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Thread: The joke of electrotherapy

  1. #71
    Curt,
    the "bulking up" of the muscle (you speak of) is from water being added to the muscle from the session stimulation. Thats why there is such as fast decrease in size (of the so called muscle) when you stop using the e stim bike. One other thing; From my knowledge it takes a minimum of 140ma to cause enough of a current to cause contractions in the quads, hams & glutes. It is my opinion that this amount of current is not good for the muscle tissue or cartilige long term. Just my opinion, not trying to get anyones panties in a twist.

  2. #72
    Senior Member Jeff's Avatar
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    I haven't participated in this topic thus far. As an avid FES biker I had to come here to even believe it. And I certainly can't read the entire history of this topic. Sorry. So I'll just add a few thoughts.

    FES causes deep muscle contractions. By stimulating muscle contractions in a pattern they become functional, you can pedal a bike. Electrodes embedded in the muscle might produce stronger contractions, but surface electrodes are sufficient.

    The increase of strength and endurance in my legs as I pedal regularly is being questioned? The centimeters added to the girth of my thighs are what? Isn't it just common sense that as you exercise you build strength? Is anyone contending that our own muscles are not responsible for pushing the pedals against resistance? So we go from zero activity to every other day pedaling. This is supposed to have no effect?

    Obviously the use of FES in SCI cannot be the issue here. Increased muscle bulk and strength. Cardio-vascular training. Certainly no one is questioning the value of FES for SCI in this regard. I don't know what the "joke of electrical stimulation" is but it has nothing to do with paralyzed persons making themselves healthy with FES. Because that's no joke at all.

    I had a four week vacation from FES back in December/January. I started a topic about it in this forum. It took almost three weeks for any significant changes in my legs to be apparent.

    Anyone who's tried FES doesn't question it. At least not any paralyzed person. Nope. For us it's our first shot at real exercise for our paralyzed muscles. Exercise that uses our own muscles and nothing else. Exercise that increases our heart rate and cardio-vascular conditioning.

    I'm shocked there has been four pages of discussion regarding this. For me there's little left to talk about. Only educating the not yet informed as to the great benefits of FES should generate this many messages.

    ~See you at the SCIWire-used-to-be-paralyzed Reunion ~

  3. #73
    Jeff..the history is:

    A cartoon character came in and bashed Dr. Young, the Keck Center, S.Petrofsky, FES and all of traditional neuroscience.

    He thought he was bright. He sarcastically asked if I was also a schoolteacher...LOL how funny because...I AM!!!
    (this is not fair, he actually may be bright, but he sounds very bitter)

    So, Scott put a name to him further proving that no one is anonymous on the internet. LarWatson is brilliant in my opinion deserves whatever legal fees he charges anyone...( that is generous coming from me seeing as I think I sent my divorce lawyers second child through college).

    Curt is a good defender, and a few like ChasB offered good counterarguments which are always welcome when they are done with some taste and manners..(miss you chasb)

    Meanwhile, after one post, I sat back and watched.

    Mr. Don Quixote, did you go bye byes? Sorry, but I am a mother too...

    Well I think that's about all of it. Now I have to go to therapy for E-stim because I thoroughly enjoy my reduction of pain that does not work according to mr..greg whatever...

    Mary

    If I can see it, then I can do it. If I believe it, there's nothing to it.

  4. #74
    Jeff,
    I've already mentioned everything you did. There is no point arguing with this guy. You can't make someone see what they don't want to see. He seems to base his entire opinion on FES not affecting Type II muscle fibers...which I don't care what type of muscle fibers FES affects...it's definately affecting some type of muscle in my husband's legs and gluts(which will help prevent pressure sores)also as yours. I've made reference to how power lifters that lift extreme weights are not bulked up (type II muscle fibers are genetic and vary from individual to individual, some people have more some less)like Arnold Swartezzenager wouldn't dream of lifting what that Russian guy was lifting over his head who just looked like he drank too many beers and ate too much pizza! And there is no way you can doubt the cardio benefit of pedaling a bike at 47 to 50 rpm for an hour 3 times a week.
    I appreciate you posting

