Granted Patent B2

US 8,473,064 · App. 12/487,431 · Granted Jun 25, 2013

Abstract

Claims (58)

1. A method for reducing joint compression caused by co-contraction of antagonist and agonist muscles in a patient in need thereof comprising:

applying neuromuscular electrical stimulation having a biphasic or triphasic pulse train pattern to at least two muscles associated with a target joint in said patient; and

wherein said step of applying neuromuscular stimulation decreases co-contraction of said at least two muscles after said applying step;

wherein said decreased co-contraction is measured by a decrease in pain at said target joint, improved muscle strength, decreased inflammation of said target joint, and an improved delayed gadolinium-enhanced magnetic resonance imaging of cartilage (“dGEMRIC”) score.

2. The method of claim 1 , wherein said step of applying neuromuscular electrical stimulation having a biphasic or triphasic pulse train pattern comprises:

providing a first channel comprising two electrodes, wherein a first electrode of said first channel is positioned in electrical contact with tissue of a first muscle of said target joint of said patient and a second electrode of said first channel is positioned in electrical contact with tissue of said first muscle or a second muscle of said target joint of said patient;

providing a second channel comprising two electrodes, wherein a first electrode of said second channel is positioned in electrical contact with tissue of said second muscle or a third muscle of said target joint of said patient and a second electrode of said second channel is positioned in electrical contact with tissue of said second muscle, third muscle or a fourth muscle of said target joint of said patient; and

applying a series of electrical pulses having said biphasic or triphasic pulse train pattern to said target joint of said patient through said first and second channels in accordance with said procedure for reducing said joint compression.

3. The method of claim 2 , wherein said first electrode of said first channel is positioned so as to stimulate a trapezius muscle of said patient, and said second electrode of said first channel is positioned so as to stimulate a cervical paraspinal muscle of said patient; and

wherein said first and second electrodes of said second channel are positioned bilaterally so as to stimulate a second trapezius muscle and a second cervical paraspinal muscle of said patient.

4. The method of claim 2 , wherein said first electrode of said first channel is positioned so as to stimulate a lower cervical paraspinal muscle and an upper thoracic paraspinal muscle of said patient, and said second electrode of said first channel is positioned so as to stimulate a cervical paraspinal muscle of said patient; and

wherein said first and second electrodes of said second channel are positioned bilaterally so as to stimulate a second lower cervical paraspinal muscle, a second upper thoracic paraspinal muscle, and a second cervical paraspinal muscle of said patient.

5. The method of claim 2 , wherein said first electrode of said first channel is positioned so as to stimulate a thoracic paraspinal muscle of said patient, and said second electrode of said first channel is positioned so as to stimulate an upper thoracic paraspinal muscle of said patient; and

wherein said first and second electrodes of said second channel are positioned bilaterally so as to stimulate a second thoracic paraspinal muscle and a second upper thoracic paraspinal muscle of said patient.

6. The method of claim 2 , wherein said first electrode of said first channel is positioned so as to stimulate a thoracic and/or lumbar paraspinal muscle of said patient, and said second electrode of said first channel is positioned so as to stimulate an abdominal muscle of said patient; and

wherein said first and second electrodes of said second channel are positioned bilaterally so as to stimulate a second thoracic and/or lumbar paraspinal muscle and a second abdominal muscle of said patient.

7. The method of claim 2 , wherein said first and second channels each further comprise a third electrode and a fourth electrode;

wherein said first and second electrodes of said first channel are positioned so as to stimulate a multifidus muscle of said patient, and said third and fourth electrodes of said first channel are positioned so as to stimulate an abdominal muscle of said patient; and

wherein said first, second, third, and fourth electrodes of said second channel are positioned bilaterally so as to stimulate a second multifidus muscle and a second abdominal muscle of said patient.

8. The method of claim 2 , wherein said first and second electrodes of said first channel are positioned so as to stimulate a biceps brachii muscle of said patient; and

wherein said first and second electrodes of said second channel are positioned so as to stimulate a triceps brachii muscle of said patient.

