1. Electrical Stimulation Goals
and Treatment
Adapted from Therapeutic
Modalities: Art & Science, Knight
& Draper (2008) for KIN 195

2. Competencies for Therapeutic
Modalities
TM-C2
Explain the principles of physics, including basic concepts
associated with the electromagnetic and acoustic spectra
(e.g., frequency, wavelength) associated with therapeutic
modalities.
TM-C3
Explain the terminology, principles, basic concepts, and
properties of electric currents as they relate to
therapeutic modalities.
TM-C4
Describe contemporary pain-control theories.

3. Competencies for Therapeutic
Modalities, cont.
TM-C6
Explain the body's physiological responses during and
following the application of therapeutic modalities.
TM-C7
Describe the electrophysics, physical properties, biophysics,
patient preparation and modality set-up (parameters),
indications, contraindications, and specific physiological
effects associated with commonly used therapeutic
modalities.
TM-C8
Identify appropriate therapeutic modalities for the treatment
and rehabilitation of injuries and illness.

4. Basics of Electricity
• Must understand why as well as how to
use electrical stimulation.
Or
• You’ll be a knobologist.

5. Review: Requirements for Ion
Migration: Chemical Effects
• Must have continuous monophasic DC electron
flow to cause ion migration.
• Moving electrons against gradient
– Like pushing a car uphill
– When you pause, it rolls back down.
• Why does a twin-pulse high-volt current not
produce a chemical effect?

6. Review: Polarization & Action
Potentials
• Stimulation requires a polarized
membrane (between inside and
outside of nerve membrane).
–
–
More positive ions than negative
ions outside nerve and more
negative ions than positive ions
inside membrane
When polarized, membranes have
a potential of −70 to −90 mV
between inside and outside of
membrane

7. Review: Polarization and Action
Potentials (cont.)
• Nerve action potential eventually causes
– An ascending sensory impulse to the brain
Or
– A descending muscle action potential
• Muscle action potential causes muscle
contraction.

8. Review: Polarization and Action
Potentials (cont.)
• Nerve repolarizes
quickly.
• Absolute refractory
periods vary from 0.4
to 2 msec
– Depends on specific
nerve

9. Review Excitability: Nerve Size and
Depth
• The larger the nerve, the easier it can be stimulated.
• The more superficial the nerve, the easier it can be
stimulated.
• In a practical sense:
–
–
Large sensory nerves are more excitable than motor nerves.
Motor nerves are more excitable than pain fibers.

10. Review Excitability: Rate or
Frequency
• Doesn’t effect individual threshold
– Effects torque as it approaches tetany
– Increased rate means increased fatigue rate.
fati
gu
tetany
5/sec
e

11. Review Electrodes: Physical
Dimensions
• Shape is unimportant
– Most are round or square or rectangular.
• Size and placement determine the
number of motor units stimulated.

12. Review Electrode Function
• Active electrode
– Electrode under which the current density
is great enough to elicit the desired
response
• Indifferent (dispersive) electrode
– Electrode under which the current density
is not great enough to elicit the desired
response

13. Most Commonly Used Wave
Forms
DC: DC
IF: Polyphasic
HV: Twin pulse
LV: Biphasic and polyphasic burst (Russian)
TENS: Biphasic

14. Review: Pulse and Cycle
Characteristics
• Pulse: finite period of
charged particle
movement, separated
from other pulses by a
finite time during which
no current flows
• Made up of one or more
phases

15. Review: Pulse and Cycle
Characteristics (cont.)
• Pulse named by number of
phases
– Monophasic
• One phase
• Current flows in one
direction only.
– Biphasic
• Two phases
• Current flows in both
directions.
– Polyphasic
• Many phases

16. Review: Burst Characteristics
• Burst
– Finite series of pulses flowing for a finite time period
followed by no current flow
• Think of it as turning a pulse train or AC current on and off.
– Burst interval
• Time during which burst occurs
– Interburst interval
• Time between bursts, usually in milliseconds

17. Review: Current Timing &
Modulation
• Pulse width (pulse duration)
–
–
Time required for each pulse
to complete its cycle
Reported in microseconds or
milliseconds
• Short pulse duration: <150
µsec
• Long pulse duration: >200
µsec
• Interpulse interval
–
Time between successive
pulses

18. Review: Surge Characteristics
• Ramp up
–
Time during which the
intensity increases
• Plateau
–
Time during which pulses
remain at maximum
preset intensity
• Ramp down
–
Time during which the
intensity decreases

