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The joke of electrotherapy

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    #16
    Sen,
    The section you posted/quoted, only suggests that the potential may be there, using FES, but not currently, given "normal FES machines usually cannot deliver more thant 50-100 millijoules of electrical energy", much less than what Dr. Kern used and that any effects were with "enormous" amounts of energy, which have shown to be dangerous and possibly even harmful, from what was stated. This of course doesn't preclude the researches from continuing to develp means that enable positive results/benefits at lower currents for consumer use. One further thing: "He suggests that such stimulation can restore muscle in people as long as 25 years after injury although he did not present much data to support this statement." This always makes me skeptical and concerns are, people often overlook how critical this is, especial;ly coming from scientists who should know better than to make such blanket statements. If they are suggesting that there is a high probablity of restoration of muscles (for ex, but applies to whatever the study is on), then they should state it as such, with the data to support their statements.

    Nevertheless, there is no conclusive evidence of significant benefits of electrical stim/FES. There's data supporting both advocates and nay sayers. Much of it depends on the specifics of what one is studying, doesn't it. Individual's might be recieving some benefit in using FES. Maybe they aren't significant benefits or restoring muscle function per se, but if there are noticeable (or even percieved) results- ie increased mass, and that helps to motivate a person to excercise harder, improve strength and conditiong of functioning muscles, then all the power to em. If it serves to simply improve one's appearance by increasing bulk to otherwise diminished muscles, then so be it. This can help improve one's confidence and self image, which can help personal drive and initiative to further improve health and care of one's body. Whatever the reasons, if there is no harm being done, through the use of such machines, then why shouldn't a person use them.

    "Harm". Harm can also be in the form of being taken advantage of by profiteers, who will promise anything. So, as long as one makes a fully informed decision. That is their choice.

    Comment


      #17
      Here you are Don http://electrologic.com/biblio.htm

      I will anxiously await the unveiling of your FES beating therapy.
      "Life is about how you
      respond to not only the
      challenges you're dealt but
      the challenges you seek...If
      you have no goals, no
      mountains to climb, your
      soul dies".~Liz Fordred

      Comment


        #18
        We know what Dr. Young's medical and research background is and hold him in high esteem. What is your background and what research, not articles, have you drawn this conclussion on FES? What is your relationship with the SCI world?

        Thank You
        ~Pat~

        T-10 complete
        10/08/01


        T-10 complete
        10/08/01
        "Life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well-preserved body, but rather to skid in sideways, chocolate in one hand, martini in the other, body thoroughly used up, totally worn out and screaming 'WOO HOO' what a ride!"

        Comment


          #19
          Hey Don Quixote...How much do YOU make for selling one of these "galvanism" machines that you promise will make a complete walk in 8 years?

          Maybe you should spend a little more on your web site.

          Sell your crap somewhere else.

          Kap

          "It's not easy being green"
          accept no substitutes

          Comment


            #20
            Don Quixote,

            You are making some pretty sweeping statements, i.e. "joke of electrical stimulation", "unwitting charlatantry", and "ignorant neuroscientists". You appear to be basing your belief that electrotherapy (referring to surface stimulation with commercial devices) is useless because:

            1. there is "no evidence that electrical stimulation has any effect on slowing or reversing atrophy"
            2. "no body builder uses electrotherapy" and NASA has decided not to use FES to build or prevent muscle atrophy of astronauts in space.
            3. "restoration of cross-sectional area of type II muscle can be accomplished only be 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"
            4. "...the devices... don't pass electrical charge", the FDA will not approve machines that pass more than "half of one thousandth of an ampere", "a prohibition that dates to 1855".

            Let me discuss each of these points sequentially below.

            You state that there is "no evidence that electrical stimulation has any effect on slowing or reversing atrophy". There is evidence that electrical stimulation of muscle can increase bulk and strength of paralyzed muscle, and even reverse muscle atrophy and osteopenia in bones of stimulated legs. There are of course many studies but I will cite only two. Baldi, et al. (1998) from Ohio State University published a study assessing whether unloaded FES isometric contractions and FES-cycle ergometry could prevent muscle atrophy. They tested 26 subjects who started <3 months after injury and found that 3 months of FES-cycle ergometry but not FES-isometric contractions prevented muscle atrophy and caused significant muscle hypertrophy after 6 months. Belanger, et al. [2000) from the University of Quebec studied the effects of FES and resistance training on osteopenia, stimulating the left quadriceps of 14 subjects with spinal cord injury, comparing these against the right quadriceps of the individuals and 14 unstimulated control subjects. They concluded that osteopenia of the distal femur and proximal tibia and the loss of strength of the quadriceps can be partly reversed by regular FES-assisted training.

            You state that "no body builder uses electrotherapy". I had pointed out that this is a spurious argument because able-body builders can exercise muscles much more effectively through voluntary muscle activation against resistance. NASA probably chose to test voluntary muscle exercise in astronauts because it is more effective and efficient than FES. Furthermore, surface stimulation of muscles can improve neuromuscular function. Marqueste, et al., (2003) recorded muscle force, surface EMG, and M-wave of the rectus femoris and flexor digitorum brevis during a 6-week period of FES. Although the M-wave did not change after FES, they found that FES improved muscle function and activation.

