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history


f03: Galvanic Apparatus.From left to right: Emil Stöhrer’s zinc–carbon (or zinc–platinum) battery, universal electrode handle with ivory interrupter, metallic electrodes of various sizes, and sponge electrode with long handle. Stöhrer (1813–1890) was a noted scientific instrument maker, who established a shop in Dresden specifically for electrotherapeutic equipment. Figure source: Beard & Rockwell, 1871.48

Mentions: Galvanic stimulation is a form of electrotherapy that involves the use of direct current applied to specific areas of the body. The “Era of Galvanization” began in 1800 with the invention of the galvanic pile (i.e., the battery) by Italian physicist Alessandro Volta (1745–1827), who was stimulated to pursue this development by his disagreements with Italian physician Luigi Galvani (1737–98) concerning “animal electricity.”48 Shortly thereafter various investigators and quacks applied galvanism indiscriminately,48, 49 but as noted by American neurologists and electrotherapists George Miller Beard (1839–83) and Alphonse David Rockwell (1840–1933) in their monograph, A Practical Treatise on the Medical and Surgical Uses of Electricity (1871), galvanism “failed to fulfil [sic] the extravagant expectations that had been formed of it; a reaction followed, and it fell into disrepute.”48 Electrotherapeutics regained legitimacy in the 1850s with the work of Guillaume-Benjamin-Amand Duchenne de Boulogne (1806–75) in France and Robert Remak (1815–65) in Germany (Figure 2).48,50–52 Thereafter, galvanic, faradic, and combined forms of electrotherapeutics enjoyed wide popularity for various conditions, and were touted in various neurology textbooks in the late 19th century, including Hammond’s A Treatise on Diseases of the Nervous System (1871).3 Examples of the wide range of electrotherapeutic apparatus were also illustrated in textbooks and monographs (Figure 3).3, 48

Bottom Line: Initial anecdotal reports of success were seldom confirmed with subsequent experience.Several novel invasive therapies were also developed and promoted, all of which damaged or destroyed either upper or lower motor neuron pathways, and were also often associated with high mortality rates.Subsequently, all the invasive procedures employed were directed at lessening or removing the manifestations, rather than the underlying cause, of the abnormal central nervous system "irritation," usually by imposing paresis or paralysis.

Electronic Stimulation

Soothing Electro Medical Therapy

Peripheral nerve and Spinal cord stimulation has been used since 1965 to treat chronic and intractable pain. Since then there has been significant physiologic research and advances in technology.

Utilizing surface electrodes and computer -driven eletroceutical medical systems, pain and fatigue was markedly reduced in 3 out of 4 fibromyalgia and chronic pain patients. Tender points were also reduced in number and intensity. Sleep improved in quality and duration. Successful outcome was obvious by the third treatment. A total of 12 treatments over 6 weeks produces the maximum effect which persists without further maintenance treatments.

Lane Chiropractic uses an internationally patented technology, known as Hako-Med, for pain relief. Hako-Med is the most advance tool in the field of bioelectric medicine. For example, it has been proven to eliminate over 80% of pain in osteoarthritis. Hako-med essentially works by using a combination of AM and FM radio wave frequencies, which neutralize pain and stimulate repair by resonating with the area of injury. This non-invasive modality is safe, effective, and easy to use and has no negative side effects. Whereas a typical TENS unit creates a distraction from pain, Hako-Med actually increases energy in the body to promote healing and recovery from injury. This sophisticated technology, developed with German engineering, allows the physician the choice of 200 pre-programmed protocols or the ability to develop customized protocols based on specific patient parameters. Clinical indications and usages of Hako-Med include chronic pain, muscular dysfunction (e.g., atrophy, range of motion limitations, spasms, weakness, etc.), peripheral nerve pain, poor circulation, post-traumatic injuries, and post-surgical pain and prevention of thrombophlebitis. Hako-Med can be used in conjunction with, in alternation to, or independently from any other therapy. A typical treatment session can last anywhere from 10 to 15 minutes. When used alone, the recommended protocol for Hako-Med is three times weekly for 4 to 8 weeks. However, when used in combination with other therapies, Hako-Med works synergistically to accelerate the healing response and reduce recovery time.

The following are some frequently asked questions regarding electromedical treatment. Patients should note that there are noticeable differences between home-based and clinical electromedical products. These differences can have an effect on the level of efficacy obtained. Hako-Med systems in particular can only be purchased and prescribed by a licensed physician. Please consult your physician if you are interested in experiencing an electromedical treatment.

Q: I notice my skin is reddened under where the electrode was placed. Is this dangerous?

A: No. With proper dosage, there is occasionally a reactive hyperemia (increased blood flow to the area). This will disappear in a short time. If you experience a burning sensation, consult with your physician.

Q: My Hako-Med electromedical treatment was combined with the VasoPulse vasopneumatic device. I felt like I was getting an additional massage, but it left some red rings on my skin under the vacuum electrodes. Is the suction harmful?

A: No. With some skin types, a suction induced redness might be produced but this is temporary and will disappear shortly. The redness indicates an increase of blood flow to the area. Not only does this vacuum massage sensation feel good, but it produces a rapid increase in blood circulation under the electrode area. This enhances the ability of the treatment to enter the body.

Q: How many treatments are necessary for good results?