  5. #75
    a different way to look at it...

    instead of focusing on his shots at fes, why not actually thinking that his proposed therapy might work? basically, b/c he came out shooting at Dr Young, fes, Petrofsky, etc, everyone doesn't like DQ so they focus on shooting him down. while his manner of promoting his therapy is controversial, the therapy may be right on. why not try it? if fes therapy had been promoted in the same manner, where would all you die-hard fes users be today?

    this electrochemistry theory/therapy could possibly be the "next big thing." maybe it will get better results than fes...maybe it won't. how will you know w/o trying it? i know the guy he wrote about, Clayton Dixon, he was a bit overweight and out of shape when we were in rehab. now he's fit b/c of DQ's device. he is an incomplete injury and that may be why he's out of the chair now, but i guarantee the therapy helped a lot, if not the reason he's out now. he only used the device a few months and in those months he had huge results!

    the problem here isn't electrochemistry vs fes. the problem is that nobody is reasonable b/c they are mad about the posts. i'm sure fes had humble beginnings, but people tried it & liked it, and those people support it now. don't confuse backing up a therapy you like w/ contempt for an alternative therapy. when electrochemistry has been tried by enough people it will build the necessary foundation and hopefully take off like fes. i know i'll be trying it as soon as i can get ahold of a machine. i'll have to take caution not to damage my skin, but fes, tens, & estim have the same precautions.

    SEE THROUGH THE CONTEMPT!!! this post went as far as tracking the guy down, and also threatened a lawsuit...geez! that was all just as unnecessary as the attacks on Dr Young. gimme a break, just consider the therapy...

  6. #76
    HI to everyone,

    I thought I would write and set a few things straight. I do not know where this member obtained his information. The basic research began in the 1970's and has been ongoing around the world. This technology is used by Therapeutic Alliances and Electrologic of America in the commercial FES bikes. The FDA only allows seven claims to be made by manufactures of electrical stimulators because these claims have been proven. One of the claims is reversal of muscle disuse atrophy. If you search Medline, the primary search engine for medical papers, you will see 42 papers published on reversal of muscle atrophy with electrical stimulation using needle biopsies as proof. A like number of papers have been written using cat scans showing the cross sectional muscle area increase with the use of FES.

    With the early research on the FES bike development, Dr. Barth Green, a top neurologist who started the Miami Project and its cure program, studied with us the effects of FES on muscles and proved its benefits using biopsies and cat scans in 1983. He worked in conjunction with my brother Jerrold at Wright State University and Dr. Ragnarsson at NYU. Dr. Green, Jerrold and I were part of the startup team of Therapeutic Technologies. The early basic research was the foundation for the develop of the REGYS and the ERGYS bikes at TTI. I was VP of Engineering and R&D at Therapeutic Technologies, before stating my current company Electrologic. Over the years, these technologies were greatly improved in the StimMaster's three generations of development.

    To help with the information on muscle fibers, in layman's terms, there are two types of muscle fibers. One type is used for quick response and heavy muscle force. The other type is used for long periods of continuous work. FES does train and increase both types. The FES bike, trains the endurance fibers most of all. Let us not forget, disuse atrophy is not the most important consideration for the use of the FES bike. Its best advantage is cardiovascular conditioning which is only obtained by using your own muscles for peddling the bike through the use of FES. This action increases circulation, decreases skin breakdown, and decreases spasms.


    Steven H. Petrofsky

  7. #77
    Originally posted by ScottS:

    a different way to look at it...

    instead of focusing on his shots at fes, why not actually thinking that his proposed therapy might work? basically, b/c he came out shooting at Dr Young, fes, Petrofsky, etc, everyone doesn't like DQ so they focus on shooting him down. while his manner of promoting his therapy is controversial, the therapy may be right on. why not try it? if fes therapy had been promoted in the same manner, where would all you die-hard fes users be today?

