Chad’s Continued Electric Stimulation Notes 2015-17 and Onward

This is a continuation of the “Notes From My Year Year of Electric Muscle Stimulation” which is becoming one of my more popular blog posts. Those notes were what I wrote down as I did EMS (electric muscle stimulation) for all major muscle groups instead of weight training for an entire year (October 2013 thru … Read more

Carbonized Rubber Electrodes Best for EMS & TENS

Factors influencing quadriceps femoris muscle torque using transcutaneous neuromuscular electrical stimulation.Physical Therapy. 1991 Oct;71(10):715-21; discussion 722-3. Lieber RL, Kelly MJ. Abstract Quadriceps femoris muscle torque was measured in 40 subjects during transcutaneous neuromuscular electrical stimulation (NMES). Three different electrode types (carbonized rubber, sponge, and adhesive) were used on each subject, permitting determination of the factors … Read more

Ness Handmaster EMS for Stroke, Didn’t Appear to Work

Electrical stimulation of the upper limb in stroke: stimulation of the extensors of the hand vs. alternate stimulation of flexors and extensors. de Kroon JR, IJzerman MJ, Lankhorst GJ, Zilvold G. American Journal of Physical Medicine & Rehabilitation. 2004 Aug;83(8):592-600. AbstractOBJECTIVE:To investigate whether there is a difference in functional improvement in the affected arm of … Read more

TENS, More Electric Stimulation is Better than Less

Adjusting pulse amplitude during transcutaneous electrical nerve stimulation (TENS) application produces greater hypoalgesia.Pantaleão MA, Laurino MF, Gallego NL, Cabral CM, Rakel B, Vance C, Sluka KA, Walsh DM, Liebano RE. J Pain. 2011 May;12(5):581-90. AbstractTranscutaneous electrical nerve stimulation (TENS) is a noninvasive technique used for pain modulation. During application of TENS there is a fading … Read more

TENS Electrodes Work Best Over Muscle or Soft Tissue

An investigation into the magnitude of the current window and perception of transcutaneous electrical nerve stimulation (TENS) sensation at various frequencies and body sites in healthy human participants. Hughes N, Bennett MI, Johnson MI.Clin J Pain. 2013 Feb;29(2):146-53. AbstractINTRODUCTION:Strong nonpainful transcutaneous electrical nerve stimulation (TENS) is prerequisite to a successful analgesic outcome although the ease … Read more

Electroacupuncture and Motor Points

Bilateral effects of 6 weeks’ unilateral acupuncture and electroacupuncture on ankle dorsiflexors muscle strength: a pilot study. Arch Phys Med Rehabil. 2012 Jan;93(1):50-5. Zhou S1, Huang LP, Liu J, Yu JH, Tian Q, Cao LJ. Normally I could completely disregard this paper because I am not a fan of acupuncture and agree with Colquhoun and … Read more

Notes from My Year of Electric Muscle Stimulation

“My own results have been so favorable that I am not interesting in debating whether or not EMS works but rather in optimizing the use of EMS in the training of elite athletes.” Charlie Francis About August or September of 2013 I got really interested in the capabilities of electrical muscle stimulation (EMS) for strengthening. … Read more

Electric Muscle Stimulation for Athletes

Electromyostimulation–a systematic review of the effects of different electromyostimulation methods on selected strength parameters in trained and elite athletes. J Strength Cond Res. 2012 Sep;26(9):2600-14. Filipovic A1, Kleinöder H, Dörmann U, Mester J. AbstractThis is the first part of 2 studies that systematically review the current state of research and structure the results of selected … Read more

Greater EMS Rate Causes Greater Blood Flow with Peripheral Artery Disease

Calf muscle stimulation with the Veinoplus device results in a significant increase in lower limb inflow without generating limb ischemia or pain in patients with peripheral artery disease. J Vasc Surg. 2013 Mar;57(3):714-9. Abraham P1, Mateus V, Bieuzen F, Ouedraogo N, Cisse F, Leftheriotis G. AbstractOBJECTIVE:Increase in arterial inflow to the lower limbs is important … Read more

