Method and apparatus for applying neuromuscular electrical stimulation
A method and apparatus for applying neuromuscular electrical stimulation to an agonist/antagonist muscle pair to move a limb about a joint includes generating a first pattern of neuromuscular electrical stimulation pulses for output through a first channel to a first pair of electrodes and generating a second pattern of neuromuscular stimulation pulses for output through a second channel to a second pair of electrodes. The first pair of electrodes are attached to the agonist muscle of the agonist/antagonist muscle pair, and the second pair of electrodes are attached to the antagonist muscle. A first pattern of electrical stimulation pulses is transmitted through the first pair of electrodes to the agonist muscle at a first intensity level to initiate contraction of the agonist muscle, and then at a second intensity level which is less than the first intensity level to continue contraction of the agonist muscle. A second pattern of electrical stimulation pulses is transmitted through the second pair of electrodes to the antagonist muscle at a first intensity level to reduce the acceleration of the limb, and then at a second intensity level which is less than the first intensity level to regulate the movement of the limb.
1. A device for applying neuromuscular electrical and ultrasound stimulation to an agonist/antagonist muscle pair to move a limb about a joint, said device comprising a main stimulator controller, an ultrasound controller and a pulse pattern generating circuitry in communication with the main stimulator controller and ultrasound controller, wherein the main stimulator controller and ultrasound controller are configured to control said pulse pattern generating circuitry to:
automatically generate, for each burst period of a plurality of burst periods, a first pattern of electrical stimulation pulses for transmission through a first pair of electrodes to the agonist muscle, wherein the first pattern is generated:
(i) at a constant first current amplitude level for a period sufficient to initiate contraction of the agonist muscle, and
(ii) at a constant second current amplitude level, less than the first current amplitude level, for a period sufficient to continue contraction of the agonist muscle, the second current amplitude level period consecutive to the first current amplitude level period;
automatically generate, for each burst period of the plurality of burst periods, a second pattern of electrical stimulation pulses, different from the first pattern, for transmission through the second pair of electrodes to the antagonist muscle, wherein the second pattern is generated:
(i) at a constant third current amplitude level for a period sufficient to reduce an acceleration of the limb,
(ii) at a constant fourth current amplitude level, less than the third current amplitude level, for a period sufficient to regulate a movement of the limb, the fourth intensity level period consecutive to the third current amplitude level period; and
automatically generate ultrasound treatment parameters from a user interface controller and to set up an ultrasound generator for output through an ultrasound applicator.
2. The device of claim 1 , wherein each burst period of the plurality of burst periods:
(i) represents a predetermined period of time during which electrical stimulation is applied to the agonist/antagonist muscle pair, and
(ii) is followed by a predetermined rest period during which electrical stimulation is not applied to the agonist/antagonist muscle pair.
3. The device of claim 1 , wherein each burst period of the plurality of burst periods further includes generating the first pattern of electrical stimulation pulses during a first burst period and generating the second pattern of electrical stimulation pulses during a second burst period that begins after the beginning of the first burst period and ends no later than the end of the first burst period.
4. The device of claim 1 , wherein the ultrasound treatment parameters cause the ultrasound generator to produce electrical energy at a frequency of 1 MHz.
5. The device of claim 1 , wherein the ultrasound treatment parameters cause the ultrasound generator to produce electrical energy at a frequency of approximately 3.3 MHz.
6. The device of claim 1 , further comprising the ultrasound applicator.
7. The device of claim 1 , wherein the main stimulator controller and ultrasound controller are further configured to control said pulse pattern generating circuitry to apply therapeutic treatment with both electrical stimulation and ultrasound simultaneously.
8. The device of claim 1 , wherein the second current amplitude level is 75-90% of the first current amplitude level, and wherein the fourth current amplitude level is 10-30% of the third current amplitude level.
9. The device of claim 1 , wherein the period of the second current amplitude level is at least three times greater than the period of the first current amplitude level, and wherein the period of the fourth current amplitude level is 5-15 times greater than the period of the third current amplitude level.
10. The device of claim 1 , wherein the first pattern of electrical stimulation pulses comprises a series of pulses, each of which has a pulse duration that is within the range of 20-400 μsec, and wherein the second pattern of electrical stimulation pulses comprises a series of pulses, each of which has a pulse duration that is within the range of 20-400 μsec.
11. The device of claim 1 , wherein the first pattern of electrical stimulation pulses comprises a series of pulses generated at a frequency that is within the range of 20-80 Hz, and wherein the second pattern of electrical stimulation pulses comprises a series of pulses generated at a frequency that is within the range of 20-80 Hz.
12. The device of claim 1 , wherein the electrical stimulation pulses in the first pattern of electrical stimulation pulses are generated at current amplitudes within the range of 10-150 mA, and wherein the electrical stimulation pulses in the second pattern of electrical stimulation pulses are generated at current amplitudes within the range of 10-150 mA.
13. The device of claim 1 , wherein the first pattern of electrical stimulation pulses comprises a waveform selected from the group consisting of symmetrical biphasic, asymmetrical biphasic, high volt and premodulated, and wherein the second pattern of electrical stimulation pulses comprises a waveform selected from the group consisting of symmetrical biphasic, asymmetrical biphasic, high volt and premodulated.
14. The device of claim 1 , wherein each burst period of the plurality of burst periods has a duration between 200 and 5000 msec.
15. The device of claim 1 , wherein each burst period is followed by a predetermined rest period during which electrical stimulation is not applied to the agonist/antagonist muscle pair, and each rest period has a duration at least 2-5 times the duration of the immediately preceding burst period.