    this electrochemistry theory/therapy could possibly be the "next big thing." maybe it will get better results than fes...maybe it won't. how will you know w/o trying it? i know the guy he wrote about, Clayton Dixon, he was a bit overweight and out of shape when we were in rehab. now he's fit b/c of DQ's device. he is an incomplete injury and that may be why he's out of the chair now, but i guarantee the therapy helped a lot, if not the reason he's out now. he only used the device a few months and in those months he had huge results!

    the problem here isn't electrochemistry vs fes. the problem is that nobody is reasonable b/c they are mad about the posts. i'm sure fes had humble beginnings, but people tried it & liked it, and those people support it now. don't confuse backing up a therapy you like w/ contempt for an alternative therapy. when electrochemistry has been tried by enough people it will build the necessary foundation and hopefully take off like fes. i know i'll be trying it as soon as i can get ahold of a machine. i'll have to take caution not to damage my skin, but fes, tens, & estim have the same precautions.

    SEE THROUGH THE CONTEMPT!!! this post went as far as tracking the guy down, and also threatened a lawsuit...geez! that was all just as unnecessary as the attacks on Dr Young. gimme a break, just consider the therapy...
    1. When you want to promote a therapy it is unnecessary to attack others.

    2. You certainly don't attack the Dr.'s who are recommending the therapy out of goodfaith as being "fraudulent."

    3. Nobody here threatened a lawsuit. They warned him of the legal grounds upon those he was charging with fraud had a basis for a complaint. Myself, Curtis, et al. have no standing to bring a claim.

    4. See my posts below. I told him several times to stop the negative campaigning against FES and just prove up his theory. One incomplete injury with success does not a therapy make. I gave him 3 specific steps to do this. 1. State his name and his credentials. 2. Provide peer reviewed documentation of the therapies effectiveness. 3. Provide a published article in a respected journal outlining his research.

    He stated in 1999 that this therapy was about to be distributed. He states the same thing five years later. He has actively sought patients to try his therapy. WITH NO FDA approval. In his own words the FDA is a baseline for safety.

    In short, I have no problem with new and better therapies. The more the merrier. But not at the expense of our safety or the safety of others.

    Prove up the product. Get it on the market. And compete with Petrofsky. If he's right he will be able to attract plenty of investors in his technology and Petrofsky will be out of business in no time.

    Heck, I've got people who would talk with him. But he needs to come to the table with a lot more than what he's shown before I would even consider making those introductions. And any potential serious investor certainly would not want him posturing himself like this on a public forum.

    In short, he needs to stop the squawking and go to work.

    Enough said.

    What we do in life echoes in eternity. Maximus - Gladiator

  8. #78
    One more point:

    Note that in serious discussions of cure and therapies, the frontrunners have posted under their own names. If there is a screen name, the most credible to me do not hide out in the bushes. When asked who he was, DQ said..it did not matter. I say it does. He is marketing something...it most certainly does matter. If you want to try the machine, try it..maybe that is wise for you to do. I would hope the operation manual is complete and in print before you turn on the switch. It was not wrong for the members to search for his identity, it was responsible. They care, and it mattered to them. Like Lar said, market the thing...properly and compete. I was never angry...I questioned but was not angry. DQ had no problem giving it out...when one does that, he or she must be ready to get it back in equal measure.

    Mary

    If I can see it, then I can do it. If I believe it, there's nothing to it.

  9. #79
    Thank you , Steve Petrofsky, for finally speaking up. The chorus of true believers in FES was getting deafening, which in itself is not bad, but the incoherence was a little off-putting. Thank you for telling me that there are 42 papers out there that conflict with the research done by Greve JM, Muszkat R, Schmidt B, Chiovatto J, Barros Filho TE and Batisttella LR (1993). Functional electrical stimulation (FES): muscle histochemical analysis. Paraplegia. 31: 764-70. Department of Rehabilitation, Clinics Hospital, School of Medicine, University of Sao Paulo, Brazil. Could you please cite me to them. I have searched PubMed for 'functional electrical stimulation' and 'muscle atrophy,' and gone 20 pages deep in each case, as I have regularly over the years. I found nothing that conflicts with the findings of the Brazilians, and would greatly appreciate some guidance here. I did find two thing which were curious, one of them by a relative of yours perhaps:

    1: J Spinal Cord Med. 2003 Winter;26(4):384-9. Links

    Physiologic responses to electrically assisted and frame-supported standing in persons with paraplegia.