Electric Stimulation and Peripheral Vascular Disease

Chronic muscle stimulation improves ischaemic muscle performance in patients with peripheral vascular disease. Eur J Vasc Surg. 1994 Jul;8(4):419-22. Tsang GM1, Green MA, Crow AJ, Smith FC, Beck S, Hudlicka O, Shearman CP. AbstractThere is currently no established treatment for intermittent claudication with proven long term benefit. Exercise classes have been shown to improve walking … Read more

Electric Muscle Stimulation Helps Rheumatoid Arthritis

Neuromuscular electrical stimulation and volitional exercise for individuals with rheumatoid arthritis: a multiple-patient case report. Physical Therapy. 2007 Aug;87(8):1064-77. Piva SR1, Goodnite EA, Azuma K, Woollard JD, Goodpaster BH, Wasko MC, Fitzgerald GK. AbstractBACKGROUND AND PURPOSE:Muscle atrophy is common in patients with rheumatoid arthritis (RA). Although neuromuscular electrical stimulation (NMES) is a viable treatment for … Read more

EMS Increases Circulation and Function with Severe PVD

The influence of electrostimulation on the circulation of the remaining leg in patients with one-sided amputation. Angiology. 2002 May-Jun;53(3):329-35. Presern-Strukelj M1, Poredos P. AbstractThe aim of the authors’ study was to investigate, in patients with one leg amputated, the influence of electrostimulation on the arterial circulation of the other lower limb and on the ability of a … Read more

Electrical Stimulation to Treat Cluster Headaches

Nociception specific supraorbital nerve stimulation may prevent cluster headache attacks: Serendipity in a blink reflex study. Cephalalgia. 2014 Mar 10. [Epub ahead of print] Haane DY1, Koehler PJ. AbstractBACKGROUND:In cluster headache, neuromodulation is offered when patients are refractory to pharmacological prophylaxis. Non-invasive peripheral neuromodulatory approaches are of interest. We will focus on these and particularly … Read more

Migraine Headache Prevention with TENS (Cefaly Effectiveness Study)

Migraine prevention with a supraorbital transcutaneous stimulator: a randomized controlled trial. Neurology. 2013 Feb 19;80(8):697-704. Schoenen J, Vandersmissen B, Jeangette S, Herroelen L, Vandenheede M, Gérard P, Magis D. Abstract OBJECTIVE: To assess efficacy and safety of trigeminal neurostimulation with a supraorbital transcutaneous stimulator (Cefaly, STX-Med., Herstal, Belgium) in migraine prevention. METHODS: This was a … Read more

Safety and Satisfaction of Cefaly (Headband TENS) for Headaches

Safety and patients’ satisfaction of transcutaneous supraorbital neurostimulation (tSNS) with the Cefaly® device in headache treatment: a survey of 2,313 headache sufferers in the general population. J Headache Pain. 2013 Dec 1;14:95. doi: 10.1186/1129-2377-14-95. Magis D, Sava S, d’Elia TS, Baschi R, Schoenen J. AbstractBACKGROUND:Transcutaneous supraorbital nerve stimulation (tSNS) with the Cefaly® device was recently … Read more

Migraine Headaches, Electric Stimulation and Paresthesia Concordancy

Peripheral neuromodulation and headaches: history, clinical approach, and considerations on underlying mechanisms. Reed KL. Curr Pain Headache Rep. 2013 Jan;17(1):305.< From the Review: “With the publication of their “Gate Control Theory” of pain modulation in 1965, Wall and Melzack provided a conceptual mechanistic foundation for considering direct electrical stimulation of the spinal cord and peripheral … Read more

EMS Decreases Pain, Numbness, Burning, and Improves Sleep with Neuropathy

External electric muscle stimulation improves burning sensations and sleeping disturbances in patients with type 2 diabetes and symptomatic neuropathy.  Pain Med. 2009 Mar;10(2):413-9.  Humpert PM, Morcos M, Oikonomou D, Schaefer K, Hamann A, Bierhaus A, Schilling T, Nawroth PP. OBJECTIVE: External muscle stimulation (EMS) of the thighs was previously shown to have beneficial effects in … Read more