9. The method of claim 2 , wherein said first electrode of said first channel is positioned so as to stimulate a biceps brachii muscle of said patient, and said second electrode of said first channel is positioned so as to stimulate a pectoralis major muscle and an anterior deltoid muscle of said patient; and

wherein said first electrode of said second channel is positioned so as to stimulate a triceps brachii muscle of said patient, and said second electrode of said second channel is positioned so as to stimulate an infraspinatus teres minor muscle and a posterior deltoid muscle of said patient.

10. The method of claim 2 , wherein said first electrode of said first channel is positioned so as to stimulate a biceps brachii muscle of said patient, and said second electrode of said first channel is positioned so as to stimulate an anterior deltoid muscle of said patient; and

wherein said first electrode of said second channel is positioned so as to stimulate a triceps brachii muscle of said patient, and said second electrode of said second channel is positioned so as to stimulate a posterior deltoid muscle of said patient.

11. The method of claim 2 , wherein said first electrode of said first channel is positioned so as to stimulate a flexor muscle of a hand of said patient selected from a group consisting of flexor digitorum superficialis and flexor digitorum profundus, and said second electrode of said first channel is positioned so as to stimulate a flexor muscle of a wrist of said patient selected from the group consisting of flexor carpi ulnaris and flexor carpi radialis; and

wherein said first electrode of said second channel is positioned so as to stimulate an extensor muscle of said hand of said patient selected from the group consisting of extensor digitorum and extensor digiti minimi, and said second electrode of said second channel is positioned so as to stimulate an extensor muscle of said wrist of said patient selected from the group consisting of extensor carpi ulnaris and extensor carpi radialis.

12. The method of claim 2 , wherein said first electrode of said first channel is positioned so as to stimulate a flexor muscle of a hand of said patient, and said second electrode of said first channel is positioned so as to stimulate a biceps brachii muscle of said patient; and

wherein said first electrode of said second channel is positioned so as to stimulate an extensor forearm muscle of said patient, and said second electrode of said second channel is positioned so as to stimulate a triceps brachii muscle of said patient.

13. The method of claim 2 , wherein said first electrode of said first channel is positioned so as to stimulate an extensor digitorum brevis muscle of said patient, and said second electrode of said first channel is positioned so as to stimulate a tibialis anterior muscle, an extensor digitorum longus muscle, and/or an extensor hallucis longus muscle of said patient; and

wherein said first electrode of said second channel is positioned so as to stimulate an intrinsic foot muscle of said patient, and said second electrode of said second channel is positioned so as to stimulate a posterior tibialis muscle and a flexor hallucis muscle of said patient.

14. The method of claim 2 , wherein said first and second electrodes of said first channel are positioned so as to stimulate a tibialis anterior muscle and an optional peroneus muscle of said patient; and

wherein said first and second electrodes of said second channel are positioned so as to stimulate a triceps surae of said patient.

15. The method of claim 2 , wherein said first electrode of said first channel is positioned so as to stimulate a tibialis anterior muscle of said patient, and said second electrode of said first channel is positioned so as to stimulate a quadriceps muscle of a leg of said patient; and

wherein said first electrode of said second channel is positioned so as to stimulate a triceps surae of said patient, and said second electrode of said second channel is positioned so as to stimulate a hamstring muscle of said leg of said patient.

16. The method of claim 2 , wherein said first electrode of said first channel is positioned so as to stimulate a vastus medialis muscle of said patient, and said second electrode of said first channel is positioned so as to stimulate a gluteus medius muscle, a gluteus minimus muscle, and a tensor fasciae latae muscle of said patient; and

wherein said first electrode of said second channel is positioned so as to stimulate a biceps femoris muscle, a semitendinosus muscle, and/or a semimembraneous muscle of said patient, and said second electrode of said second channel is positioned so as to stimulate an adductor magnus muscle, an adductor longus muscle, an adductor brevis muscle, and a medial hamstring muscle of said patient.

