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Thread: The joke of electrotherapy

  1. #1

    The joke of electrotherapy

    The joke of electrical stimulation

    In the essay "Breakout Session3: Issues Related to Muscle Growth, Atrophy, and Tissue Engineering" (Clinical Orthopaedics and Related Research, Number 403S, pp. S252-S261, Lippincott Williams & Wilkins, Inc., 2002) the authors come right out and say, within a few sentences, that not only is there no evidence that electrical stimulation has any effect on slowing or reversing atrophy and that no professional athlete uses it, but also that it is only used on the handicapped, especially those with spinal cord injuries. That's right. Not only does it not work, but it is only used on the handicapped, those who are desperate enough to pay for anything that might work. Yet it is standard practice in the neuroscientific community to still push electrotherapy as a type of treatment, whether the treatment is called EMS, PEMS, FES, E-Stim, or whatever. The whole field is characterized by unwitting charlatanry, for many of the physicians who urge the treatment on people they can't otherwise help, really believe that what they are doing will have some benefit, even though they will not use it on themselves. But they can make money using it on those who are desperate. Not even NASA, which admits that debilitation of flight crews from disuse is the biggest obstacle to manned exploration in the solar system, will have anything to do with electrotherapy despite the claims of doctors who urge it upon the handicapped for this very purpose, but don't use it on themselves. No body builder uses electrotherapy. What's the story here?
    When a muscle atrophies what takes place is the type II muscle fiber loses its cross-sectional area. What must be done to restore this cross-sectional area, and thereby the strength and mass of an otherwise wasted muscle, is trigger the synthesis of the proteins that make up this muscle structure. This can only be accomplished by strong physical exercise, the traditional resistance exercises, or the introduction of an electrical charge to the neuromuscular junction from which the type II fiber grows. In particular, that electrical charge must be introduced from the anode of the direct or monophasic current. This is elementary electrochemistry. Only through electrochemistry can nervous system trophism, like that needed to build muscle, be simulated.
    Why don't all of the devices currently available to provide electrical stimulation work? Because they don't pass electrical charge. For example the PEMS touted by Christopher Reeve and reputedly being testing by the European Space Administration on the international space station, is said to achieve 'charge neutrality', that is, there is no current (amperage) passed, no matter how many volts are involved. We won't be hearing of any great healings coming from Reeve's organization and the ESA. Neuroscientific insularity with regard to the phenomenon of electricity is so institutionalized, in fact, that the FDA, in its guidelines for powered muscle stimulators that use electricity to make muscles contract, says that no machine will be approved for use and sale unless it passes no more than one half of one thousandth of an ampere. This means that the FDA will approve only those muscle stimulators that will not work. The question is why is there this prohibition on the passage of amperage. You can read about it in the essay "Biology, Electromagnetism, and the Nervous System" on the web page at www.galvanism.org This prohibition dates to 1855, long before the phenomenon of electricity was understood by physicists.
    Here is something else to consider then. If only exercise [actual hard use of] a muscle or electrochemistry will strengthen that muscle, than no amount of laufband training or passive movement of the limbs will restore the muscle. Like an astronaut who returns to earth severely debilitated from months of life in zero gravity, the paralytic can be that way because of the deterioration of his muscles, not because of enduring and irreversible nerve damage or, as ignorant neuroscientists would have it, 'learned non-use'. The problem may be myopathy, not neuropathy, disuse atrophy which advances during the acute phase of injury. In a study published in 1996 in the Journal of Experimental Neurology, it was reported that in the case of the quadriplegics studied the nervous system was found to work, but that for some reason when the nerve impulse reached the muscle its power was not taken up by the muscle. This is not a lower motor neuron problem. This is an indication something is wrong with the muscle. Please check out the website. It's not yet complete. Coming soon is a tutorial on the role of electrochemistry in the origins and evolution of life. But what you can see now, in addition to a number of essays dealing with neuroscience and electricity, are pictures of the human body showing the number and distribution of neuromuscular junctions and ganglia on the body. Using electrochemistry, one must go to each of these points to deliver negative electrical charge to trigger post-synaptic protein synthesis. You can not find in any neuroscientific text any charts which number and locate all these points. Modern knowledge about the functioning of the synapse is based upon research done on squids. Maybe you don't have to be paralyzed after all, unless you stick with medical science, which claims that your paralysis [if your are an incomplete injury] is due to a learning problem, and which still holds that the electricity of the body is due to ion movement, or 'proticity', an idea for which Peter Mitchell got a Nobel in '78, an idea which, like most of neuroscience, has no clinical relevance whatsoever.

