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Can anyone advise on Galvanic / Interrupted Galvanic setup for stimulating muscle contraction/rehab of denervated muscle?

Hello, While researching the modalities on my new Combination Therapy machine I read that Galvanic current can be use to stimulate muscle contraction in muscles with compromised nerve supply. Is this the case? If so can someone advise on programming the machine for this purpose? Are their any other MSK uses of Galvanic current? Advise on: Polarity Form Width Rate Time Appreciated. Thanks, Kipp

Kipp Clark

5 months ago

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Cliff Eaton
Cliff Eaton

Hi Kipp Clinically I use the Chattanooga Physio portable NMES device for denervated patients. I have successfully returned three professional athletes to competition following axonotmesis. I also work with the UK military teaching them to use Denervation programmes on SCI patients to maintain body image The parameters used on this machine, for Total Denervation, are a rectangular waveform of 100ms pulse width and 2sec on time. 100ms pulse width is x400 longer than for a nerve cell (0.25ms). All the parameters can be changed depending on the patient's reaction. I learnt with interest, from Ethne's reply, that she has had to go as high as 1000ms to achieve the desired effect. Muscles tire quickly so the programme runs for only 8 minutes. My personal recommendation is to use it 2-3 times a day. If the patient presents with paresis or when the muscles start to get some return of neural input, I change to a triangular waveform for the reasons explained in Ethne's reply. Remember to use carbon electrodes with a gel medium or placed inside damp sponge to ensure these waveforms are transmitted. Normal adhesive electrodes do not work well for these type of waveforms The parameters suggested should be available on your combination machine. I trust this information is of some assistance to you Cliff

Dr Ethne Nussbaum
Dr Ethne Nussbaum

The thesis is that you would be electrically stimulating (ES) contraction via the muscle fibre, not the nerve. To harness the different response of nerve & muscles to ES, programme a long duration pulse with a slowly rising amplitude,. e.g 300 - 600 ms, & triangular pulse form. Intact nerve accommodates to such a waveform & the nerve never reaches firing threshold (theoretically). This prevents nerves in the vicinity from being activated. Muscle fibre is sluggish in response to ES; it does not accommodate to slowly rising amplitude (i.e. the slope of the triangular wave). The muscle fibre itself will contract when amplitude gets high enough. I have needed to use pulse duration even up to 1000ms if the nerve is deep (e.g. lady after hemipelvectomy for bone tumour with incredible amount of pelvic swelling post surgery - ES used in diagnostic testing at surgeons request to determine if the femoral nerve had been transected during surgery or was only partially denervated due to pressure). ES for denervation is of debatable benefit. In the distant past it was used regularly for purpose of maintaining muscle fibre health. For years it was a No-No. Now research is beginning to turn that around. Animal studies even showing enhanced recovery. I used it in the recent past for diagnostics - to plan further treatment. Its fun - get immediate results needing interpretation. In the past for maintaining fibre health we would apply ES at least 3/wk to muscle fibre - response is directly under the electrode; thus you must vary the electrode placement at each session.
BTW - it is not really Galvanic current - the pulses are usually less than 1000 ms.

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