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Goals
To know what is Microcurrent? The physiological effects Therapeutic effects Clinical evidence Decision
Materials
www.ovid.com www.coherence.com www.nhl.lib.org www.pubmed.com www.medline.com www.ptjournal.org www.jama.com www.electrotherapy.org
Definition
low-intensity direct current that delivers monophasic or biphasic pulsed microamperage currents across the intact surface of the skin
MET uses currents that are 1/1000th of an ampere smaller than those delivered by standard TENS devices (milliamperes)
American Physical Therapy Association. Electrotherapeutic terminology in physical therapy: Report by the Electrotherapy Standards Committee of the Section on Clinical Electrophysiology of The American Physical Therapy Association (APTA).Alexandria, VA: APTA, 1990.
Terminologies
Microcurrent electrical nerve stimulation Microamperage stimulation Low-intensity direct current and Pulsed low intensity direct current
History
Carlos Matteucci(1830) Dubois Reymond(1843) injured tissue 1 microamp
Wolcott et.al 1960 200-800 microamps.on variety of wounds 200-350% faster healing rates in exp.group
Gault and Gatens 1975-76 Q.plegia, CVA, Brain Tumor, PVD, Burns, DM, TB, Fracture and Amputation
History contd..
Illingsworth and Barker (1980) stump of a finger tip 10-30 micro amperes Borgens et al 1980 Barker, Jaffe, and Vanable 1982 Healing of wounds and union of bones
History contd..
Bio stimulation and Bio electric therapy Cheng et al (1982) effect of current on various intensities
At milliamps level ATP generation Amino acid uptake 20-73% Protein synthesis 50%
At 500 microamps level ATP generation 500% Amino acid uptake 30-40% Protein synthesis
Weak stimuli increase physiologic activity and very strong stimuli inhibit or abolish activity.
Dermatron
The first commercial device Dr. Reinhold Voll of Germany in1960 Primarily used for electro-diagnostic testing and also therapeutically
Pulse frequencies between 0.5pps and 150 pps with periodic reversals in polarity
Delivered using probe electrodes(sometimes in the form of a pen) or pad electrodes Applied to acupuncture points,trigger points or over the site of pain. MET can also be administered on ear lobes and transcranially, where it is claimed that it will relieve migraine, headache, insomnia and stress
Heffernan MS. Comparative effects of microcurrent stimulation on EEG spectrum and correlation dimension. Integrative Physiol Behav Sci 1996; 31:202209.
Some MET devices have a point finder to detect areas of the skin with low resistance, which are believed to correspond to acupuncture points
DuPont JS, Graham R, Tidwell JB. Trigger point identification and treatment with microcurrent. Cranio 1999; 17: 29396.
MET developed from the claim that tissue health is maintained by a direct current electrical system in the human body and that a shift in thisnormal current flow occurs when tissue is Damaged
Watson T. Electrical stimulation for wound healing: a review of current knowledge. In: Kitchen S ed. Electrotherapy: evidence-based practice, eleventhedition. Edinburgh: Churchill Livingstone, 2002:31334
This direct current shift described as the current of injury, with a magnitude in the microampere range
Advocates claim that MET simulates this current of injury to assist tissue growth and healing, and that milliampere currents delivered by standard TENS devices are detrimental to this process of repair
Cheng N, Hoof HV, Bockx E. The effects of electric current on ATP generation, protein synthesis, and membrane transport in rat skin. Clin Orthop Rel Res 1982; 171: 264 72.
