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Chiropractic Treatment of Patients with Chronic Pain
Published in Michael S. Margoles, Richard Weiner, Chronic PAIN, 2019
When a patient first visits a doctor of chiropractic, he or she will have a health (or rather disease and accident) history taken, receive an examination, and perhaps X-rays will be taken. After analyzing this information, the chiropractor may proceed with his or her treatment and recommendations. The doctor may use his or her hands or an instrument to reposition and mobilize any misaligned spinal or skeletal bones. The doctor may also use heat, cold, ultrasound, electrical muscle stimulation, massage, etc., working also with the patient’s muscular system. Specific exercises and/or nutritional recommendations may be made. There are many diverse methods in chiropractic all with the same goal: to remove nerve interference from the body.
Power versus endurance
Published in Francesco E. Marino, Human Fatigue, 2019
In terms of relative fatigue profiles, a direct comparison of strength and power production using electrical muscle stimulation between humans and extant apes has not been reported. Nevertheless, using existing anatomical and morphological comparisons some reasonable assumptions can be made. First, compared with slow-twitch muscle fibres, fast-twitch fibres produce high force with faster speed of contraction. This difference is due to the neural input which determines the muscle fibre characteristics; larger myelinated neurons innervate fast-twitch fibres. However, the cost of this neuronal arrangement is greater fatigability for the fast-twitch fibre. Second, humans have substantially less myelinated spinal cord axons than do chimpanzees, which in turn have comparatively lower numbers of slow-twitch fibres (MacLarnon 1995, 1996). These general characteristics of fast- and slow-twitch fibres mean that when subjected to stimulation they will exhibit different force responses. When stimulated at 1 Hz with similar pulse width, fast-twitch fibres will react faster but will also exhibit a faster relaxation time so that the muscle fibre can be ready for the next stimulation. This particular characteristic has the advantage of developing high force output, but when stimulated at higher frequencies, such as 10–20 Hz, the slow-twitch fibre does not have time to reach baseline relaxation, which means the next impulse will be superimposed. As the stimulating frequency increases, the individual twitches fuse or summate until the muscle produces a smooth force (Figure 9.9).
Metabolic Therapies for Muscle Injury
Published in Kohlstadt Ingrid, Cintron Kenneth, Metabolic Therapies in Orthopedics, Second Edition, 2018
Ana V. Cintrón, Kenneth Cintron
High-voltage pulsed galvanic stimulation of tissue is gaining widespread use for wound healing, especially diabetic ulcers, edema reduction and pain relief, by combining very short pulse duration (of constant intensity) and high peak voltage, yet low total current per second, to give relative comfort and avoid tissue damage while stimulating muscle contraction [30]. Although the main use of HVPGS in sports rehabilitation is for the relief of pain, it can also be used to aid in tissue healing when used post-operatively. The muscle contraction elicited by HVPGS is sought to stimulate circulation by pumping blood through venous and lymphatic channels after acute injuries, when fluid accumulation is significant, while keeping an injured joint protected. Despite the limitation of studies specifically investigating this modality after muscle strains, a review by Lake [31] concluded that electrical muscle stimulation may be helpful in controlling edema after injury, preventing loss of muscle bulk and strength associated with immobilization, selective strengthening and enhancing motor control. Therefore, its use after muscle strains may be considered in view of the aforementioned proposed mechanisms, although high-quality strain-specific studies are lacking.
The effect of sitting position changes from pedaling rehabilitation on muscle activity
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Lu Zongxing, Wei Xiangwen, You Shengxian
At present, the main rehabilitation methods for treating muscle disuse atrophy are electrical stimulation and exercise rehabilitation training (Shengguang et al. 2018). Electrical stimulation can increase capillary density, and enhance the activity of aerobic metabolic enzymes such as succinate dehydrogenase (SDH) and adenosine triphosphatase (ATPase). They can accelerate the transformation of fast muscle fibers to slow muscle fibers, and excite neuromuscular tissue, inhibiting the production of oxygen free radicals and thereby achieving the goal of preventing muscle atrophy (Kebaetse et al. 2005; Sole et al. 2011). Du and Gong (2014) used the hindlimb braking method to establish the model of muscle disuse atrophy. Soleus muscle atrophy in rats was significantly improved after 30 days of low-frequency electrical stimulation, and long-term low-frequency electrical stimulation can effectively improve muscle disuse atrophy, which may be related to pathway activation. Hirose et al. (2013) evaluated changes in the cross-sectional area of lower limb muscles weekly via computed tomography in six control group patients and nine EMS (electrical muscle stimulation) group patients. EMS was performed every day after admission in these patients, and the results showed that muscle atrophy in EMG (electromyography) group was better than that in the control group, and electrical stimulation could effectively prevent muscle disuse atrophy.
Respiratory, cardiac and metabolic responses during electrical muscle stimulation in quadriceps muscle versus comparable voluntary muscle contractions
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2021
Eleni A. Kortianou, Evangelia K. Papafilippou, Andonis Karagkounis
There is an increasing clinical interest in the use of electrical muscle stimulation (EMS) as part of a comprehensive therapeutic approach for humans in every age with muscle mass impairment, prolonged bed rest and movement limitations owned to musculoskeletal impairment, respiratory or cardiac diseases [1–3]. Studies have shown that EMS interventions for thigh muscles can improve muscle strength, aerobic capacity and functional ability in patients with chronic obstructive pulmonary disease (COPD) [4,5], heart failure [6] and neuromuscular diseases [7] even when this is applied as the only intervention [5–7] or compared with low exercise loads [4]. When moderate to high-frequency (>50 Hz) EMS is applied systematically in adults who are not able to perform prolonged muscle contractions prevents muscle waste [1], improves local systemic microcirculation [8] and alters muscle thickness [9]. Moreover, a single session of EMS (lasting up to 30 min) has been found to improve vascular endothelial function [10], skeletal muscle microcirculation [8], carbohydrate utilization [11] and increases the anabolic response of the contracted muscles [12].
Physical exercise, nutrition and hormones: three pillars to fight sarcopenia
Published in The Aging Male, 2019
Paolo Sgrò, Massimiliano Sansone, Andrea Sansone, Stefania Sabatini, Paolo Borrione, Francesco Romanelli, Luigi Di Luigi
Although physical exercise exerts many positive effects, elderly people may unable or unwilling to perform dynamic training schedule; for such a reason, the results of electrical muscle stimulation (EMS) on global strength should be carefully evaluated. Few scientific evidence is present in literature regarding the effectiveness of Whole Body Vibration (WBV), representing a novel technique able to induce a muscular stimulus by means of vibrations [46]. EMS and WBV may be useful in the elderly as they do not require a full active effort; indeed, in both techniques muscle stimulation comes mainly from an exogenous source [47–49]. WBV should be performed at medium frequency and medium duration to exert the best results [50]. Following on, in our aim to highlight priorities it should be considered that a simple and practical home exercise program has been effective in improving muscle mass and walking speed in elderly men [51].