A: Electromedical treatment regimens are like drug treatment regimens – normally requiring 8-15 treatments (depending on the individual and the medical condition). Typically, the physician will ask you to receive treatment daily for the first 3-5 treatments, then 3 times per week for the next 2 or 3 weeks. Treatment time varies from 10-15 minutes.

Q: Hako-Med electromedical treatments relieved my chronic migraine pain in 3 treatments, yet my doctor wants me to get 10-15 total treatments. Is this really necessary?

A: Prescribed regimens are usually based on research documentation and published medical reports. These documents recommend what is necessary for long-lasting results. It should be discussed with your doctor, but a complete electromedical regimen increases chances for an optimal result.

Q: Are there any side effects from the Hako-Med electromedical treatment?

A: Typically there are minimal to no side effects. Depending on the individual patient and their medical condition, some side effects might include: relaxed or fatigued sensation with a desire to sleep, increased energy with difficulty falling asleep, occasional mild headache, increased bowel or bladder activity, and pain having moved to a new location. Most of these side effects have to do with changes (improvement) in blood circulation. Always advise your doctor of any changes or abnormalities you experience from electromedical treatment.

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AcTual state of the matter
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Electronic Nerve Stimulator Circuit
Bio-Electric Stimulation Therapy (BEST) is the technique in which very small current is passed through the Skin of an affected region to relieve pain. This pulsed current will mimic the natural Action potentials of the nerves so that the nerve conduction will be activated. The most common method of bio electric nerve stimulation is the Transcutaneous Electrical Nerve Stimulation abbreviated as TENS.

TENS is used in Palliative care and Pain medicine to relieve pain in the affected parts of the body. It is recommended in cases of Neuropathic pain caused by nerve damage. The effect of TENS depends on the individual’s physiology and response to electrical stimuli and the pain threshold. The TENS unit consists of one or more electrodes, a pulse generator and power source battery. The circuit inside the TENS is programmable to generate pulses of electrical stimuli with variable current strength, pulse rate and pulse widths. The waveform from the TENS is biphasic so that electrolytic effects on the skin can be eliminated. The important parameters used in TENS for the patient’s comfort are

1. Amplitude of Signal – A comfortable strength of current of low intensity, just above the threshold level is applied to the skin. 2. Pulse rate – Frequency of 80 – 100 impulses per second are used. 3. Pulse width – Duration of electrical pulses between 10 – 1000 micro seconds.

TENS Unit

Patients are instructed to select the correct frequency and intensity of pulses at which they feel free from pains. This can be found out by trial and error. Usually the electrodes are placed on the skin of the painful area. TENS have three settings to use in different therapeutic methods. The Conventional TENS uses a frequency of 40 – 150 Hz with low intensity and the current between 10 – 30 mA. Pulse duration is set at the maximum of 50 micro seconds. In Acupuncture mode, the frequency is set at 1-10 Hz at high intensity close to the tolerance limit. In Pulsed Mode, low intensity stimuli are applied as high frequency bursts around 1 – 2 Hz.

Physiological aspects
TENS is based on the electrical conductivity of the Skin and the electrical activities of the nerves. The current output from the TENS depends on the combined impedance of the electrodes, skin and muscle tissue. When repetitive discharges are applied to the same area of the skin, the impedance of the skin reduces which results in the flow of greater current through the skin. Studies have shown that TENS reduces pain through the inhibition of the Dorsal Horn of the Spinal cord thus limiting its central transmission. The electrical stimuli applied to the skin activate the low threshold Myelinated nerve fibers. The Afferent input from these fibers inhibits the flow of impulses in non Myelinated “C fibers”. This blocks the transmission of impulses to the “target cells” present in the dorsal horn. High frequency TENS activates the “Delta Opioid” receptors present in the Spinal cord and medulla while low frequency TENS activates the “Mu-Opioid” receptors in the spinal cord and medulla. High frequency TENS causes the inhibition of “Excitatory Neuro transmitters” like Glutamate and increases the production of “Inhibitory Neurotransmitters” like GABA (Gamma Amino Butyric Acid) in the spinal cord. At the same time, the “Muscarinic receptors” present in the Central Nervous system is activated. This causes a temporary blocking of the “Pain Gate” leading to Analgesia.

The low frequency TENS causes the release of the Neurotransmitters Serotonin and activates Serotonin receptors in the spinal cord. The production of GABA is also activated.

Gate Control Theory
Melzack and Wall in 1965 proposed the Gate control theory to explain the action of TENS on the nervous system. The ion gate is usually closed and inhibits the transmission of impulses through the “C Fibers” from the periphery to the target cell (T cell) of the dorsal horn of the spinal cord. When the peripheral pain stimulation occurs, C Fibers carry the pain stimuli that reach the T cell and “Gate” opens. This allows the transmission of pain stimuli to the Thalamus (Relay centre) and Cortex of the brain. Brain will interpret the stimuli as pain.

The gate control theory explains the mechanism of ‘closing of the gate’ to prevent further transmission of pain stimuli. The closing of Gate is achieved by the inhibition of C Fibers by impulses in the activated Myelinated fibers.

Safety considerations

Since pulsed electrical signals are used in TENS, adequate safety measures should be adopted while using the TENS electrodes. 1. Electrodes should not be used on or near the eyes, mouth, front part of the neck, on the area of numb skin, on wounds, on the facial nerves etc. 2. TENS should not be used in pregnant woman or persons having artificial pace maker. 3. TENS should be used with caution if there is a history of Epilepsy.

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check out Myths and FACTS about Muscle Stimulators and there Application.
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