Electrotherapeutic apparatus

Surgery: light – thermal – and electrical application – Light – thermal – and electrical application – Electrical therapeutic systems

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A61N 132

Patent

active

055735525

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BRIEF SUMMARY
The present invention relates to an apparatus for electrotherapeutic applications which operates in the medium frequency range between 1000 Hz and 100,000 Hz, with paired, diametrically opposed electrodes applied in relation to a body part to be treated.
It has been known long since and so far also been utilized electrotherapeutically to force excitable cells (nerves, muscles and receptors of nerve ends) of the human body, by electrical stimuli externally supplied in the form of electrical pulses, to an electrical response, the so-called action potentials (refer to FIG. 12). These action potentials are cell-intrinsic electrical pulses with a defined height and width for the relevant cell type. For one nerve, for instance, a pulse width of about 1 ms and a height of about 80 mV to 100 mV is typical. The cell reverts to its cell membrane voltage, which at rest, depending on cell type, has a value between 60 mV and 120 mV. This voltage is caused by different ion concentrations in the extracellular and intracellular spaces separated by the cell membrane. More positive ions are found outside the cell. According to definition, the potential outside the cell is set to 0 V, so that a negative potential is given in the cell (refer to FIG. 12).
In healthy humans, the action potentials are generated by the body itself and utilized for information transfer and to trigger cellular processes.
In electrotherapy, therapeutic effects are induced by specific generation of action potentials (defined number and at specific loci).
Prior apparatuses for electrotherapy use a plurality of different current, or pulse shapes. Aiming to choose the electrotherapy best suited for the present (specific) indication, the therapist should be able to revert to criteria of maximally clear definition. These criteria derive from the replies to questions about the effectiveness and tolerance of the various current forms.
The spectrum of effects includes, e.g., the areas of pain alleviation, stimulation of striated and nonstriated muscles, of influencing perfusion, the detumescent mechanisms, of the areas of checking inflammatory processes and of promoting regeneration (wounds, accelerated healing of bones, etc.). The aim in the application should always be achieving the desired effect in the affected area by proper selection of the current form, either distal or proximal to the electrode or in the depth of the body.
Regarding tolerance, it should be assured that the current will not cause any damage, neither systemically nor locally.
The systemic tolerance of currents is determined primarily by the ventricular fibrillation threshold and the risk of triggering epileptic seizures. This means that the therapeutic range should be removed as far as possible from these thresholds. Thus, currents are to be preferred in which these thresholds are especially high.
The local tolerance is determined by the risk of burns and cauterizations as well as by the pain threshold.
Therefore, preference goes to currents and pulse shapes with which the desired effects are obtained, without any negative side effects being felt by the patient.
Basically, prior electrotherapeutic apparatuses are based on two stimulus current methods, the polarity-dependent "polar stimulation principle" and the polarity-independent "apolar stimulation principle."
Low-frequency currents (LF current) ranging from 0 to 200 Hz are used in the "polar stimulation principle." Hyperpolarization (rise in membrane voltage) occurs beneath the positive electrode, the anode, making the spacing between the potential in the cell and the stimulus threshold greater. In contrast, the membrane voltage drops beneath the negative electrode, the cathode. As the stimulus threshold is reached, the cell triggers automatically an action potential.
Prior stimulant current apparatuses employ different pulse shapes in the low-frequency spectrum of about >0 to 200 Hz (LF current). Applicable are, e.g., the so-called delta currents, rectangular currents, diadynamic currents, high-voltage currents, ultrastimulant

REFERENCES:
patent: 3774620 (1973-11-01), Hansjurgens
patent: 5018524 (1991-05-01), Gu et al.
patent: 5048523 (1991-09-01), Yamasawa
patent: 5109847 (1992-05-01), Liss et al.
"Elektrische Differential-Therapie" (Electrical Differential Therapy), pp. 9, 49, 68-70, Hansjurgens et al, 1990.
"Fibel der Elektrodiagnostik und Elektrotherapie" (Primer of Electrodiagostics and Electrotherapy), p. 193, Herbert Edel, 1983.

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