  2. #2
    Don Q, I am sorry but I disagree with these authors. I have personally seen the increase of muscle bulk that comes with surface stimulation of muscles. The argument that "no body builder uses electortherapy" is spurious. There is no question that neural activation of muscle is much more efficient than surface electrical stimulation of muscles. For a person who can activate muscles, it would be silly to use FES. But, for a person who cannot voluntarily activate muscles, it is often useful. By the way, most such stimulation is not activatin the muscles directly but activating axons that then release acetylcholine to activate the muscle. Also, for many people, what the electrical stimulation is doing is activating spinal reflexes and spasticity that is actually providing mot of the activation of the muscles. It is one of the reasons why people should not take such high doses of anti-spasticity drugs that they are flaccid.

    By the way, if you don't mind, what is the basis of your expertise?

    Wise.

  3. #3
    I am living proof with the physical stamina and the body I have now in using FES for the last three years that it does work. It gives me a good physical workout, to the point where I am working my cardiovascular system, muscles, etc. It works just fine, I dont know why so many people have such a hard time believing that E stim can be a real good thing given the proper circumstances.

  4. #4
    There is evidently a great deal of contradictory statements regarding SCI out there. I know that the medical community uses e-stim in regard to injured atheletes in sports medicine (so it's not just used for SCI). I also know the E-stem unit my husband has works...I've tried it. Crank it up and it hurts! It stimulates the muscles to contract... my husbands legs can lift 10 lbs when using the TENS unit in this manner at about 40 which is pretty low.On there own, his legs can do nothing, not even a twitch. The FES bike also works, and is an amazing piece of equipment.