19. Commonly Used Wave Forms
(p.142)
• Direct (galvanic)
wave form
– Pure DC current,
used for
iontophoresis

20. Commonly Used Wave Forms
(p. 142, cont.)
– Monophasic, rectangular, pulsed
• Also called a modified square wave
• Similar to DC but modulated from AC input
current
• On and off times are not necessarily equal

21. Commonly Used Wave Forms
(p. 142, cont.)
– Polyphasic, symmetrical, balanced,
sinusoidal
• Wave form generated and sold by utility
companies

22. Commonly Used Wave Forms
(p. 142, cont.)
• Faradic wave form
–
–
–
–
Induced asymmetrical AC current
Biphasic, asymmetric, unbalanced, spiked
Positive portion: short duration, high amplitude, and spiked
Negative portion: long duration, low amplitude, and curved

23. Commonly Used Wave Forms
(p. 142, cont.)
• Biphasic wave form
– Symmetrical, balanced, rectangular, pulsed

24. Commonly Used Wave Forms
(p. 142, cont.)
• Russian wave form
– Polyphasic, symmetrical, sinusoidal, burst
– Developed by Russian scientist Kots; thus the name
– Initially a 2500 Hz AC current burst, modulated every 10
msec, now many frequency choices

25. Commonly Used Wave Forms
(p. 142, cont.)
• Twin pulse wave form
– Monophasic, pulsed, twin spiked
– Common wave form of high-volt muscle simulators
– Has been called high-volt galvanic and pulsed direct
current
– However, not direct or galvanic current
– Result of misunderstanding physiology

26. Commonly Used Wave Forms
(p. 142, cont.)
• Interferential wave form
–
Symmetrical, sinusoidal, high frequency (2000–5000 Hz) AC
–
–
Two channels, with different frequencies, used simultaneously
Two currents cause a tissue current amplitude modulation

27. Commonly Used Wave Forms
(p. 142, cont.)
• Two identical currents
Interferential wave form: current amplitude modulation
Two offset currents
Two opposite currents
Usually accomplished with two
different frequency currents

28. Use of Electrical Current
Stimulation for Pain Relief
• Transcutaneous electrical nerve
stimulation (TENS)
• Interferential current therapy (IFC)
• Iontophoresis
• Neuromuscular electrical stimulation
(NMES)

29. For all modalities…
• Know the effects, indications, contraindications,
& precautions
• Verify the modality is set up correctly before
treatment begins
• Prepare the patient psychologically & physically
for the treatment
• Begin treatment conservatively and ask for
patient feedback
• At the end of treatment, clean up the modality
and instruct the patient about next treatment and
activity level until then
• Maintain the machines appropriately

30. TENS
• TENS
– Transcutaneous:
through the skin
– Electrical
– Nerve: sensory
– Stimulation:
depolarize
• Stimulate sensory
nerves with pulsed
current via surface
electrodes

31. TENS: Physiological Aspects
• Electrode placement
– Usually at the site of
pain
• Clinician can change
the patient’s
perception of acute
and chronic pain.
• Selective
depolarization of
afferent nerves

32. How does TENS work?
• Many theories
• Gate system and sensory TENS
– 80-150 pps
• Endogenous Opiate system stimulated
– Motor TENS and brief-intense TENS
• Low beat frequency 1–5 pps
• Slight muscle twitch

33. Brief Research Findings on
TENS
• Research is difficult.
• TENS has relieved pain associated with
–
–
–
–
Osteoarthritis
Rheumatoid arthritis
Dysmenorrhea
Low back pain
• Postoperative TENS

34. TENS
Advantages
1. Portable
a. Can be used during
activity
2. Self-treatment
3. Alternative to cold
during cryokinetics
Disadvantages
1. Eliminates pain; not
cause of pain
2. May mask more
serious problems
3. We don't know
enough about it yet
4. May become a
panacea (too reliant
on it, maybe even after
healthy)

35. TENS: Indications &
Contraindications
Indications
1. Pain of peripheral
origin
2. Acute pain
3. Chronic pain
Contraindications
1. Do not use on person
with:
a. An implanted pacemaker
b. History of heart disease
2. Do not treat transthoracic area
3. Discontinue use if a skin
irritation develops

36. TENS: Precautions
G. Precautions
1. Treatment over an area with:
a. Impaired sensation
b. Skin lesions (cuts, abrasions, new skin, recent scar tissue)
2. While driving or operating heavy machinery
3. Temporary decrease in pain does not mean
cause of pain has gone.
4. Delicate unit, not a cheap radio
a. Treat it kindly.