    Jacobs PL, Johnson B, Mahoney ET.

    Department of Neurologic Surgery, University of Miami School of Medicine, Miami, Florida 33136, USA. pjacobs@miamiproject.med.miami.edu

    BACKGROUND: Systems of functional electrical stimulation (FES) have been demonstrated to enable some persons with paraplegia to stand and ambulate limited distances. However, the energy costs and acute physiologic responses associated with FES standing activities have not been well investigated

    This study, as you see, was done in 2003, and published in the winter of that year. Not so long ago. 'Not well investigated'...curious. I was lead to believe the work was done. I know that your and your machine are more soundly based in science. Just FDA approval and adoption by the VA assure this, or so the chorus chanted. But let's consider another study:


    Neuromuscular Rehabilitation by Treadmill Running or Electrical Stimulation after Peripheral Nerve Injury and Repair.

    Marqueste T, Alliez JR, Alluin O, Jammes Y, Decherchi P.

    UPRES EA 3285, Faculty of Sciences and Sport, Marseille, Bouches-du-Rhone, France; UPRES EA 2201, Faculty of Medicine Nord, Marseille, Bouches-du-Rhone, France.

    Numerous studies were devoted to the regeneration of the motor pathway toward a denervated muscle after nerve injury. However, the regeneration of sensory muscle endings after repair by self-anastomosis was few studied. In previous electrophysiological studies, we showed that the functional characteristics of tibialis anterior muscle afferents are differentially affected after injury and repair of the peroneal nerve with and without chronically electrostimulation. The present study focuses on the axonal regeneration of mechano- (fibers I and II) and metabosensitive (fibers III and IV) muscle afferents by evaluating the recovery of their response to different test agents after nerve injury, repair by self-anastomosis, during 10 weeks of treadmill running (LSR group). Data were compared to control animals (C), animals with nerve lesion and suture (LS), and animals with lesion, suture and chronic muscle rehabilitation by electrostimulation (LSE) with a biphasic current modulated in pulse duration and frequency, eliciting a pattern mimicking the activity delivered by the nerve to the muscle. Compared to the C group, results indicated that, 1) muscle weight was smaller in LS and LSR groups, 2) the fatigue index was greater in LS group and smaller in LSE group, 3) metabosensibility remained altered in the LS and LSE groups, and 4) mechanosensitivity presented a large increase of the activation pattern in the LS and LSE groups. Our data indicated that chronic muscle electrostimulation partially favors the recovery of muscle properties (i.e. muscle weight and twitch response were close to the controls) and that rehabilitation by treadmill running also efficiently induced a better functional muscle afferent recovery (i.e. the discharge pattern was similar to the controls).

    Afferent, as you know, does not mean efferent, that is, functional motor skill, but feeling. Nothing here to support the motor functioning thing. It's curious though. Here the authors claim that a BIPHASIC current mimics THE ACTIVITY DEVLIVERED BY THE NERVE TO THE MUSCLE. I'll talk about physics shortly. But in the meantime here it is:

    The effect of previous weight training and concurrent weight training on endurance for functional electrical stimulation cycle ergometry.

    Petrofsky JS, Laymon M.

    Department of Physical Therapy, Loma Linda University, CA 92350, Loma Linda, USA, jerry-petrofsky@sahp.llu.edu