            I agree that surface FES stimulation with commercial devices does not increase type II fiber diameters. Greve, et al. (1993) showed the FES did not change diameters of type I, IIa, and IIb fibers although the number of type IIa fibers increased. Crameri, et al., (2002) showed FES increased vastus lateralis work output, cross-sectional area of the muscle, vascularization, and muscle enzymes but reduced the percentage of type II fibers and myosin heavy chains. Type I or slow-twitch fibers are responsible for tone and posture while type II or fast-twitch fibers are used for phasic movements. FES induced muscle hypertrophy therefore is likely to be due to increase in type I muscle fibers. On the other hand, there may be some benefits to transforming fast fatigable muscles towards slower, fatigue-resistant ones (Pette & Vrbova, 1999).

            I agree that commercial devices do not pass enough current to activate denervated muscles. Kern, et al. (2002) showed that high currents are necessary and sufficient to activate denervated muscles. They were able to achieve tetanic contraction of such muscle with intense stimulation (pulse duration 30-50 msec, 16-25 Hz, and pulse amplitudes of up to 250 mA). They passed these enormous currents by using large electrode pads, reducing the current density. They estimated that this stimulation approach restored 2-4 million muscle fibers per quadriceps muscle of 3-4 years in muscles that had been denervated for 15-20 years. However, commercial FES surface stimulators can activate nerves that in turn activate muscles, as well as spinal reflexes that activate muscles. Although not particularly efficient, neuromuscular stimulation with surface electrodes can activate innervated muscles sufficiently to generate limb movements against resistance.

            Wise.

            References

            • Baldi JC, Jackson RD, Moraille R and Mysiw WJ (1998). Muscle atrophy is prevented in patients with acute spinal cord injury using functional electrical stimulation. Spinal Cord. 36: 463-9. Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus 43210, USA. Severe muscle atrophy occurs rapidly following traumatic spinal cord injury (SCI). Previous research shows that neuromuscular or 'functional' electrical stimulation (FES), particularly FES-cycle ergometry (FES-CE) can cause muscle hypertrophy in individuals with chronic SCI (> 1 year post-injury). However, the modest degree of hypertrophy in these already atrophied muscles has lessened earlier hopes that FES therapy would reduce secondary impairments of SCI. It is not known whether FES treatments are effective when used to prevent, rather than reverse, muscle atrophy in individuals with acute SCI. This study explored whether unloaded isometric FES contractions (FES-IC) or FES-CE decreased subsequent muscle atrophy in individual with acute SCI (< 3 months post-injury). Twenty-six subjects, 14-15 weeks post-traumatic SCI, were assigned to control, FES-IC, or FES-CE against progessively increasing resistance. Subjects were involved in the study for 3 or 6 months. Total body lean body mass [TB-LBM), lower limb lean body mass [LL-LBM), and gluteal lean body mass [G-LBM) were determined before the study, and at 3 and 6 months using dual energy X-ray absorptiometry [DEXA). Controls lost an average of 6.1%, 10.1%, 12.4%, after 3 months and 9.5%, 21.4%, 26.8% after 6 months in TB-LBM, LL-LBM and G-LBM respectively. Subjects in the FES-IC group consistently lost less lean body mass than controls, however, only 6 month G-LBM loss was significantly attenuated in this group relative to the controls. In the FES-CE group, LL-LBM and G-LBM loss were prevented at both 3 and 6 months, and TB-LBM loss was prevented at 6 months. In addition, FES-CE significantly increased G-LBM and LL-LBM after 6 months of training relative to pre-training levels. Within the control group, there was no significant relationship between LL-LBM loss [3 and 6 months) and the number of days between injury and baseline measurement. In summary, this study shows that FES-CE, but not FES-IC, training prevents muscle atrophy in acute SCI after 3 months of training, and causes significant hypertrophy after 6 months. The magnitude of differences in regionalized LBM between controls and FES-CE subject raises hopes that such treatment may indeed be beneficial in preventing secondary impairments of SCI if employed before extensive post-injury atrophy occurs.