Electric Muscle Stimulation Better than TENS for Neuropathy

Effective treatment of symptomatic diabetic polyneuropathy by high-frequency external muscle stimulation. Diabetologia. 2005 May;48(5):824-8.  Reichstein L, Labrenz S, Ziegler D, Martin S. Abstract AIMS/HYPOTHESIS: Diabetic distal symmetrical sensory polyneuropathy (DSP) affects 20-30% of diabetic patients. Transcutaneous electrical nerve stimulation (TENS) and electrical spinal cord stimulation have been proposed as physical therapies. We performed a controlled, … Read more

Electric Stimulation Complementary with Drug Treatment for Neuropathy

Diabetic peripheral neuropathy. Effectiveness of electrotherapy and amitriptyline for symptomatic relief. Diabetes Care. 1998 Aug;21(8):1322-5. Kumar D, Alvaro MS, Julka IS, Marshall HJ. From the study: Abstract OBJECTIVE:To evaluate the efficacy of combining electrotherapy with amitriptyline for the management of chronic painful peripheral neuropathy in patients with type 2 diabetes.RESEARCH DESIGN AND METHODS:Patients (n = … Read more

Electric Stimulation Decreases/Eliminates Painful Neuropathy

Diabetic peripheral neuropathy: amelioration of pain with transcutaneous electrostimulation. Diabetes Care. 1997 Nov;20(11):1702-5. Kumar D, Marshall HJ. Abstract OBJECTIVE: To evaluate the efficacy of transcutaneous electrotherapy for chronic painful peripheral neuropathy in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: Thirty-one patients with symptoms and signs of peripheral neuropathy were randomized to the electrotherapy … Read more

Muscle Spasms and Low Back Pain

This was a pair of studies by the same authors that have some great, real world implications with regards to prevention and physical therapy treatment of low back pain and neck pain. Short rest periods after static lumbar flexion are a risk factor for cumulative low back disorder. J Electromyogr Kinesiol. 2005 Feb;15(1):37-52. Courville A, … Read more

Not Just Strength but Also Neuromuscular Exercise and Counseling Decreases Low Back Pain.

Neuromuscular exercise and counseling decrease absenteeism due to low back pain in young conscripts: a randomized, population-based primary prevention study.   Spine (Phila Pa 1976). 2013 Mar 1;38(5):375-84.   Suni JH, Taanila H, Mattila VM, Ohrankämmen O, Vuorinen P, Pihlajamäki H, Parkkari J.   Abstract STUDY DESIGN: Controlled intervention with group randomization. OBJECTIVE: To investigate … Read more

EMS Better than TENS for Pain

Combined neuromuscular electrical stimulation and transcutaneous electrical nerve stimulation for treatment of chronic back pain: a double-blind, repeated measures comparison. Arch Phys Med Rehabil. 1997 Jan;78(1):55-60. Moore SR1, Shurman J. INTERVENTIONS:Subjects self-administered NMES, combined NMES/TENS, TENS, and placebo treatments. Each treatment had a duration of 5 consecutive hours per day over 2 consecutive days, with … Read more

Electric Stimulation Increases Strength and Decreases Pain in Patients with Osteoarthritis

Neuromuscular electrical stimulation (NMES) reduces structural and functional losses of quadriceps muscle and improves health status in patients with knee osteoarthritis. J Orthop Res. 2013 Apr;31(4):511-6. From the study: “OA patients presented smaller vastus lateralis thickness (11.9 mm) and fascicle length (20.5%) than healthy subjects (14.1 mm; 24.5%), and also had a 23% smaller knee … Read more

Electric Muscle Stimulation Prevents Atrophy after Total Knee Replacement

Early neuromuscular electrical stimulation to improve quadriceps muscle strength after total knee arthroplasty: a randomized controlled trial. Physical Therapy. 2012 Feb;92(2):210-26. Stevens-Lapsley JE1, Balter JE, Wolfe P, Eckhoff DG, Kohrt WM. From the study: “Sixty-six patients, aged 50 to 85 years and planning a primary unilateral TKA, were randomly assigned to receive either standard rehabilitation … Read more

Physical Therapy after Total Knee Arthoplasty: Neuromuscular Electrical Stimulation Causes a Significant Boost in Quadriceps Strength