  5. #5
    I am not surprised that anyone had a comment about how, yes, it could be that chronic paralysis following spinal cord injury might follow from advanced myopathy from disuse. This would fly in the face of the current doctrine championed by the neuroscientific community, the same people who, for over a century, have been able to offer nothing in the clinic for the paralytic. That dogma states that all paralysis following spinal cord injury is due either to enduring damage to the cord or 'learned non-use', the latter being a lower motor neuron problem. Nothing is said about the muscle. Now let's look at the replies to my post.
    In the first response Findacure upholds the orthodox views which have prevented a cure from being found so far. Findacure thinks that paralysis is something that can be cured like a disease, as if paralysis were not a condition, and claims that E-stim works because it is used, not because it has ever been tested on a control group. In this she contradicts the opinions of the experts who come down on the side that there is little or no evidence that it works, that not even NASA will touch it to overcome the biggest obstacle for manned exploration in the solar system. As an example she cites her husband whose muscles only work while the machine he is using [a TENS unit] is turned on and cranked up. Without he cannot even make the muscle twitch. In other words, the TENS unit is not really restoring his muscles at all since they do not work without the machine. The FES bike, she states, also works, and 'is an amazing piece of equipment'. Her husband's muscles apparently work too with this bit of equipment, but not on their own. We are asked to believe that this is a sign of muscle restoration. Findacure, like most people who think that making a muscle contract will make it stronger, believes that it doesn't matter how the muscle is made to contract, all that is important is to see that muscle twitch, that it doesn't matter if voltage transmission is the mode, or a simulation of nervous system trophism using electrochemistry, or induced contractions from the ingestion of psilocybin mushrooms which send the muscles into a state of tetany for hours. She has no idea that to restore a muscle the structure of that muscle must be affected. Goodbye, Findacure.
    Curt Leatherbee, a moderator for the site, says, in another example of anecdote overruling science, that he is 'living proof'. He has used FES for three years, and has nothing to say about the need for electrical charge to trigger protein synthesis. He betrays not the slightest understanding of the difference between contractions caused by voltage transmission and and those caused by oxidation-reduction reactions involving the use of DC. He says nothing about muscle structure, but, like Findacure, thinks that what is important is the contraction. He too uses a device approved by the FDA which has ruled out, by its regulations involving powered muscle stimulators, the possibility of electrochemical intervention. Mr. Leatherbee apparently knows nothing about the history of electrotherapy, about how, for over a century and a half, it has never resulted in anything replicatable, about how researchers for the first half of the 20th century found it didn't work and how it was discarded with the elevation to near sainthood of John Eccles, Alan Hodgkin, and Andrew Huxley with the award of Nobel in '63 for a preposterous model of the electrical nature of the nerve impulse based upon an 1888 thermodynamic equation from Walter Nernst. Thank you, Curt.
    Finally we have Dr. Wise Young who, like the previous two, disagrees with the experts on the basis of personal experience. He says that the argument that no body builder uses electrotherapy is 'spurious.' This is not an argument. This is a statement of fact. We are then regaled with a farrago of statements about electrical and neural stimulation of muscle, including the claim that neural stimulation of muscle is more efficient than surface electrical stimulation of muscle, and that anyone who can use his muscle would be silly to use FES. That's why body builders don't do it, maybe? They don't want to be silly? Dr. Young writes, "... for a person who cannot voluntarily activate muscles, it is often useful." Often? If your are correct, why not always? What are the cases where it is useful, and have the biopsies been done to show an increased cross-sectional area of type II muscle fiber, the sine qua non of muscle mass and voluntary muscle strength? Or is personal opinion enough here for the handicapped community wishing to find a 'cure.'? Then there is the amazing claim that "what the electrical stimulation is doing is activating spinal reflexes and spasticity", a statement that reveals a profound lack of knowledge about the structure and function of muscle. Spinal reflexes and the reflex arc are inventions of Sir Charles Sherrington having roots in his work in the first 5 years of the twentieth century, long before electricity and the structure of muscle were understood. Sherrington and Young would have us believe that a severely atrophic muscle is capable of contraction because of nerve impulses when, it was found in the 1930s and reported upon by Walter Cannon in his book The Supersensitivity of Denervated Structures, that such spasticity is a response to blood chemistry and local conditions, not nerve impulses. Apparently Dr. Young still believes that spasticity is a result of the firing of reflex arcs. In my post I reported that researchers who published in 1996 in the Journal of Experimental Neurology said that in the case of quadriplegics examined the nervous system was found to be working below the level of injury, but the muscles would still not contract. This conflicts starkly with the claims of Sherrington and Young. Dr. Young also claims that FES does not activate the muscles directly, but activates axons that then release acetylcholine which subsequently activates the muscles. It turns out that no amount of voltage transmission, the only thing available to FES, thanks to the FDA, will cause the secretion of acetylcholine at the nerve endings found in the motor endplate regions or neuromuscular junctions. The only thing that will cause this secretion is electrical charge, ruled out by the FDA, delivered by the anode in a simulation of nervous system trophism like that needed to cause the secretion of acetylcholine so that the muscle can be made to contract voluntarily. FES, like PEMS and E-Stim, and EMS, I will say again, is a bit of modern charlatanry perpetrated on the desperate by a neuroscientific community which knows nothing of history and little of physics.
    Nowhere yet have I seen any response or replies which address the issues of muscle structure, or the contrast of voltage with electrical charge. The point I am trying to make here is that the clinical poverty of neuroscience is due not to a lack of data, but to the institutionalization of flawed models of the nerve impulse and bioenergetics as a result of the Nobels in '63 and '78. Gentlemen, we must return to fundamentals, we must revise our knowledge in the light of new discoveries that succeeded these awards.

    Don Quixote

  6. #6
    Tilting at windmills again Don?
    Quote "that no professional athlete uses it"...
    My background is in sports medicine and athletic training, and I beg to differ. You can research the use of FES, TENS, and Russian Current in most sports medicine literature. These types of e-stim are used to "reeducate muscle" as well as build basic strength. A basic overview of these therapies can be read about in "Rehabilitation techniques in sports medicine" by William Prentice, this is a basic 3rd year text book for the sports medicine professional.



    Eric Harness,CSCS
    Project Walkâ„¢

  7. #7
    yes as dr young pointed out
    "The argument that "no body builder uses electortherapy" is spurious. There is no question that neural activation of muscle is much more efficient than surface electrical stimulation of muscles. For a person who can activate muscles, it would be silly to use FES."


    thats why those ab stimulators belts you see advertised on TV around xmas time dont work , at least for AB..

  8. #8
    Hi Don,

    I have heard that Russian body builders use(d) FES, I believe the first FES machines were developed by the Russians for their olympic athletes.

    As a C7 complete quad, personal experience says that FES does increase muscle tone.