Seegers JC, Engelbrecht CA, van Papendorp DH.Activation of signal-transduction mechanisms may underlie the therapeutic effects of an appliedelectric field. Med Hypotheses 2001; 57: 224 30
Beckers theory
Polarity reversal sets up a current of injury Initiates and signals beginning of tissue repair and regeneration
Injury currents(DC)
The body does have a means of activating its own semiconductor bioelectric circuits to send endogenous biological electricity where it is needed for healing
the classical description of acupuncture meridians are actually maps of this glial cell network which parallel the peripheral nervous system these electrical signals are conducted through the Schwann cell and glial cell perineural sheath
injury currents conducted through this system are the naturally occurring bioelectric signals for tissue repair and regeneration acupuncture points are maximally conductive windows into this bioelectric system serving as amplifiers to compensate for downstream damping of signal strength
the insulation properties of the arterial microcapillaries can be adjusted by the body to shunt bioelectricity into the area of injury through the blood stream
Robert O. Becker, M.D. (Becker 1985); Bjorn Nordenstrom, M.D. of Sweden; and Richard Borgens, Ph.D. at Purdue University
Injury currents(DC)
The body does have a means of activating its own semiconductor bioelectric circuits to send endogenous biological electricity where it is needed for healing
These electrical signals are conducted through the Schwann cell and glial cell perineural sheath
the classical description of acupuncture meridians are actually maps of this glial cell network which parallel the peripheral nervous system injury currents conducted through this system are the naturally occurring bioelectric signals for tissue repair and regeneration acupuncture points are maximally conductive windows into this bioelectric system serving as amplifiers to compensate for downstream damping of signal strength the insulation properties of the arterial microcapillaries can be adjusted by the body to shunt bioelectricity into the area of injury through the blood stream
Injury currents(DC)
The body does have a means of activating its own semiconductor bioelectric circuits to send endogenous biological electricity where it is needed for healing these electrical signals are conducted through the Schwann cell and glial cell perineural sheath
The classical description of acupuncture meridians are actually maps of this glial cell network which parallel the peripheral nervous system
injury currents conducted through this system are the naturally occurring bioelectric signals for tissue repair and regeneration acupuncture points are maximally conductive windows into this bioelectric system serving as amplifiers to compensate for downstream damping of signal strength the insulation properties of the arterial microcapillaries can be adjusted by the body to shunt bioelectricity into the area of injury through the blood stream
Injury currents(DC)
The body does have a means of activating its own semiconductor bioelectric circuits to send endogenous biological electricity where it is needed for healing These electrical signals are conducted through the Schwann cell and glial cell perineural sheath the classical description of acupuncture meridians are actually maps of this glial cell network which parallel the peripheral nervous system injury currents conducted through this system are the naturally occurring bioelectric signals for tissue repair and regeneration
Acupuncture points are maximally conductive windows into this bioelectric system serving as amplifiers to compensate for downstream damping of signal strength
the insulation properties of the arterial microcapillaries can be adjusted by the body to shunt bioelectricity into the area of injury through the blood stream
Injury currents(DC)
The body does have a means of activating its own semiconductor bioelectric circuits to send endogenous biological electricity where it is needed for healing These electrical signals are conducted through the Schwann cell and glial cell perineural sheath the classical description of acupuncture meridians are actually maps of this glial cell network which parallel the peripheral nervous system injury currents conducted through this system are the naturally occurring bioelectric signals for tissue repair and regeneration acupuncture points are maximally conductive windows into this bioelectric system serving as amplifiers to compensate for downstream damping of signal strength
The insulation properties of the arterial microcapillaries can be adjusted by the body to shunt bioelectricity into the area of injury through the blood stream and there is an intracellular influx of calcium
Injury currents(DC)
The body does have a means of activating its own semiconductor bioelectric circuits to send endogenous biological electricity where it is needed for healing These electrical signals are conducted through the Schwann cell and glial cell perineural sheath the classical description of acupuncture meridians are actually maps of this glial cell network which parallel the peripheral nervous system injury currents conducted through this system are the naturally occurring bioelectric signals for tissue repair and regeneration acupuncture points are maximally conductive windows into this bioelectric system serving as amplifiers to compensate for downstream damping of signal strength the insulation properties of the arterial microcapillaries can be adjusted by the body to shunt bioelectricity into the area of injury through the blood stream and there is an intracellular influx of calcium
Uncapping of insulin receptors on the cell membrane and enhancement of protien and DNA synthesis
Physiological effects
1) Spasmolysis of smooth muscles of the circulatory, lymphatic and hollow organ systems. 2) Tonification of elastic fibers, for example, increasing lung capacity in emphysema patients. 3) Reduction of inflammatory processes through reducing infiltrative, proliferative, and exudative processes. 4) Reduction of degenerative process by restoring diffusionosmotic equilibrium. 5) Restoration of polarization to the nerves. 6) Stimulus of ATP function in freshly injured striated muscle.
Usage in PT
Pain relief
Anti nociceptive? (primary) (not percieved) Tissue healing (secondary) Protein synthesis Tissue healing Antimicrobial effects
Lambert et al- Reduction of pain Double blind,Placebo controlled conditions on induced DOMS over 30 adults.
Lambert MI, Marcus P, Burgess T, Noakes TD. Electro-membrane microcurrent therapy reduces signs and symptoms of muscle damage. Med Sci Sports Exerc 2002; 34: 602 607
Clinical trials
Lerner et al- Significant reduction of pain Double blind, placebo controlled trial On 40 chronic low back pain patients MET administered for two 6 secs period to 16 points on low back, 3 times /week for 2 weeks.