37. Electrode placement
techniques for TENS
Electrode placement
a. Over acupuncture or trigger points
b. Directly over the pain
c. Proximal or distal to pain
d. Crisscross over pain (two-channel unit)
e. Over motor point (helps with spasms)
f. Dermatome placement

38. Application Parameters: TENS
Adjust pulse width and rate
a. Go through entire range and select most
comfortable
settings.
b. Specific settings for specific conditions.
i. Acute pain: narrow pulse width (75 µsec) and high pulse
rate (80–200 pps)
a) Pain relief is almost immediate, but short lasting (1–60 min)
ii. Chronic pain: wide pulse width (200 µsec) and low pulse
rate (1–5 pps)
a) Pain relief may take ½ hr but will be long lasting (6–7 hr)

39. Application Parameters: TENS
(cont.)
Length of application
1. Extremely variable
2. Some treat for 30–60 min, others for hours
Frequency of application
1. Three or four times a day as needed for pain
Duration of therapy
1. Use until TENS is no longer effective.

40. Interferential Current
• Interference or superimposition of two
separate medium-frequency sinusoidal
currents on one another
• Symmetrical, sinusoidal, medium
frequency (2000–5000 Hz) AC
• Invented in 1950; used in United States
by 1980s
• Fifth most frequently used physical agent

41. What Is IFC Therapy? (cont.)
• Basic principle
– Decrease tissue impedance (resistance) so
simulation is less painful
• Impedance at 50Hz = ~3200 Ω
• Impedance at 4000 Hz = ~40 Ω
• Current passes more easily through skin
•
Advantages of vector pattern
–
–
–
–
–
Surface and deep stimulation
Targeted tissues for added benefit
Treatment of easily localized pain
Treatment of large areas
Treatment of poorly defined pain

42. How Does IFC work? (cont.)
• Example: One channel runs at 5000 Hz
another at 5100 Hz
– Use a dynamic vector (or scan for poorly
defined pain)
– Use target for easily localized pain
– Treats most of the area bracketed by the
electrodes (scan or dynamic vector)

43. Is IFC Therapy Effective? (cont.)
•
Those who have had success
– Correctly position vector
– Use appropriate size and positioning of
electrodes
– Use appropriate stimulation parameters
– Persevere, if pain relief is not immediately
obtained

44. IFC advantages &
disadvantages
Advantages
1. More comfortable than
a TENS
a. Medium-frequency
currents meet with less
skin resistance than low
frequency currents.
i. TENS uses low frequency
currents
2. Stimulates tissues
deeper than a
TENS unit
3. Larger coverage area
than TENS
Disadvantages
1. Eliminates pain;
doesn't deal with
cause of the pain
2. May mask more
serious problems
3. Few portable units
available
4. Sometimes
becomes a panacea

45. IFC: Indications & Contraindications
Indications
1. Acute pain
2. Chronic pain
3. Muscle spasm
4. Pain that covers a
large area
Contraindications
1. Do not use on a
person who has:
a. Implanted pacemaker
b. History of heart
disease
2. Do not treat
transthoracic area
3. Discontinue if skin
irritation develops

46. IFC Precautions
Precautions
1. Be cautious when using IFC over:
a. Impaired sensation
b. Skin lesions (cuts, abrasions, new skin, recent scar
tissue, etc.)
2. Use caution when using IFC while driving or
operating heavy machinery.
3. A temporary decrease in pain does not mean
the cause of the pain has gone.

47. Application Parameters: IFC
Adjust pulse rate settings for specific injury
a. For acute pain
i. Use a high pulse rate of 80–200 pps
ii. Pain relief is almost immediate
iii. Lasts only a few minutes to 1 hr
b. For chronic pain
i. Use a low pulse rate of 1–5 pps
ii. Pain relief may take ½ hr
iii. May last 6–7 hr
Target or vector
a. Pain that is easily identifiable and pinpointed
i. Use target or vector buttons to move spot
where current intersects to area directly
over pain
b. Pain that is hard to pinpoint
i. Use dynamic vector

48. Application Parameters: IFC
(cont.)
C. Length of application
1. 20–30 min
D. Frequency of application
1. Once or twice daily, as needed for pain
E. Duration of therapy
1. Use until IFC is no longer effective.