17. The method of claim 2 , wherein said first electrode of said first channel is positioned so as to stimulate a rectus femoris muscle and/or a vastus lateralis muscle of said patient, and said second electrode of said first channel is positioned so as to stimulate a vastus medialis muscle of said patient; and

wherein said first and second electrodes of said second channel are positioned so as to stimulate a biceps femoris muscle, a semimembranosus muscle, and/or a semitendinosus muscle of said leg of said patient.

18. The method of claim 2 , wherein said series of electrical pulses comprises a plurality of cycles of a biphasic sequential pulse train pattern; and

wherein said biphasic sequential pulse train pattern comprises a first phase of electrical pulses applied to said first channel and a second phase of electrical pulses applied to said second channel, and wherein said second phase of electrical pulses commences after termination of said first phase of electrical pulses.

19. The method of claim 2 , wherein said series of electrical pulses comprises a plurality of cycles of a biphasic overlapping pulse train pattern; and

wherein said biphasic overlapping pulse train pattern comprises a first phase of electrical pulses applied to said first channel and a second phase of electrical pulses applied to said second channel, and wherein said second phase of electrical pulses commences before termination of said first phase of electrical pulses.

20. The method of claim 2 , wherein said series of electrical pulses comprises a plurality of cycles of a triphasic sequential pulse train pattern;

wherein said triphasic sequential pulse train pattern comprises a first phase of electrical pulses applied to said first channel, a second phase of electrical pulses applied to said second channel, and a third phase of electrical pulses applied to said first channel; and

wherein said second phase of electrical pulses commences after termination of said first phase of electrical pulses and said third phase of electrical pulses commences after termination of said second phase of electrical pulses.

21. The method of claim 2 , wherein said series of electrical pulses comprises a plurality of cycles of a triphasic overlapping pulse train pattern;

wherein said triphasic overlapping pulse train pattern comprises a first phase of electrical pulses applied to said first channel, a second phase of electrical pulses applied to said second channel, and a third phase of electrical pulses applied to said first channel; and

wherein said second phase of electrical pulses commences before termination of said first phase of electrical pulses and said third phase of electrical pulses commences before termination of said second phase of electrical pulses.

22. The method of claim 2 , wherein said first electrode of said first channel is positioned so as to stimulate an upper quadricep muscle of said patient, and said second electrode of said first channel is positioned so as to stimulate a vastus medialis muscle of said patient; and

wherein said first electrode of said second channel is positioned so as to stimulate a hamstring muscle of said patient, and said second electrode of said second channel is positioned so as to stimulate a triceps surae muscle of said patient.

23. The method of claim 1 , wherein said decreased co-contraction is also determined using EMG.

24. The method of claim 1 , wherein said decreased co-contraction is also determined using a tissue hardness and tissue compliance measuring system.

25. The method of claim 1 , further comprising a step of co-administering said electrical stimulation to said patient and a therapeutically effective amount of an agent selected from a group consisting of nonsteroidal anti-inflammatory drugs (NSAIDS) or analgesics; tramadol; codeine; propoxyphene; glucosamine; chondroitin sulfate; salicylates; Cox-2 NSAIDS; surface application of capsaicin cream 0.25%; steroids, corticosteroids, or hyaluronic acid preparations.

26. The method of claim 1 , wherein a delay between each said pulse train pattern is between 400 milliseconds and 1200 milliseconds.

27. The method of claim 1 wherein said decreased co-contraction is also measured by a decrease in the I-EMG in said at least two target muscles of said patient at rest or at a predetermined load.

28. The method of claim 1 wherein said decreased co-contraction is also measured by a decrease in the FFT in said at least two target muscles of said patient at rest or at a predetermined load.

29. The method of claim 1 wherein said decreased co-contraction is also measured by a decrease in the hardness of said at least two target muscles using a tissue hardness and tissue compliance measurement system.

Assignments (9)