1.-THE ELECTRODES FOR TRANSCUTANEOUS TRANSMITTION.
These are indespensable elements, and determing factors for the achievement of good results with muscular electro-stimulation. In many occasions it is the electrodes that cause the lack of the desired effects. In the same way, good care of the electrodes will mean a more pleasurable sensation when the current is applied to the body, as well as meaning that they are more durable, saving us unnecessary expenditure.
-Before doing anything else, it is important that the skin on which we are going to apply the electro-stimulation is clean. If it is not, the top layer of dead skin will stick to the adhesive gel, creating an insulating effect. To counteract this, we would raise the intensity which would result in an impulse that would cause an uncomfortable sensation. Cleaning the skin is advisable so that we get rid of this last layer of loose cornea of the skin and some of the grease, so that these two insulators don’t stick to the electrodes.
-Put in place and remove the electrodes in the correct way. If the skin is clean and by mistake we put our fingers on the gel, we do ourselves little favour. We should also remember that the corners and sides, where the gel is, tend to break easily because it is these parts that we touch to stick or remove the electrodes. If we pick up the impregnated area without touching the gelled areas, the duration of the electrodes will be greater. Needless to say, we should never remove the electrode by pulling the cable, as this will most likely cause the electrode to be unusable.
-Even taking great care with the electrodes, they do lose their adherence, due to dehydration; the gel dries and the electrodes lose their adherence and conductivity.
What we can do in this case is add a bit of transmitter gel to the electrode the moment we are going to put it back in its small bag, which will mean the electrodes last longer.
It is always necessary to keep the electrodes in their watertight plastic bag, pressing down the bag a little with the fingers to squeeze out the air from the inside. In the bag and on the original plastic in which they came stuck, the electrodes will have maximum duration. In this way, the electro-stimulation electrodes will have their maximum durability and effectivity.
It goes without saying that exposing the electrodes to bad weather, the sun, dust or any other type of dirt will impede their functioning and resuce their usability.
2.-THE CABLES AND THE ELECTRO-STIMULATOR CONNECTIONS.
As we well know, the equipment requires excellent care; we should generally take good care of an electrical generator. In physiotherapy, we take as much care of the cables of the equipment, as without cables in excellent condition, an electro-stimulator is not useful to us.
It is an indespensable requisite that the cables be kept in the special box or container in which they came, folded up properly to ensure they are never forced at any time which, upon repetition, could cut off the connections which are inside the plastic. We will avoid this type of damage, as the internal cable can easily part, especially in older equipment.
When plugging the plug into the electrode and inserting the connector in the electro-stimulator it is important to do so gently. Brisque movements and excessive pressure have an accumulative effect which will have bad results.
We all pay special attention to the area on which the electrodes are to be placed as, if they are not placed on a motor point, we will not achieve the desired result. However, we don’t pay the same amount of attention to the cables once they are connected, so we will mention it here: it’s important to always take exquisite care with where the cables are situated. If any movement in the body results in the cables swinging to one extreme or the other, it could mean they catch on something which will mean we’ll have to reconnect and revise the connections. Therefore, we have to always try to keep the cables as fixed as possible, which means it will be practically impossible for the electrodes to get pulled, so we will have a better experience with the equipment, and the electrodes and the cables will last longer.
There are many ways of fixing the electrodes; the most normal amongst them is with cinch straps which permits movement without suffering at each moment when something doesn’t work well. Ensure that the electrodes do not become stuck or squashed on our body. In short, it is vital to take exquisite care of the application of the electrodes, as is the placing of the cables during training.
3.- ELECTRO-STIMULATION EQUIPMENT.
It is important to follow the instructions of the manufacturer. As an example and to give a general idea, we are going to present a series of warnings of one particular manufacturer; T-ONE EVO II, which is one of the most modern manufacturers which offers a great price-quality ratio with its products.
T-ONE EVO II works with an interior rechargable Ni-Mh 1600mAh 4.8V battery.
The apparatus does not generate nor receive electromagnetic interferances from other equipment.
In any case, it is advisable to use the devise, keeping it within a distance of at least 3 metres from televisions, monitors, mobiles or any other electronic apparatus.
Not to be used in the presence of equipment which monitor patients.
Do not use the T-ONE EVO II with electrosurgery or therapy equipment.
Not to be used by persons with a limited comprehension capacity.
