Hi Myriam, I have conducted traditional strength duration curve testing on many patients with peripheral nerve damage. Most times the referral came from a physician who wanted to know whether conventional NMES could be applied at home to aid recovery. A muscle response to a 1 ms square wave pulse indicates the presence of some intact motor units. If there are very few such innervated fibres, the muscle response will be very small and will not move the limb through range. To stimulate muscle fibres directly and, at the same time, to prevent a response from nearby normally innervated muscles, I suggest using a triangular pulse shape (i.e. an exponentially rising pulse), at least 300 msec duration (if no response to 300 ms then try 400-600 msec duration). Support the muscle in its mid range - a stretch on the muscle will make it harder to activate. Realize that you are going to see no more than a twitch response. I agree 20x3 contractions. Recommend once daily. Only evidence is from the Alberta group using animals for most their work. Conventional portable muscle stimulators usually deliver 300 microsec pulses. Big difference to what I am suggesting. There used to be devices made in the U.S.A. that provided long duration, exponential pulses. Good luck with your patient.
Last updated 2 months ago