49. NeuroMuscular Electrical Stimulation
•
NMES is used for
– Muscle reeducation and prevention of
disuse atrophy
– Decreasing muscle spasm
– Decreasing edema

50. History of NMES
• 1980 companies started manufacturing
Russian current
• No North American scientist has been
able to duplicate Kots’s claims of 30%
increase in force vs. voluntary
contractions and lasting gains up to 40%
in healthy athletes
– Great amount of pain (as the current
amplitude was increased to try to replicate a
voluntary muscle contraction)

51. Why NMES?
• Used on patients who cannot perform a
voluntary muscle contraction
– Peripheral nerve innervation is intact, yet muscle
is too weak to contract from atrophy, pain,
immobilization, etc.
• Promotes early AROM in postsurgical and
immobilized limbs
• Break pain-spasm-pain cycle of muscle
spasms

52. Don’t Replace Strength
Training with NMES
• NMES recruits fibers in the opposite
order than that of a voluntary contraction.
– Machine = large fibers followed by small
– Voluntary = small fibers followed by large
• Patient needs to move on to more
traditional weight training ASAP.

53. Tetanic Contraction to break
Muscle Spasm
•
Goals
–
–
–
–
Increase local circulation
Remove metabolic wastes
Mechanically stimulate muscle fibers
Induce some muscle spasm fatigue

54. NMES for Decreasing Edema
• Produce cyclic muscle contractions to
help pump chronic edema
– 5–10 sec on; 5–10 sec off

55. NMES Effects
Effects
1. Muscle contraction
a. Increase blood flow
b. Retard atrophy development
c. Decrease and retard neuromuscular
inhibitions
d. Increase muscle relaxation; decrease
spasm
2. Decrease pain
a. Possibly by decreasing muscle spasm

56. NMES Advantages & Disadvantages
C. Advantages
1. Can be applied to
immobilized body
part
D. Disadvantages
1. Sometimes
becomes a
panacea

57. NMES Indications &
Contraindications
Indications
1. Residual or chronic muscle
spasm
2. Any time normal
neuromuscular function is
not possible
3. Muscle strains
4. During cast immobilization
or disuse atrophy
5. Pain owing to muscle
spasm
Contraindications
1. Do not use:
a. On a person with a
pacemaker
b. Over the heart or brain
c. Over recent or non-union
fractures
d. Over potential
malignancies

58. NMES Precautions
G. Precautions
1. Be cautious over an area with:
a. Impaired sensation
b. Skin lesions (cuts, abrasions, new skin,
recent scar tissue)
c. Decreased range of motion
d. Extensive torn tissue

59. Application Parameters:
NMES
C. Length of application
1. 10–30 min
2. See individual manufacturer’s
instructions.
D. Frequency of Application
1. As often as twice per day if separated by
3–4 hr

60. Iontophoresis: Basic Principle
 Like charges repel like charges,
 Drug ions are repelled or pushed into the underlying tissue.
 Two electrodes
– One drug delivery
– One larger dispersive electrode

61. How Does Iontophoresis
Work?
•
When an electrical DC current is
applied
– Positively charged electrode delivers
positively charged drug ions into skin and
surrounding tissues
– Negatively charged electrode delivers
negatively charged drug ions into skin and
surrounding tissues

62. Why Use Iontophoresis?
•
Delivering medicine such as antiinflammatories and pain relievers directly
without the negative effects of
– Painful needle injections
– Risk of infection from nonsterile needle
injections
– Avoid the gastrointestinal side effects of
NSAIDs and COX-2 inhibitors
– Localized drug delivery; doesn’t travel through
entire system
– Machine is Portable and easy to transport

63. Common Drug Ions Used in
Sports Medicine
•
Dexamethasone
–
–
•
Negative ion
Reduces inflammation by inhibiting
biosynthesis of prostaglandins and various
other inflammatory substances
Acetate
–
–
Negative ion
Assists in dissolving calcium deposits and
scar tissue in soft tissues

64. Common Drug Ions Used in
Sports Medicine (cont.)
• Hydrocortisone
– Positive ion
– Assists in decreasing tissue inflammation
by inhibiting biosynthesis of
prostaglandins
• Lidocaine
– Positive ion
– Assists in decreasing local pain by
blocking nerve impulse transmission

65. Is Iontophoresis Effective?
• Debate
– Research has shown it to deliver
medication from 6 to 20 mm below the skin
• Effective in reducing pain and
inflammation associated with
• Plantar fasciitis
• Temporomandibular disorders
• Epicondylitis
– When dexamethasone, lidocaine, or
sodium salicylate is used

