Self-Care and OTC Products
CAM Paper Neuromuscular Electrical Stimulation (NMES) operates by sending electrical impulses to target muscles groups in a human’s body to stimulate active motion of these muscles which can serve as a strengthening tool for healthy athletes, a rehabilitation tool for immobilized or partially immobilized patients, a post-exercise recovery tool, and can be used to test the neuro or muscular function in vivo.
When NMES is applied for rehabilitative purposes, precautions and parameters need to be set before the muscle stimulation can occur. The patient isn’t mobile during this type of therapy and is supposed to lay flat without moving their body during the session. The electrodes are initially placed on the belly of the muscle and the stimulation is then applied at very low levels to ensure that no damage can be done early on in the process. Then, based on the response that the muscles being activated are giving back, the electrodes are then adjusted so that they are in the best places possible to stimulate muscle movement. Parameters then need to be placed on the electrical stimulation unit such as the frequency and duration of each pulse, the strength of the pulse, the time the rest periods take during the therapy session, duration of the treatment session, and the decreasing and increasing levels of energy set into the unit. Some other precautions need to be taken such as ensuring that the session doesn’t exceed one hour, that there are no more than one hundred pulses per second, and that the duration of each pulse doesn’t exceed one thousand microseconds. Also, the therapy session should not injure the patient or make the patient feel uncomfortable so therefore, the strength of the pulse should give the patient a strong, comfortable feeling for the duration of the therapy session. If the impulse being sent through the skin is too strong, skin burning or irritation can occur or the stimulation can continue to occur in the muscles for a few seconds or minutes even though the electrical impulse is no longer being sent. NMES therapy can be received at a doctor’s office for about one hundred dollars or home portable systems can be purchased for as low as fifty dollars. It is much safer to use this type of therapy under the watchful care of a licensed doctor so that none of the adverse effects can occur and the product can be safely used.
NMES can be used a strength-training tool because the use of this stimulation can cause neuromuscular adaptations during voluntary strength training. When using the NMES during voluntary strength training, many adaptations can occur during this process that are both neural and muscular adaptations similar to the effects of resistance training. The use of NMES has proven to “improve motor cortical excitability, which in turn can cause functional improvements to occur” (European Journal of Applied Physiology). Although there are benefits to training with NMES, the real benefits of this type of electrotherapy lie in its use in muscular rehabilitation.
There is another type of electrotherapy called transcutaneous electrical nerve stimulation (TNES) which is very similar to NMES even though it acts in a different way. NMES stimulates muscle movement but TNES works more on the neurological side of pain and rehabilitation. TNES is more of a pain reliever than NMES is because it is able to block nerve receptors that are responsible for letting the brain know that a certain part of the body is in pain.
TNES is able to relieve pain by stimulating proprioceptors to block the competing signals of pain receptors. In the gate of pain in the human body, neutral fibers that carry the signal for pain and the fibers that carry the proprioception fibers travel in the same central junction. Therefore, when the slightly quicker proprioceptor fibers are stimulated by the TENS, they are able to block the slower pain receptors from reaching the brain. Pain