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Wetenschappelijke studies micro-stroom:
Microcurrent Therapy: "Wave" of the Future.
By Deborah L. Wieder, MS, PT, ATC Microcurrent therapy is one
of the most controversial. Confusing. Frustrating. Amazing and
fascinating modalities available to the physical therapist.
How can one modality create so many different emotions in one
clinician? Each day therapists working with microcurrent became
amazed with the clinical results in some cases and frustrated
with the results in others, Probably the greatest frustrations
encountered are the dearth of professional research and the
difficulty in determining the ideal protocol of use for a specific
patient. Microcurrent is a much smaller current than was previously
available for clinical use. Historically, the approach has been
that if some electricity is good, perhaps more is better the
microcurrent original thinkers and investigators have recently
challenged this concept. Among them Dr. Robert Becker and Dr.
Bjorn Nordenstrom. It has been demonstrated that trauma will
affect the electrical potential of cells is tile damaged tissue.
Because electricity will always take the path of least resistance.
Traditional electrical charges placed on the body will travel
around the traumatized cells. A smaller current - one that can
penetrate the cell and balance the cell electrically - can restore
a more normal physiological state to the damaged cells. Small
electrical charges may be helpful in initiating and perpetuating
the numerous electrical chemical reactions in the healing process.
Microcurrent Therapy: "Wave" of the Future. Becker found a constant
direct-current control system in his investigation of animals.
It appears that repair occurs after an injury in response to
signals that emanate from this electrical system. Becker refers
to this as the current-of-injury, It has been suggested that
the current of injury has become less efficient with evolution;
therefore. Many animals have a greater capacity for self-healing
than do humans. For example the starfish who is able to generate
a new limb after injury. The seemingly amazing results that
we can obtain with microcurrent therapy may just be a matter
of throwing an electrical switch that allows the heating to
commence.
(I) Nordenstrom also believes in the human electrical potential.
He states that the human body has the equivalent of electrical
circuits that play a very important role in healing.
(2) Like transcutaneous electrical nerve stimulation (TENS).
microcurrent is capable of decreasing or eliminating pain. In
addition to the treatment of pain, microcurrent also appears
to have a capacity for stimulating the healing process. Clinical
observation clearly shows that microcurrent therapy does more
than just block pain, because microcurrent is such a small current.
Typically less than 600 microamps, there is no patient discomfort
or even sensation during application. The various modes of application
adjustable treatment variables, and relatively few contraindications
make it the modality of choice for a large variety of clinical
problems. Nocioceptive fibers, the free nerve endings sensitive
to tissue dysfunction are found in variety of tissues including
skin, fibrous capsule periosteum intra-muscular arteries, blood
vessel walls, and in abundance In the blood vessels of adipose
tissue. Deformation of Nocioceptive fibers may cause stimulation
and therefore reporting of' pain to the brain specifically.
for example, if nocioceptive fibers are located in a joint capsule
and are reporting pain, it is usually due to a joint effusion.
In order for this pain to be reduced, one of three courses must
be he taken; I. Medications - block the brain's realization
of the pain. 2. TENS - block the afferent input of the pain
to the brain..
3. Reduction of the joint effusion get rid of the cause of the
pain. It is speculated that microcurrent works to decrease pain
by reducing the cause of pain and altering the electrical activity
surrounding the injured area- Microcurrent 5 very effective
on areas of increased blood supply and therefore increased Nocioceptive
fibers. Muscle tissue. Periosteum, and joint capsule are areas
often easily affected by microcurrent therapy A study of Cheng
found that microcurrent is able to increase adenosine triphosphate
(ATP) production three to five fold, augment membrane transport,
which increases nutrients into the area and boost protein synthesis.
This was found in animal skin studies using 50-1000 microamps
of electricity. Interestingly ATP production actually decreases
with 5000 microamps of electricity.
(3) The most versatile units available allow for the most variability
in choice of frequency, current, and ramp. The ideal units for
clinical use allow the therapist to treat with both pads and
probe applicators. for more specific techniques. One of the
units displaying this versatility is the Intellect 600MP. The
intellect 600MP offers the therapist the desired variability
of functions as well as a feedback mode wherein the therapist
is able to search diagnostically for high conductance points
in the body. Once the area is located, it may he treated to
help reduce pain and muscle spasm. According to clinical research
by Lynn Wallace, Ph.D.. P.T.
(4). there are two general modes of treatment which produce
maximum effectiveness. The pain mode is used to reduce pain
in a patient. The pain mode consists of a short ramp of .01
seconds. a frequency of 30 Hz, and a current of 80- 100 microamps.