  9. #9
    [QUOTE]Originally posted by Don Quixote:


    In the first response Findacure upholds the orthodox views which have prevented a cure from being found so far. Findacure thinks that paralysis is something that can be cured like a disease, as if paralysis were not a condition, and claims that E-stim works because it is used, not because it has ever been tested on a control group."
    ............................................
    First, if you're going to say what I believe, please get it right...orthodox??? I don't agree with the traditional-minded medical community at all.
    No. Paralysis unfortunately can't be "cured" like a disease...at least not yet. You can call it a "condition" if you like. So is Muscular Dystrophy, MS, etc...
    I never claimed that FES is a cure. I wish it were. But it is definately a means to gain back what is possible for that individual to gain back, through forced use and re-education of the nervous system/muscles. How much an individual can gain back, or rather they gain back anything at all, depends on the injury . No two are alike. I don't think much of a control group from this perspective, as no two people will have exactly the same results anyway. Some might have results, some not. FES in the least is a means to keep my husband's legs from going away... When the cure or therapy for SCI is found, we want him to be able to benefit from it. I also wonder if perhaps when an individual has less nerves innervating a muscle, that it might require more muscle mass to move the muscle itself. Just a thought. Anyway, FES is one of many therapies my husband does.

    Second, I'm basing my statements on what I've personally seen. What my husband has personally experienced. We don't tend to believe everything we read, everything we see on TV, or something just because some doctor said it. We have minds of our own. E-stim builds muscle mass. It works. I know because I've seen it. You know, book knowledge is all well and good, but it doesn't compare to real life experience.
    .....................................
    Don Quixote says:
    As an example she cites her husband whose muscles only work while the machine he is using [a TENS unit] is turned on and cranked up.
    ..........................................
    You should know that 40 is a low setting...it definately isn't cranked up. My husband doesn't have voluntary control, not even of a "twitch" as I stated earlier, however the e-stim stimulates his muscles to contract and build muscle mass, like spasms help to keep muscles from atrophying, from wasting away to nothing. I believe he wouldn't have regained as much as he has with his hands, if not for his TENS unit. He now has about 6 lbs of grip in his left hand and about 10 in his right. I believe you have to go after function, not just sit there and wait for it to come back. I mean, it might come back on it's own, but chances are it won't. What do you have to lose by trying? What do you have to lose by not trying? Just because an individual works hard and has a great attitude and does FES, etc isn't saying that they will be "cured", or that they will gain anything, but what will you gain if you don't try? It's been a little over 2 1/2 years since my husband's injury. We haven't given up. You're entitled to your opinion, but we disagree.
    GOODBYE DON QUIXOTE...

  10. #10
    Let's run through this again, very quickly. Findacure, you are exceedingly orthodox. You fall into the category of those who believe that all paralysis following spinal cord injury is due to nerve damage, you believe that all that is needed to strengthen a muscle is to 'force' it to contract, and you believe that something approved by the FDA according to Part 890, Physical Medicine Devices, subpart F, sec. 890.5850, Powered Muscle Stimulator (which rules out the use of electrochemistry), does this in a way that strengthens and re-educates the muscle and the nerve. Like all the others who have responded to these postings so far, including the moderators and Dr. Wise Young, you show no knowledge of the structure of muscle, what it is that is lost when the muscle atrophies, and what it takes to grow this protein back. Like Dr. Young, you too think that spasticity is driven by the nerves when, if a muscle is severely atrophic, the nerves cannot even cause it to twitch, and therefore spasticity cannot possibly be a nerve-related thing but, as was discovered in the 1930s, it is a result of blood chemistry. The implication is that flaccidity is a sign of loss of circulatory power. But this implication is lost on you. You are too orthodox. You ask, "What do you have to lose by trying?" I agree with the sentiment you are expressing here, but I disagree with what it is you are trying. If you're husband has recovered anything at all it is due to his trying, not to any FDA approved device he might use. Do you really want to continue trying? Try electrochemistry. Look at the website at galvanism.org Familiarize yourself with what is there. The equipment is not yet available, but will be by midsummer after it is manufactured. The only problem is that it is outlawed by the FDA. And it is cheaper then a TENS unit. All you need is the understanding of how to use it. Your husband has been hurt for 2 ½ years. If he started treating his muscles this summer with this device, he will be back on his feet in just under 8 years. Stick with TENS and FES and he will die in the chair trying. If your husband has recovered anything, anything at all, since the time of his neck injury, he is an excellent candidate for complete recovery. But the longer you wait, the longer it will take for him to recover since the body's muscles and organs deteriorate rapidly, so rapidly that the official word from the VA is that for each day of prolonged bed rest, three days of exercise are needed to recover.

