200 ms and a polarity with the cathode proximally applied.
Highlights
To counteract denervation atrophy long-term electrical stimulation with a high number of muscle contractions has to be applied
ANOVA evaluated a significant difference between groups for REL, and for in absolute values (INT) a tendency to significance
INT intensity recorded in absolute values in mA, REL intensity relatively provided in percentage to the first stimulation of each patient, extensor digitorum communis muscle (EDC) extensor digitorum communis, df degrees of freedom, F F-ratio, level of significance (p-value) of the two variables effective muscle contraction
Summary
To counteract denervation atrophy long-term electrical stimulation with a high number of muscle contractions has to be applied. This may lead to discomfort of the patient and negative side effects like burns. In clinical practice a selective stimulation of denervated muscles with triangular pulses is used. The aim of the study was to evaluate the influence of polarity and pulse duration on the stimulation intensity of triangular pulses in denervated muscles in patients with peripheral nerve lesions. To selectively stimulate a denervated muscle, a slow rising triangular pulse is required as this muscle has less ability to accommodate [2]. The stimulation should achieve a moderately strong contraction without unnecessary discomfort for the patient [3] and resemble a normal activity of the motor neuron [8]
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