Neuromuscular electrical stimulation for quadriceps muscle strengthening after bilateral total knee arthroplasty: a case series. Journal of Orthopaedic & Sports Physical Therapy. 2004 Jan;34(1):21-9. AbstractSTUDY DESIGN:A case series. OBJECTIVES:The purpose of this case series was to assess the effect of high-intensity neuromuscular electrical stimulation (NMES) on quadriceps strength and voluntary activation following total knee arthroplasty … Read more

Physical Therapy and EMS after Total Knee Arthoplasty: More Current = More Muscle

Relationship between intensity of quadriceps muscle neuromuscular electrical stimulation and strength recovery after total knee arthroplasty. Physical Therapy. 2012 Sep;92(9):1187-96. AbstractBACKGROUND:Neuromuscular electrical stimulation (NMES) can facilitate the recovery of quadriceps muscle strength after total knee arthroplasty (TKA), yet the optimal intensity (dosage) of NMES and its effect on strength after TKA have yet to be … Read more

Electric Muscle Stimulation Well Tolerated by Patients at Sufficient Intensities to Strengthen Muscle after Total Knee Replacement

Response of male and female subjects after total knee arthroplasty to repeated neuromuscular electrical stimulation of the quadriceps femoris muscle. Am J Phys Med Rehabil. 2010 Jun;89(6):464-72. AbstractOBJECTIVES:To examine responses to repeated neuromuscular electrical stimulation of the quadriceps femoris muscle in male and female subjects after total knee arthroplasty. DESIGN:Sixty-four subjects who underwent total knee … Read more

Cluster Headaches and Migraines, What I Am Learning from the Surgically Implanted Electrical Stimulation Studies.

Greater occipital nerve stimulation via the Bion microstimulator: implantation technique and stimulation parameters. Clinical trial: NCT00205894. Pain Physician. 2009 May-Jun;12(3):621-8. Abstract BACKGROUND: Millions of patients suffer from medically refractory and disabling primary headache disorders. This problem has led to a search for new and innovative treatment modalities, including neuromodulation of the occipital nerves. OBJECTIVES: The … Read more

Electric Stimulation for Headaches, Migraines (My Results)

This treatment is serendipitous, so I’ll add some background information on how I came to it.  As shown by my other blogs, in the last year I’ve been especially interested in electric muscle stimulation (EMS) to help recovery by accelerating strength gains better than exercise alone.  A number of my knee and back pain patients … Read more

Electric Muscle Stimulation BEFORE Total Knee Replacement Improves Outcomes

“Effects of preoperative neuromuscular electrical stimulation on quadriceps strength and functional recovery in total knee arthroplasty. A pilot study. BMC Musculoskelet Disord. 2010 Jun 14;11:119. ” <br) BACKGROUND: Supervised preoperative muscle strengthening programmes (prehabilitation) can improve recovery after total joint arthroplasty but are considered resource intensive. Neuromuscular electrical stimulation (NMES) has been shown to improve … Read more

Electric Muscle Stimulation for Strength, How to Make It Work.

”Electromyostimulation–a systematic review of the influence of training regimens and stimulation parameters on effectiveness in electromyostimulation training of selected strength parameters. J Strength Cond Res. 2011 Nov;25(11):3218-38. ” Since I plan to discuss a number of studies on electric stimulation, I figured I should get this one out there. It gives some background as to which … Read more

Physical Therapy and EMS: Restores Activation, Strength 1 Year Post TKA

”The use of neuromuscular electrical stimulation to improve activation deficits in a patient with chronic quadriceps strength impairments following total knee arthroplasty. Journal of Orthopaedic & Sports Physical Therapy. 2006 Sep;36(9):678-85.” This was a single-patient case study of a patient who had high level function but persistent quadriceps weakness and activation deficits 13.5 months post op. … Read more

EMS Decreases Back Pain, Increases Core Strength, Endurance

“Effects of electrical stimulation program on trunk muscle strength, functional capacity, quality of life, and depression in the patients with low back pain: a randomized controlled trial. Rheumatol Int. 2009 Jun;29(8):947-54.” Right now this is my favorite electric muscle stimulation (EMS) study with regards to low back pain as I read it soon after I … Read more