Lerner F, Kirsch D. A double blind comparative study of micro-stimulation and placebo effect In short term treatment of the chronic back pain patient. J Chiropract 1981; 15: 101 106
MET effects are comparable to TENS for patients with migraine and chronic head aches
Annal N, Soundappan S, Palaniappan K, Chandrasekar S. Introduction of transcutaneous, low voltage, non-pulsatile direct current (DC) therapy for migrane and chronic headaches. A comparison with transcutaneous electrical nerve stimulation (TENS). Headache Q 1992; 3: 43437
Less effective than LASER for improving mobility and relieving pain in patients with degenerative joint diseases.
Bertolucci LE, Grey T. Clinical comparative study of microcurrent electrical stimulation to mid-laser and placebo treatment in degenerative joint disease of the temporomandibular joint. Cranio 1995; 13: 116 20
Clinical trials
Specific Frequency Microcurrent for Fibromyalgia and Myofascial Pain January 2006 Carolyn McMakin ,Portland
McMakin CR, Gregory WM, Phillips TM 2005. Cytokine changes with microcurrent treatment of fibromyalgia associated with cervical spine trauma. J Bodywork Move Ther 9:169-176 McMakin CR 2004. Microcurrent therapy: A novel treatment method for chronic low back myofascial pain. J Bodywork Move Ther 8:143-153 McMakin C. 1998. Microcurrent treatment of myofascial pain in the head, neck and face. Top Clin Chiro 5(1):29-35
Relieves pain?
Contradictory results
Inconclusive evidences from clinical trials Clinical trials lack methodological rigor
Rowley BA, McKenna JM, Chase GR, Wolcott LE. The influence of electrical current on an infecting microorganism in wounds. Ann N Y Acad Sci 1974; 238: 54351
Rowley BA, McKenna JM, Wolcott LE. Proceedings: The use of low level electrical current for enhancement of tissue healing. Biomed Sci Instrum 1974; 10: 11114
Clinical trials
2 well controlled animal studies MET not accelerating induced wound healing in rats and Yucatan pigs.
Leffmann D, Arnall D, Holmgren P, Cornwall M. Effect of microamperage stimulation on the rate of wound healing in rats. A histological study. Phys Ther 1994; 74: 195 200
Byl NN, McKenzie AL, West JM et al. Pulsed microamperage stimulation: a controlled study of healing of surgically induced wounds in Yucatan pigs. Phys Ther 1994; 74: 201 13
Clinical trials
Carley and Wainapel et al.- 30 patients 2 hours twice a day for 6 weeks MET accelerated healing against conventional wound dressing
Carley P, Wainapel S. Electrotherapy for acceleration of wound healing: low intensity Direct current. Arch Phys Med Rehabil 1985; 66: 443 46
Absence of placebo control group Healing of wounds and ulcers are undermined by lack of appropriate control groups
Wolcott L, Wheeler P, Hardwicke H, Rowley B. Accelerated healing of skin ulcers by electrotherapy. South Med J 1969; 62: 795 801 Assimacopoulos D. Low intensity negative electric current in the treatment of ulcers of the leg due to chronic venous insufficiency. Preliminary report of three cases. Am J Surg 1968; 115: 683 87 Sinitsyn L, Razvozva E. [Effects of electrical microcurrents on regeneration processes in skin wounds.] Ortop Travmatol Protez 1986; Feb (2): 2528 (Rus)
Indications
Alleviation of Pain Inflammation Spasm
Promotion of Healing
Low J, Reed A. Electrical stimulation of nerve and muscle. In: Low J, Reed A eds. Electrotherapy explained: principles and practice. Oxford: Butterworth-Heinemann, 1994: 39116. Bjordal JM. Electrical currents. In: Bjordal JM, Johnson MI, Couppe C eds.Clinical electrotherapy. Your guide to optimal treatment. Kristians andHoyskoleForlaget Norwegian Academic Press, 2001:102 16
CellStim400T
INDICATIONS
chronic and acute pain inflammation - edema synovitis musculoskeletal dysfunctions sports injuries - sprains, strains and contusions arthritic conditions - osteoarthritis sciatica neuropathies temporalmandibular joint dysfunction TMJ fibromyalgia FMS plantar fasciitis tennis elbow carpal tunnel syndrome CTS fractures - bone reunion wound healing - ischemic ulcers
CONTRAINDICATIONS
on pain syndromes where the etiology has not been established pregnancy demand type cardiac pacemakers wound infections through malignant or benign tumors through the eyeball through carotid sinus osteomyelitis over laryngeal musculature over the thorax intersecting the heart presence of topical substances containing metal ion
Microcurrent 850
Specifications Channels Power Source
:Dual :9V alkaline battery :12 volts :20, 40 min and constant :0.3, 8 and 80Hz
Patches
MC in cosmetic therapy
Conclusion
HAVE FUN
Discussion
References
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