    Forty-five paraplegic subjects participated in three series of experiments to examine the interrelationships between previous weight training, concurrent weight training and muscle strength and endurance during cycle ergometry elicited by functional electrical stimulation (FES). When subjects only underwent isokinetic weight training (series 1) three times per week on the quadriceps, hamstring and gluteus maximus groups for 12 weeks, strength increased linearly with time for all three muscle groups from an initial average of 17 N to 269 N at the end of training, a 15-fold increase. In the second series of experiments, different groups of subjects either underwent no strength training prior to cycle ergometry or underwent strength training of these same three muscle groups for 2 weeks, four weeks, or 6 weeks prior to cycle ergometry. Any strength training was effective in increasing endurance for cycle ergometry. However, the rate of increase in endurance during cycle ergometry with no prior strength training was only 5 min per week, whereas the rate of increase in cycle endurance during ergometry was 14.6, 25.0, and 33.3 min per week increase in endurance after strength training for 2.4 and 6 weeks, respectively. When weight training was accomplished during FES cycle ergometry (concurrently) in a third series of experiments, there was an additional increase in endurance during cycling if strength training was concurrently accomplished. With no weight training, endurance increased 23 min per week, whereas with concurrent weight training at three times per week, endurance increased during cycling by 41.6 min per week. The results of these experiments seem to
    I don't know if this the Jerold Petrofsky who originally pioneered the FES thing, or what relation he is to you, but look at that conclusion: "The results of these experiments seem to show a clear advantage of weight training concurrently and before FES cycle ergometry. Results are given as mean (SD)." This seems to support the idea that more is gained from weight training effort than from FES. Am I wrong here? Did I read this properly, did your namesake find that FES is superfluous? Please help me here. Direct me to one, just one, of the 42 papers that are out there that say that biopsies show that FES increases the cross-sectional area of the type II fiber. I have been looking for it for years.
    Now let's get to physics. As an engineer you will understand this, I'm sure, though the transition to physiology might be challenging. You know, of course, that in the graph of a sinusoidal wave showing the voltage change over time of an alternating current, the area between the curve and the x axis is the measure of electrical charge passed. This means that for a biphasic current, like that cited above in the work done by Marqueste et al. which, it is claimed, simulates nervous functioning, the amount of electrical charge passed is zero, unless that biphasic wave is asymmetrical. But nothing was said about this in the article, so I will assume it is symmetrically biphasic. Again, that means no current or charge was passed. This rules out electrochemistry. How, then does a biphasic current simulate nervous functioning, which is not known to work by AC? More particularly, how does FES work? What does your wonderful machine do? In causing contractions without passing electrical charge (indeed, this is outlawed by the FDA no less, and your machine has FDA approval), how does the electrical current act upon muscle, and is this an adequate simulation of the way the nerve does it? We both know that voltage transmission alone can't cause biochemical changes like those necessary for the synthesis of proteins. So how does voltage transmission strengthen muscle, that is, increase cross-sectional area of the type II fiber, without using chemistry, which is possible only with mon-ophasic current? I'm just dying to know. Please, please, let me in on the secret. You see, because, in principle, before even seeing the Greve research which says FES has no affect on the type II fiber, physics and chemistry alone suggest that this is what should be found - that FES does not have any influence on muscle atrophy. Please, let me in on the secret. I won't tell anyone. Or else cite me to the research that says it does. Oh please!!

  10. #80
    Dr. Petrofsky, welcome, again, to CC and thank you for participating.

    Larwatson, good suggestions.

    ScottS, I mentioned in another post that perhaps a better way to market this product would have been as an alternative to FES but to attempt to promote a product by discrediting the validity of the science behind another is certain to raise anyones ire, especialy those who have achieved success with it, but I suspect this was DQ's intention. How better to bring attention to yourself. Make your product available, allow users to decide which is preferable based on the results it produces, and if it works as suggested, it will stand on its own merits. Rehab specialists will flock to it in no time and FES based technology will become obsolete. Lars is right, no investor worth his salt would back a product that's promoted in this manner. DQ stated that FES proponents have claimed that its use alone could return motor control to the paralytic and get people out of their chairs when the fact is that those claims were never made. He's failed to understand exactly what FES has been shown to do. I hope his machine does work as he suggests, perhaps finalizing the technology will take less time than his previous attempts seem to indicate. The quicker he subjects his machine to the same stringent criteria FES has been subjected to, completes the necessary trials and receives FDA approval, the better.

    [This message was edited by seneca on 03-18-04 at 10:20 PM.]

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