Techniques for Electrical Stimulation

The techniques are generally divided into three: Faradic Galvanic Interferential However, as explained below, for function it is generally the case that faradic stimulation is applied.

Faradic Electrical Stimulation

Faradic stimulation is used for innervated muscle, ie when the lower motor neurons are intact. Stimulation is applied via the nerves often at the muscle motor points. The nerves depolarisation leads onto muscular contraction. Faradic stimulation can be considered to be ac with pulse widths <1ms (typically around 0.3ms with a frequency <100 Hz (due to the absolute refractory period of normal muscle). The contractions produced can be: approaching near normal voluntary levels of muscle force sustained tetanic It is for these reasons that the majority of functional electrical stimulation techniques require intact lower motor neurons, and use fardic stimulation techniques to achieve the desired muscle contraction.

Galvanic Electrical Stimulation

This is often known as interrupted dc as it conventionally requires pulsewidths of about 100 ms. It is used to stimulate denervated muscle directly, but at best produces weak tetanic forces. The use of this technique for functional restoration is therefore limited, and with the conventional approach the therapeutic benefits have been considered minimal. However, more recent work, including that at Surrey, in collaboration with Odstock

Hospital, Salisbury, has indicated that there are increased, though largely therapeutic, benefits to be gained by using biphasic waveforms of around 1015 ms pulsewidth and frequencies of about 10Hz. A study has begun at Surrey, to investigate the optimal parameters to be used for denervated muscle stimulation. For more details contact Alan Woodcock or David Ewins

Interferential Electrical Stimulation

This is used for deep tissues where with fardic type pulses a high, and consequently often painful, stimulation intensity is needed to reach the desired muscles, eg pelvic floor muscles. By increasing the frequency the body impedance is reduced and thus the necessary stimulation intensity to ensure depolarisation of the deep nervous tissue is lowered. In a simple application two medium frequency signals, eg of the order of 3kHz, are applied to the body. The "mixing" of these within the body produce a beat signal with a pulsewidth within the faradic range. This then leads onto nerve depolarisation as would be the case with direct faradic stimulation. Interferential stimulation is not often used for functional neuromotor stimulation as compared with faradic type stimulation, it requires greater energy consumption and often a greater number of electrodes.