    Seneca, bodybuilders around the world might dabble in electrical stimulation for a short time, but, since it doesn't work (regardless of your claims from personal experience) none have ever remained with it TO THE EXCLUSION OF RESISTANCE EXERCISES. FES is one of the versions of electrotherapy that is scandalously promoted by the manufacturers of medical equipment alleged to build muscle without triggering biochemical changes, but merely by making a muscle contract. This is thoroughgoing crap. The muscle must be made to contract the same way the body makes it contract, if it is to be built. That means that nervous system trophism must be simulated. The only way to do this is with electrochemistry, the anode of the direct current delivering pulsed electrical fields to the neuromuscular junction. Anything else, all things approved by the FDA, is worthless. Despite this people like Christopher Reeve, and your own Wise Young, push FES, PEMS, EMS and all manner of FDA approved junk when even the FDA states that it has no evidence that any of the stuff actually works, that it has no way of verifying that any of the stuff works, and that all research so far on the subject has not come up with any conclusive evidence for the wide variety of claims made for it. All the FDA does is make sure it is safe. Electrochemistry is safe, but it is rough on the skin if not done properly, and can leave marks if one is careless. For this the FDA outlaws it.

    Metronycguy, do you see the admission of Dr. Young that he too doesn't know jack about electrical stimulation. On the one hand he says body builders use it, and on the other he says it would be silly to use on the basis of its lack of 'efficiency'. Dr. Young doesn't know what he is talking about, and probably knows nothing of the difference between AC and DC in terms of electron behavior. He, along with John W. McDonald, Christopher Reeve's rehabilitation guru, push FES on you and others, but don't use it themselves because it is inefficient! My bet is he doesn't know squat about the structure of muscle and the changes in that structure as the muscle atrophies. These clowns stick to the dodge that paralysis of those with incomplete injuries is A LEARNING PROBLEM, and are incapable of questioning the issue of electrotherapy, electricity, and the electrical nature of the nerve impulse and nervous system trophism.

    Snowman, you must discriminate between sports medicine and sports training. Electrotherapy is used, without consequence, in sports medicine, but no athlete uses it to train. Why not? Efficiency? Give me a break. How about sports medicine? If it works in sports medicine, why not in regular medicine? It was the conclusion of the orthopedists cited in the essay "Breakout Session ..." that appeared in my first post, that electrotherapy was useless. That sports medicine doctors use it is a result of their patients being willing to pay for it. It is also used on the handicapped, without effect. You don't 're-educate' muscle. That phrase is nonsensical. You re-educate neurons to fire in patterns. But you can't re-educate neurons if the muscle isn't healthy because you can't use those neurons on a muscle that won't contract because of severe atrophy. Citing William Prentice as authoritative is an easy out, as if 3rd year texts for the sports medicine professional were conclusive, and as if texts were never mistaken. What I am saying is that this particular 'rehabilitation technique' is bogus. Prentice's textbook was a report on what is used, not an evaluation of its effectiveness. Since your background is in sports medicine and sports training, name one athlete who uses e-stim exclusively and attributes his/her condition to its use.

    I am amazed that the handicapped, the people most directly affected by the blindness and insularity of neuroscience, are the most fervent supporters of its charlatanry. But it has always been this way. You're all waiting for a miracle to be handed to you by a neuroscience that still teaches a version of the nerve impulse that models it based upon a nineteenth century, thermodynamic model of electricity in which electrons are replaced by hydrogen ions (protons), electricity is replaced by proticity. There is an appalling lack of skepticism amongst the handicapped that serves to perpetuate the benightedness of clinical neurology. Notice that your own Wise Young has absolutely nothing to say about whether advanced disuse atrophy might be the mechanism behind post-sci paralysis in some cases. He won't even entertain the issue. Why should he? He's complacent in the job security his level of knowledge allows, just like all the other paralysis researchers. They see no need to question fundamentals, calling instead for more money for even further inconsequential research into stem cells. Even when the cord is broken, if stem cells were to heal it, the person would still be paralyzed because of his muscles being weak. What say you to that, Wisey? Get a grip.

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