The pain mode is always followed by the ETR (Enhancement of
Tissue Repair) or healing mode. The ETR mode consists of a longer
ramp of 2 seconds. a frequency of .3 Hz and a current of 20-40
microamps. An average treatment includes 10 minutes on the pain
mode followed by 10-20 minutes on she ETR mode. Treatment should
be performed every other day, or daily for optimal results.
There are a variety of different methods and techniques to try
when using microamp current. Most importantly when treating
a body part with microcurrent. the placement of pads must follow
an electrical pathway within the body. Pads may he placed from
the origin to the insertion of a muscle following muscular electrical
flow, down the pathway of radiating nerve pain. through acupuncture
or trigger points, or medial/lateral through a swollen joint.
Microcurrent works best in combination with mechanics and therapeutic
exercise. When used with a stretching program microcurrent therapy
can encourage relaxation of the musculature causing a mechanical
deformation. Microamp in conjunction with exercise can encourage
muscle re-education. The effectiveness of microcurrent therapy
has recently been clinically documented by Wallace ins study
of 1,531 patients with a large variety of diagnoses 94% of the
patients experienced a reduction in pain during the first treatment.
The average number of treatments to achieve a zero/one pain
level (zero to ten scale) was 3.8. Ninety percent of the subjects
studied achieved a zero/one pain level in less than ten treatments.
(4) All the physiological rationale behind the clinical effects
of this instrument has not been ascertained. It would appear
to be more clinically effective than other form of electrical
stimulation for the following reason
1. -The microcurrent unit is biologically more compatible.
2. -It is more effective in neutralizing the oscillating polarity
of injured cells.
3. -The current under 600 microamps has a positive effect on
increasing local availability of ATP.
4. Microcurrent has a positive effect on increasing cell permeability.
3. Microcurrent increases local protein synthesis Microcurrent
therapy will continue to he controversial until a substantial
number of clinical research studies are published. In order
for confusion and controversy to rest. supportive scientific
research in this area must be encouraged.
References:
1) Becker.RO: The Body Electric. New York William Morrow and
Co. Inc. 1983
2) Nordenstrom.B: Biologically Closed Electrical Circuits, Nordic
Medical Publications. Uppsala. 1983.
3) Cheng. N.. et al. The effect of electric current on ATP generation.
protein synthesis, and membrane transport in rat skin. Clin.
Othop. 171:264-272 1582.
4) Wallace. LA. MENS Therapy: Clinical Perspectives
Vol. 1. Cleveland: privately published. 1990. Distribution.
For Patients that require a home bound M.E.N.S.or T.E.N.S. UNIT
Call . Chuck Pavey at 1-800-800-9295
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It has long been accepted that low intensity electricity has
the potential to influence and alter biological and physiological
processes. Research has shown that micro-current has the greatest
potential of all present electrical stimulation based therapies.
Synapse believes that identifying exactly how micro-current
therapy works is pivotal to delivering the optimal treatment.
Our product range reflects this philosophy. Cellular activity
and intercellular communication is regulated chemically and
electrically and this biological communication process is essential
to the maintenance of most functional physiological processes
and activity. However, research has suggested that stimuli such
as an injury or trauma can cause, in simple terms, an electro-chemical
disorder which can stop or slow down a normal physiological
process, such as healing or indeed cause an illness. The supposition
behind the mechanism of micro-current therapy is that this failure
of this physiological process does not always result in the
cells or cell groups being fundamentally spoiled but rather
a critical communication pathway between cells, the molecular
transfer between cells or messenger proteins on cells has been
disrupted. The passing of a low ampere electric current sequence
specific to the function and/or characteristics of a given cell
type or operation of the cell membrane (a key interaction point
of all cells) to the damaged area works to ignite a pathways
between damaged or affected cells or groups of cells. Measurable
research outcomes indicate that a controlled and cell specific
micro-current application stimulates the production of Adenosine
Tri-Phosphate (ATP), restores the intra/extra-cellular sodium,
potassium and calcium balance and increases the production of
hydroxyprolin. In addition, it results in a significant increase
in the uptake of amino-isobutyric acid which is essential for
protein synthesis and trans-membrane transport. It has also
been found that the recovery of the cell wall prevents leakage
of pain-causing substances (histamine, bradykinine, lactic acid)
which results in reduction of pain. This may explain why patients
undergoing the treatment application which is sub-sensory have
reported a reduction in pain levels in acute trauma cases. Enhanced
rates of cellular reproduction noted may have been triggered
by the increases in mitochondrial ATP.
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