NMES (Electrotherapy).pptx

It's a brief presentation on Neuromuscular and Muscular Electrical Stimulation (NMES).

1. Suresh Gyan Vihar University Topic:- Neuromuscular And Muscular Electrical Stimulation ( NMES ) Presented By:- Anand Kumar Semester:- 3 rd SID:- 2248164 Department:- Physiotherapy

2. INTRODUCTION Neuromuscular and Muscular Electrical Stimulation (NMES) is a modality that sends electrical impulses to nerves which causes the muscles to contract . It may be applied during functional movement or without functional movement. It has been used throughout the years for strengthening and maintaining muscle strengthening .

3. Muscle Contraction

4. INDICATIONS To improve muscle strength and prevent muscle atrophy To improve and maintain the range of motion around a joint To reduce muscle spasticity and spasms To increase cardiovascular function through the activity of large muscle groups

5. CONTRAINDICATIONS When the patient has a pacemaker When placed over the carotid sinus When we have areas of active tissue infection and devitalized skin When the patient is unable to comprehend instructions and provide feedback When the patient is pregnant When the patient has a peripheral vascular disease

6. Application First, the patient should be seated comfortably in a way that allows muscle relaxation which is necessary for easier muscle stimulation . Then, the skin should be inspected to make sure there are no skin abrasions and injuries. Following that the skin should be properly cleaned with a piece of cloth and water or alcohol-based wipes and it's very important to make sure the skin has been properly dried before the application of the electrodes on the skin.

7. Electrodes:- There is a wide variety of electrodes that can be used including self-adhesive electrodes which are quick and easy to use due to them already having a layer of conductive material on their surface, unlike carbon-rubber electrodes which are normally coupled to the skin by electrical conductive gel.

8. ELECTRODE PLACEMENTS The electrodes should be placed away from the joints and properly attached to the skin to avoid pain and discomfort. The electrodes can be placed either in a way where the cathode is placed on the motor point of the target muscle and the anode proximally on a nearby muscle supplied by the same nerve and this placement is called monopolar electrode placement and used when targeting small muscles. The bipolar electrode placement involves placing both electrodes on the muscle belly or one at the proximal end and another on the distal end of the muscle.

9. During electrical stimulation, it's important to increase the intensity of the stimulation gradually and to the maximum tolerable extent by the patient. For innervated muscles normally, the shorter the pulse duration, the greater the pulse amplitude should be whereas for denervated muscles , both pulse duration and pulse amplitude should be greater than that of innervated muscles.

10. Deep Muscle Stimulation

11. PARAMETERS Frequency (Hz) is the number of pulses in one second (20-50 pulses per second). Pulse Duration (microsecond) for small muscles is approximately 150-200 and for large muscles 200-300. Ramp time is at least 2 seconds. ON: OFF time ratio should be set in a way where off time is three times the on time. Treatment time should be between 20 and 30 minutes. The frequency of the sessions should be three times a week.

12. If your body isn’t moving, it’s not getting stronger—it’s just getting stuck in place. - Physio