Not to be used by persons with sensitivity disorders.
It is also, at the moment, prohibited for the use of disabled persons, unless they are assisted by qualified professionals, such as a doctor or a physiotherapist.
Not to be used if the equipment is demonstrating signs of deterioration.
In the case of foreign substance spillage in the equipment, immediately contact the seller or manufacturer.
In the case of the equipment falling, make sure that there are no cracks or breakage in the container. If there is any sort of malfunctioning, contact the retailer or manufacturer.
If the equipment is not functioning properly during the treatment, turn it off immediately and contact the retailer or manufacturer, and inform the patient in treatment.
Not to be used with medical devises.
Not to be used in proximity of inflammable substances or in areas with concentrated levels of oxygen.
In the case of osteosynthetic metals, consult a doctor before using the T-ONE EVO II.
In the case of prolonged muscular stimulus, it is possible that the feeling of heaviness in the muscles will occur. In this case it is advisable to cease using the T-ONE EVO II treatments for a few days and instead use the recovery and capillarisation programmes.
Pay attention to the integrity of the plug and the wrapping of the battery charger. If signs of deterioration appear in either of these parts, immediately stop using the battery charger and contact the vendor or the manufacturer.
The electrodes should not be placed in such a way that the current flows across the cardic area, that is, a black electrode on the chest and a red electrodes on the shoulder blade. However, you can put the electrodes along the muscle bundles in the cardiac area, when strengthening the pectoral muscles, for example.
Not to be used with the electrodes placed near injuries or cuts in the skin.
Do not place the electrodes near the carotid sinuses, carotid artery or genitals.
Do not place the electrodes near the eyes nor pass the current from the equipment across the eyeball area. Do not place an electrode diametrically opposite the other with respect to the eye; there should always be a distance of 3cm from the eye ball.
When using the electrodes, follow the instructions indicated in this manual and on the application of the electrodes themselves. Only use electrodes provided by the factory or the official vendor.
Do not use electrodes from other equipment.
Only use electrodes made specifically by the manufacturer; T-ONE EVO II is proven and guaranteed for the usage of the electrodes supplied.
Inadequate electrodes could provoke burns or skin reactions. Only use round electrodes on the face.
Do not use the electrodes if they are broken, even if they stick to the skin.
Do not use the electrodes when they no longer stick to the skin; repeated use of electrodes that no longer stick to the skin could compromise the safety of the stimulus which could cause redness of the skin which could last hours after the stimulus has been switched off.
Attention; with the round electrodes, the current density can reach up to 2mA/cm for each electrode during treatment. In this case, pay particular attention to the eventual reddening of the skin.
The point of contact of the electrodes is the skin; it is the place through which the current passes to arrive at the nerve motor, in order to stimulate it and provoke a muscular contraction. The application area of the electrodes must be clean, so as to keep the electrodes in a good condition as mentioned previously, and also so as the current doesn’t encounter any extra resistence.
If we keep in mind that the current has to pass through the skin to get to the nerve motor, anything which it meets along the way will generate resistence for the electricity, and therefore reduce the results, or at least will cause uncomfortable sensations when the intensity is elevated. This may occur if on the motor point there is a large amount of fatty tissue. It is advisable to first do lipolysis training. In high quality equipment there are lipolysis programmes which you can use before beginning effective electro-stimulation work.
If the quantity of hair isn’t excessive, it is not necessary to remove it. If there is a high density of hair, it is advisable to remove it. After doing so, it is recommended to wait a few hours before applying the electrodies or we will experience very intense prickling in the areas that we have hurredly shaven.
5.-POSTURE OF THE BODY.
We can do neuromuscular electro-stimulation in various different positions; we will expand on this point in another section; and in various angles which allows us to develop maximum strength in the desired training trajectory.
Professional athletes should especially keep in mind the training trajectory, and the application of maximum force in the precise angles which are most important for our sport. In this way, we can also work the musculature to develop flexibility, depending on the angle which the bone lever forms and the muscle group which we are training. The body is a total and, so, to obtain maximum results it would be advisable to have some basic knowledge of biomechanics and anatomy, which would allow us to understand to what point one joint is capable of influencing another, one muscle to another, and that training a calf muscle will influence not just the position of the ankle but also the knee. Understanding this will be very important for obtaining the maximum benefits that electro-stimulation can bring us.