What is Electro-Muscle Therapy?
Electro-Muscle Therapy can be used for wound healing, pain control or relief, reduction of inflammation, muscle re-education, reversal of atrophy and strengthening. This modality works at many levels, affecting both the sensory and motor nerves. At the cellular level, electrotherapy causes nerve cell excitation and changes in cell membrane permeability, therefore stimulating protein synthesis, osteosynthesis and fibroblast formation. At the tissue level, electrotherapy causes skeletal muscle and smooth muscle contraction. At the segmental level, it facilitates muscle-pumping action, resulting in improved joint mobility as well as circulatory and lymphatic drainage.
An application of electrical current through the skin, transcutaneous electrical nerve stimulation (TENS) is used primarily to manage pain. A small, battery-operated TENS unit delivers an electrical current to the patient through electrodes placed directly on the skin. The pulse rate, width and intensity can be adjusted according to treatment objectives. TENS works by stimulating faster sensory nerves with an electrical impulse, causing an overload of interneurons, which limits the ability of sensory nerves to transmit pain signals to the brain, creating analgesia for the patient. The effect of this modality is short-lived, however, as it generally does not last for more than an hour. In veterinary rehabilitation, TENS is used immediately post-operatively and during therapy to help a patient work through a painful treatment.
Stimulating the nerve that causes the muscles to contract, neuromuscular electrical stimulation (NMES) is used to rehabilitate muscles. This method is delivered to the patient via leads and flexible, low-resistance electrodes that conform to the skin. NMES can be used to help prevent muscle atrophy, increase local blood circulation, and maintain or increase joint mobility. It is particularly useful in patients with edema, delayed wound healing, or in those unable to perform voluntary movement.
The NMES unit features many adjustable variables, including intensity, pulse duration, current, frequency, on-off times, ramp duration and treatment duration. Ramp duration — the amount of time from the onset of the current until the full strength is delivered — is particularly important in veterinary rehabilitation. In human physical therapy, the therapist can explain to the patient how the current and contraction will feel. We don't have this luxury with our patients; therefore, we must provide a slow, gradual onset of contraction strength to alleviate as much discomfort as possible. An NMES treatment generally lasts 15 to 20 minutes per area and achieves best results when used two to three times a week.
Contraindications for electrotherapy include treatment over areas of electrical current, such as pacemakers, metal prothstetics, the carotid sinus, the cervical ganglia and the heart. This modality should be avoided (or at least used with caution) in pregnant patients or in those with a malignancy.