66. Ionto Advantages & Disadvantages
Advantages
Compared to injections:
 Virtually painless
 Noninvasive, minimizing…
 Risk of infection
 Risk of tissue necrosis,
tendon rupture, etc.
Compared to oral
medications:
 Localized drug delivery,
nonsystemic
 Avoid risk of systemic side
effects
Disadvantages
1. Eliminates pain or
inflammation
a. Doesn't deal with the
cause of the
pain/inflammation.
1. Slight risk of electrode
burns
2. Some believe
transdermal drug delivery
is not possible.

67. Iontophoresis Indications &
Contraindications
Indications
 Used to administer
water-soluble ionic
medications
Contraindications
 Damaged or denuded
skin
 Recent scar tissue
 Drug allergies
 Transcranial
 Orbital region
 Electrically sensitive
support systems
 Pacemakers

68. Iontophoresis: Precautions
Precautions
 Diabetes
 Pregnancy
 Over external metal fixation devices
 Elderly skin
 TMJ
 Dizziness
 Metallic taste

69. Ionto: Drug Dose Calculation
Dosage (mA/min) = Current (mA) ×
Treatment time (min)
•
Examples:
• 40 mA/min = 4.0 mA (current) × 10 min (time)
• 40 mA/min = 2.0 mA (current) × 20 min (time)
• 24 mA/min = 2.0 mA (current) x 12 min (time)

70. Reported Sensation of
Iontophoresis
 Some patients feel little or no
sensation; others describe it as a
tingling or warm sensation.
 The intensity of the sensation varies
among patients and depends on the
site being treated.
 These sensations usually decrease
or disappear after a few minutes.

71. Typical Skin Reactions to Ionto
 DC causes capillary dilatation, leading to
erythema (reddening) of the skin under one
or both electrodes.
 Less frequent: appearance of small fluidfilled bumps caused by the release of
histamine from dermal mast cells
 Note: These skin reactions disappear over the course of
a few minutes but may last longer in patients with
particularly sensitive skin. Also, some patients with
sensitive skin may react to the adhesive on the electrode.

72. Reduce Negative Effects from
Iontophoresis
• To help reduce the risk of skin irritation
– Clean the skin with an alcohol scrub.
– After treatment, apply a lotion containing
aloe vera.
– Increase the size of the anode or cathode
to decrease current density.
– Increase the spacing between electrodes
to decrease current intensity.

73. Application Parameters:
Ionophoresis
C. Length of application
1. Dose specific
D. Frequency of application
1. Every other day
E. Duration of application
1. Up to 3 weeks

74. High Voltage Pulsed Current
Stimulation for Wound Healing
• Electrical stimulation for the purpose of
repairing tissues includes management
of open wounds and edema reduction.
• Production of a twin-peak, monophasic,
pulsed current driven by its
characteristically high electromotive
force or voltage
• Positive or negative polarity

75. HVPC (cont.)
•
Versatile and can perform several
functions:
–
–
–
–
Pain modulation
Edema reduction
Muscle reeducation and spasm reduction
Wound healing

76. Characteristics of High-Volt Stimulator
•
•
•
•
•
•
Low volt stimulators generate <150 V
High volt stimulators generate >150 V
HVPC uses between 150 and 500 V.
High peak voltages
Low average current
Twin peak monophasic waveform
– Resembles a double spike with a fast rise
followed by a fast decline
•
•
Short pulse widths (100–200 µsec)
Pulse rates of 1–200 Hz

77. HVPC: Uses & Techniques
• Monophasic current used for
–
–
–
–
Pain reduction
Disuse atrophy
Reduction of edema
Wound management
• Monopolar or bipolar technique
– Monopolar used when treatment is directed
over a large area
– Bipolar used for muscle contraction or
chronic pain

78. HVPC: Advantages
•
Less resistance to the
current by the skin
Short phase duration
allows for moderately
high-intensity muscle
contraction with little
discomfort
•
–
Other types of
stimulators provide a
stronger contraction
• Highly variable in its
functions
• Can be used for
– Pain modulation
a. Sensory level (acute
pain)
b. Motor level (chronic
pain)
– Edema reduction
– Treating muscle
weakness
– Wound healing

79. HPVC: Disadvantages
Disadvantages
1. Cannot provide as strong of a contraction
as NMES
2. Many aren’t portable.
3. Sometimes trial and error are needed to
determine electrode polarity for wound
healing.
4. Effects (muscle contraction) are as
strong as low-volt units.

