Neuromuscular Electrical Stimulation (NMES) for Injury Rehabilitation
Muscles are vital for movement, providing power and motion and enabling our internal organs to function effectively. Injury, accidents and other ailments can cause impairments in muscular performance, when muscle weakness limits a person’s strength, power and endurance. The world of sports and athleticism is plagued with injuries, however injuries also occur during daily life activities when falls or accidents can lead to disability and immobilisation potentially resulting in disuse atrophy, affecting movement. In this article, we examine the role of neuromuscular electrical stimulation (NMES) as a rehabilitation tool to improve and restore muscle strength, power, and endurance.
What is NMES?
Muscles contract in response to electrical pulses from your nerves, via the brain. Neuromuscular electrical stimulation isa mode of treatment used in physiotherapy where electrical stimulation(currents) is applied to targeted muscles to mimic the natural action potentials transferred from the central nervous system, to produce muscle contractions. In effect, NMES overrides your brain, targeting muscle fibres you want to stimulate to contract, to promote strength, power and or endurance.
An individualised therapy approach for patients is at the heart of what we do here at Gymtherapy. The NMES unit (Compex) mode of treatment is a precise targeted approach that uses controlled frequency and intensity for rehabilitation of affected musculature.
Essentially the NMES unit delivers controlled electrical charges through wires with pads that stick on strategic sites on the skin. As an adjunctive therapy, it works to promote muscle recovery and joint range of motion (ROM). It is especially indicated for patient’s following joint or muscle surgeries, such as ACL reconstructions and joint replacements for post operation pain alleviation and recovery.
How Does it Work?
The normal physiological processes involved in the process of muscle contraction is initiated by the brain which sends a signal through the spinal cord ending at motor neurons that activate the muscle contraction process. The number and type of muscle fibre that contracts vary, dependent on what your brain decides is required. To preserve energy, the brain will minimise muscle contractions to only what is necessary to get the task done. Therefore, to increase strength in that area and work your muscles harder, you would need to add heavy weights to induce more muscle fibre involvement to build strength.
In instances where injury or disease is present or as an adjunct to an individual’s training plan, neuromuscular stimulation works to mimic this natural process by directly providing nerve impulses that act as signals for muscle contractions without active patient involvement. This is particularly useful for individuals with compromised neuromuscular function.
Following assessment, our trained physiotherapists apply the electrode pads to strategically selected sites on the skin, where electrical impulses target selected muscle groups. Patients report feeling a ‘ticklish’ sensation during treatment. This mimics the flow of current through the nervous system, acting as signals to initiate various processes throughout the body. Essentially, stimulated nerves conduct nerve impulses or ‘action potentials’ to muscular action.
Every individual and their nature of injury or training requirement is different. NMES devices are designed for individualised treatment when frequency and strength of electrical impulses can be modified, ensuring the most effective treatment experience.
Uses in Pain Management & Rehabilitation
NMES as a dynamic treatment modality is particularly beneficial for rehabilitation strengthening of skeletal muscles. Treatment can support neuromuscular retraining, preserve strength in the muscles, and prevent muscle atrophy (muscle loss) in individuals healing from surgery or injury. Neuromuscular electrical stimulation can also play a role in pain alleviation as well, especially when used in conjunction with other pain treatments such as manual therapy.
Research suggests that NMES works by blocking nociceptive stimuli (pain-causing signals), by primarily focusing on the pathways that carry pain signals as well as brain areas that process pain sensation. This is particularly helpful for chronic, painful conditions. NMES modifies pain perception by the release of intrinsic opioids and other neurotransmitters.
Summing Up the Advantages
NMES has been shown to be a versatile treatment option, which may be beneficial for training, rehabilitation across a wide variety of conditions offering a range of benefits:
- Regaining of Muscle Strength: NMES can assist immobilised patients with reduced muscle activity causing degenerative atrophy, by promoting muscle growth, increasing function and power.
- Retraining of Muscle-Nerve Connection: For injured or post-surgical patients, where immobilisation occurs, NMES can promote re-establishing the lost connection between muscle and their associated motor neurons, required for successful rehabilitation. Facilitating the repair of nervous pathways can promote improved muscular control and balance.
- Pain Alleviation: Chronic pain can greatly impact both recovery and wellbeing. The analgesic effects of NMES generated by production of endorphins or by inhibiting the nociceptive signals, may aid to reduce pain.
- Improving Mobility: NMES has been found to help restore muscle function during injury immobility, increasing independent movement.
- Improved Perfusion: NMES is known to improve blood flow to an affected/injured site. This may expedite and improve injury recovery promoting nutrients and oxygen delivery to the injured area.
- Portability: Individuals can continue treatment at home if recommended by a physiotherapist with a portable NMES device.
- Anti-Inflammatory Effect: NMES has been shown to reduce inflammation and swelling in the injured region by activation of intramuscular pumps and lymphatic drainage, aiding recovery.
- Patient Empowerment: Real-time feedback during the treatment process empowers patients in their healthcare journey.
To Finish
The practitioners at Gymtherapy are committed to modalities that improve patient health and mobility. To that end, NMES may be beneficial for individuals seeking to enhance their physical performance, manage chronic pain, or recuperate from an injury.
If you are experiencing symptoms, have had recent surgery, and/or are dealing with pain or discomfort, consider a physiotherapy consultation for tailored guidance and treatment.
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References
- Doucet, Barbara M et al. “Neuromuscular Electrical Stimulation for Skeletal Muscle Function.” The Yale Journal of Biology and Medicine 85 (2012): 201 - 215.
- Shah, Harsh R. et al. “Utilization of Spinal Cord and Peripheral Nerve Stimulation in Pain Patients: A Brief Review.” Topics in Pain Management (2020): n. Pag.
- Adler, Alexandra et al. “Neuromodulation for Spine Pain Care.” Spine Pain Care (2019): n. Pag.
- Garcia-Larrea, Luis et al. “PET-Scan and Electrophysiological Assessment of Neuromodulation Procedures for Pain Control.” (2001).
- Kimberley, Teresa Jacobson and James R. Carey. “Neuromuscular electrical stimulation in stroke rehabilitation.” Minnesota medicine 85 4 (2002): 34-7
- Chae, John et al. “Neuromuscular Electrical Stimulation for Motor Restoration in Hemiplegia.” Topics in Stroke Rehabilitation 15 (2008): 412 - 426.
- De Carvalho, I. D. G et al. “A LabVIEW™-developed Biphasic Functional Multichannel Electrical Stimulator.” 2022 Global Medical Engineering Physics Exchanges/ Pan American Health Care Exchanges (GMEPE/PAHCE) (2022): 1-5.
