Neuromuscular electrical stimulation

Alprostadil is PGEi available for exogenous administration. Alprostadil is widely used in neonates with cyanotic congenital heart disease to maintain the patency of the ductus arteriosus. Reported adverse effects include fever, apnea, flushing, bradycardia, and hyperostosis. Continuous chronic infusion of alprostadil via a portable pump and neuromuscular electrical stimulation help to improve the quality of life in patients with severe chronic heart failure waiting for a donor heart, as both treatments can be performed at home. 

Functional neuromuscular electrical stimulation Increased skeletal muscle strength and endurance Decreased spasticity and muscle spasms Skeletal muscle relaxants Skeletal muscle relaxants Nonselective cholinergic agonists may stimulate the neuromuscular junction -... 

Medical back belt with neuromuscular electrical stimulation... 

The medical back belt with integrated neuromuscular electrical stimulation (NMES) is an orthopaedic device that is able to stabilize the back after lumbar disk herniation and stimulate the muscles to make back muscle growth possible and to prevent the back from having on-going pain (Fig. 6.1). 

Neuromuscular electrical stimulation therapy is a health treatment that is often used in the physiotherapy. This therapy can be applied in different situations and manners. It is very effective and relatively pleasant for the patient and can achieve active pain relief for those with circulatory disorders and/or vegetative disorders. 

Neuromuscular electrical stimulation is one of the most currently used therapies because it can improve the muscle condition. Low-flow frequencies are applied up to 150 impulses per second and used to reinforce different muscle groups. The muscles are stimulated and activated by short electric impulses so a muscle contraction is realized in the targeted muscle. Treatment goals have to be established at the beginning of the treatment and there are three of them are the muscles moderately or strongly weakened, is there a moderate or bad muscle condition, or is a reduction of a spasticity demanded. 

The NMES device takes over the function of the brain and sends impulses to the electrodes, which are applied directly onto the muscle. It does not matter to the muscle whether the impulse comes from the brain or from an external device—the effect is the same. Neuromuscular electrical stimulation therapy is not dangerous for the human body because it works with low frequency, so the heart is not be exposed to any danger. The therapy can be applied on most parts of the body, but on some parts it is more difficult to build up the muscles. The only exception is the breast, because the therapy can have many influences on them. Further restrictions on use of the NMES device are if the patient has other internal electrical devices, for example, a pacemaker, or if the patient has established infections or wounds. 

The neuromuscular electrical stimulation consists of two main elements the NMES device and the textile electrodes. 

The tests have shown that neuromuscular electrical stimulation has the opportunity to prickle the muscles so that they will not get weaker. The tests have shown that Shieldex silver-plated nylon 2-ply can be applied direcfly onto the skin. Usually electrodes are used in combination with liquid or gel to make them more conductive and to prevent any irritations or wounds. The applied textile electrodes were used without any liquid or gel and the tests have shown that the textile electrodes did not have any negative influences on the skin. The electrical impulse can easily be transmitted and electrodes have the possibility to prickle the muscles whilst conducting electricity. To conclude, a lumbar back belt was made with the function to stabilize the back and make straight posture possible, and the muscles in the back can be stimulated by the integrated neuromuscular electrical stimulation. 

MH, manual hyperinflation NMES, neuromuscular electrical stimulation. 

Patemostro-Sluga T, Fialka C, Alacamliogliu Y, et al. Neuromuscular electrical stimulation after anterior cruciate ligament surgery. Clin Orthop Relat Res 1999 368 166-175. 

Quittan M, Wiesinger GF, Sturm B. et al. Improvement of thigh muscles by neuromuscular electrical stimulation in patients with refractory heart failure a single-blind, randomized, controlled trial. Am J Phys Med Rehabil 2001 80 206-214. 

Neder JA, Sword D, Ward SA, et al. Home based neuromuscular electrical stimulation as a new rehabilitative strategy for severely disabled patients with chronic obstructive pulmonary disease (COPD). Thorax 2002 57 333-337. 

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