80. HPVC: Indications &
Contraindications
Indications
1. Wound lesions
(pressure sores,
scarring from
incisions)
2. Edema control and
reduction
3. Residual or chronic
muscle spasm
(when low-volt unit
unavailable)
4. Pain
Contraindications
1. Do not use on patient
with pacemaker
2. Do not use over
a. Heart or brain
b. Lumbar and
abdominal area of
pregnant women
c. Potential malignancies
d. Anterior cervical area

81. HPVC Precautions
G. Precautions
1. Be cautious when using HVPC over an
area with:
a. Impaired sensation
b. Extensive torn tissue
c. Hemorrhagic area
2. Patients with epilepsy should be monitored
during treatment.

82. HVPC: Edema Management
• Curbing edema formation
– HVPC is not DC
– Decreases the permeability of
microvessels
– Decreases the leaking of vessels, reducing
the number of plasma proteins and
amount of fluid that leave the vessels to
enter the interstitial spaces

83. HVPC: Edema Management
(cont.)
• Two protocols for curbing edema
Water immersion
-Negative polarity
-120 pps
-90% of visible motor threshold
-30 min treatments every 4 hr
-Apply ASAP postinjury or as long as edema is still forming
Resolution of edema once formed
-Can be employed in a muscle pumping action to get
rid of edema
-Intensity increased until strong muscle contraction
-Setting of 1–10 pps for muscle contraction

84. HVPC: Pain Modulation
• Ineffective in reducing the pain of
delayed-onset muscle soreness
• Yet has been shown to help relieve pain
caused by muscle spasm

85. HVPC: Wound Management
• How does HVPC stimulate wound repair?
– Body possesses bioelectric currents in the
vascular and interstitial tissues.
– Blood vessel walls, insulating tissue matrix,
interstitial fluid, and intravascular plasma
are capable of conducting bioelectricity.
– When tissues are damaged, an electrical
potential is created between injured and
noninjured tissues.

86. HVPC: Wound Management (cont.)
•
•
•
•
•
•
•
DC may stimulate cellular activity when injured.
Stimulating débridement of injured tissues
Tissue regeneration and remodeling
May speed up healing by promoting the natural
healing process
May develop a difference in potential between
wound area and the surrounding healthy tissue
Injury potential typically becomes positive 24–48
hr after injury & negative 8–9 days after injury.
As the wound heals, the difference slowly returns
to baseline.
–
Can be used to enhance the natural process of tissue
recovery and healing

87. HVPC: Electrode Polarity
• Negative polarity
–
–
Increases
• Vascularity
• Stimulation of
fibroblastic growth
• Collagen
production
• Epidermal cell
migration
Inhibits bacterial
growth
• Positive polarity
–
–
Increases macrophages
Promotes epithelial
growth

88. HVPC: Electrode Polarity (cont.)
• Most treatments begin with the negative
polarity
– Encourages blood clots to dissolve and
increases the inflammatory by products
• Necrotic tissues
• Positive polarity encourages clot
formation around the wound and
granulation tissue.

89. Application Parameters:
HVPC
D. Frequency of application
1. As often as three per day if separated by
3–4 hr

90. Microcurrent Electrical Nerve Stimulation
• Therapeutic use of constant (DC) and
pulsed (interrupted) currents where the
stimulus amplitude is in the
microamperage range
• Proposed Uses
–
–
–
–
Tissue healing
Pain control
Edema control
Slow healing skin lesions

91. MENS Names
• Many names of microcurrent
– MENS does not accurately describe this device.
– Current intensity is too low (<1 mA) to cause motor
nerve depolarization
• Other than MENS, these devices have been
referred to as:
–
–
–
–
–
Low-voltage pulsed microamp stimulation
Biostimulation
Bioelectric therapy
Low-intensity direct current
Low-intensity electrical stimulation

92. MENS: Theory
•
Brief research
–
–
No clear-cut
research
supporting the use
of microcurrent
therapy
Positive effect in
treating
•
•
•
Pressure ulcers
Diabetic ulcers
TMJ disorders
• No effect in treating
– DOMS
– Pressure ulcers
– Coracoacromial
arch pain
– Surgically induced
wounds

93. MENS: Theory (cont.)
• Might play a positive role in wound healing,
an area athletic trainers typically don’t deal
with
• It is safe.