Surgery – Truss – Pad
Patent
1987-01-12
1990-04-24
Cohen, Lee S.
Surgery
Truss
Pad
128427, A61N 100
Patent
active
049191390
DESCRIPTION:
BRIEF SUMMARY
FIELD OF THE INVENTION
Apparatuses for electrical neuromuscular stimulation have been known for a long time and are used either to prevent muscular atrophy after an accident or operation, or to make certain muscles work in order to strengthen them. Many of these apparatuses use trains of electrical pulses which vary considerably from one apparatus to another. The frequency of the pulses is generally chosen within the approximate range extending from Hz to tens of KHz.
Experimental studies in physiology, carried out in recent years, have demonstrated the fact that the work of muscles is much more complex than had previously been imagined and that, consequently, the devices for electrical neuromuscular stimulation which have been proposed hitherto are actually rather rudimentary and poorly suited to the physiology of the muscles. The data on this subject which are currently to be found scattered throughout the literature show that the muscle tissue is not homogeneous and that it is formed of at least three types of fiber: a first category called slow-acting fibers and two types of fiber which respectively act quickly and very quickly. These three types of muscle fiber cannot be stimulated by the same frequencies of stimulating current; some frequencies are only suitable for the slow fibers and other frequencies for the quick fibers.
Furthermore, other studies have shown that the relatively short treatments applied hitherto are totally inadequate for combating muscular atrophy and ensuring muscle development, for example for athletes. In reality, it is necessary to envisage daily treatments lasting several hours per day, for example up to 5 hours. This presents problems, however, because other studies have shown that long treatments at constant frequencies are likely to produce harmful effects in the muscles, either by damaging the fibers or by modifying the fibers, with the result that, during the treatment, slow fibers are converted to quick fibers or vice-versa, according to the stimulating frequency used. In fact, it has not long been known that the character of the muscle fibers is not fixed. On the contrary, the proportion of the three types of fiber can change according to the work--and hence the excitation--imposed on the muscle. The fibers are capable of converting from one category to another. The frequencies should therefore be appropriately chosen and the different frequencies should be used in a balanced way to stimulate the slow fibers and the quick fibers in a manner which is itself balanced, so as not to introduce subsequent perturbations into the muscle structure.
Other studies have shown, especially with regard to the quick fibers, that it is absolutely essential to observe much longer rest periods than had previously been imagined between the different wave trains of electrical stimulation, in order to ensure that the muscle is not ultimately intoxicated by the chemical substances produced by the muscle work itself. In other words, a sufficient repair time must be allowed between the successive trains of pulses, this time being much longer than had been imagined.
Yet another problem arises because of the length of the treatments required, as we have just seen. For economic reasons, the patient cannot conceivably be asked to undergo daily sessions, lasting several hours, in a hospital or with the physiotherapist, since they would occupy premises, staff, large numbers of expensive apparatuses, etc.; it is therefore advisable to consider having an apparatus for each patient, enabling him to carry out a treatment according to a program tailor-made to suit his particular case. However, an apparatus of this type would of course have to be simplified to the greatest possible extent and be driven by a program recorded on a transfer element, it then being possible for the program to be set up in a hospital or by the therapist on a programming apparatus which would be used to set up the program while it is linked up to a stimulating apparatus connected to the patient, thereby enabling the doctor or
Bushnell Richard
Cohen Lee S.
Getzon Scott
Medicomex S.A.
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