            • Belanger M, Stein RB, Wheeler GD, Gordon T and Leduc B (2000). Electrical stimulation: can it increase muscle strength and reverse osteopenia in spinal cord injured individuals? Arch Phys Med Rehabil. 81: 1090-8. Departement de Kinanthropologie, Universite du Quebec a Montreal, Canada. OBJECTIVE: To study the extent to which atrophy of muscle and progressive weakening of the long bones after spinal cord injury (SCI) can be reversed by functional electrical stimulation (FES) and resistance training. DESIGN: A within-subject, contralateral limb, and matching design. SETTING: Research laboratories in university settings. PARTICIPANTS: Fourteen patients with SCI (C5 to T5) and 14 control subjects volunteered for this study. INTERVENTIONS: The left quadriceps were stimulated to contract against an isokinetic load (resisted) while the right quadriceps contracted against gravity (unresisted) for 1 hour a day, 5 days a week, for 24 weeks. MAIN OUTCOME MEASURES: Bone mineral density (BMD) of the distal femur, proximal tibia, and mid-tibia obtained by dual energy x-ray absorptiometry, and torque (strength). RESULTS: Initially, the BMD of SCI subjects was lower than that of controls. After training, the distal femur and proximal tibia had recovered nearly 30% of the bone lost, compared with the controls. There was no difference in the mid-tibia or between the sides at any level. There was a large strength gain, with the rate of increase being substantially greater on the resisted side. CONCLUSION: Osteopenia of the distal femur and proximal tibia and the loss of strength of the quadriceps can be partly reversed by regular FES-assisted training.

            • Marqueste T, Hug F, Decherchi P and Jammes Y (2003). Changes in neuromuscular function after training by functional electrical stimulation. Muscle Nerve. 28: 181-8. Institut Federatif de Recherches Jean Roche (IFR 11), Faculte de Medecine Nord, Universite de la Mediterranee (Aix-Marseille II), Boulevard Pierre Dramard, 13916 Marseille, France. We examined whether the neuromuscular function of rectus femoris (RF) and flexor digitorum brevis (FDB) in humans was modified after a 6-week training period of functional electrical stimulation (FES), and whether any effects persisted at the end of a 6-week post-FES recovery period. In both the stimulated and contralateral nonstimulated muscles, we recorded the muscle force, surface electromyogram, and M wave, and also measured the root mean square (RMS) and the median frequency (MF) during static contraction sustained until exhaustion at 60% of maximal voluntary contraction (MVC). FES was performed with symmetric biphasic pulses, with a ramp modulation of both the stimulation frequency and pulse duration. No changes in MCV and endurance time to exhaustion occurred in nonstimulated muscles, whereas a significant MVC increase occurred immediately after FES in RF (+14 +/- 5%) and FDB (+13 +/- 5%), these effects persisting 6 weeks after the end of FES. In FDB, FES also elicited a significant increase in endurance time to exhaustion (+18 +/- 7%). The M-wave characteristics never varied after FES, but a marked attenuation occurred in the MF decrease and the RMS increase measured at endurance time to sustained 60% MVC, especially in FDB, which contains the higher proportion of type II fibers. These data indicate that FES improves muscle function and elicits changes in central muscle activation. The benefits of FES were greater in FDB, which is highly fatigable, and persisted for at least a 6-week period.

            • 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. Functional electrical stimulation (FES) has been used in Brazil since 1989 to obtain functional improvement in paraplegic patients' orthostasis and locomotion. The aim of this paper is to evaluate the histochemical changes observed in the quadriceps femoris muscle following the use of FES. We studied four patients with traumatic spinal cord lesions at T4-10 level, Frankel A, all within 12-24 months postlesion. They were all submitted to FES using the following criteria: square-wave, 20-30 Hz frequency, pulses of 0.003 seconds, time of stimulation 5 seconds, resting interval 10 seconds. The stimulation was applied during 90 consecutive days, 30 minutes each time, twice daily. The interval between the stimulations was 6 hours. Quadriceps muscle biopsies were performed before and after the use of FES. We used ATPase technique for the histochemical analysis, where three different dying patterns can be observed for the three types of muscular fibres (I, IIa and IIb). The two samples from each patient were analysed measuring the fibres' diameters and their index of atrophy, and counting the total number of each type of fibre in each sample. The mean total number of fibres in each sample was 256 +/- 12.3. The results showed that the sizes of the three types of fibres were not modified with the use of FES; the number of type IIa fibres increased in a significant fashion, after using of FES.

            • Crameri RM, Weston A, Climstein M, Davis GM and Sutton JR (2002). Effects of electrical stimulation-induced leg training on skeletal muscle adaptability in spinal cord injury. Scand J Med Sci Sports. 12: 316-22. Sports Medicine Research Unit, Department of Rheumatology, Bispebjerg Hospital, Copenhagen, Denmark. Neuromuscular electrical stimulation has grown in popularity as a therapeutic device for training and an ambulation aid to human paralyzed muscle. Despite its current clinical use, few studies have attempted to concurrently investigate the functional and intramuscular adaptations which occur after electrical stimulation training. Six individuals with a spinal cord injury performed 10 weeks of electrical stimulation leg cycle training (30 min d(-1), 3 d week(-1)). The paralyzed vastus lateralis muscle showed significant alterations in skeletal muscle characteristics after the training, indicated by an improvement in total work output (52-112 kJ; P < 0.05), an increase in fiber cross-sectional area [18 to 41 x 10[2) microm[2); P < 0.05), a reduction in the percentage of type IIX fibers [75% to 12%; P < 0.05), a decrease in myosin heavy chain IIx [68% to 44%; P < 0.05), an increase in capillary density [2-3.5 capillaries around fiber; P < 0.05) and increases in activity levels of citrate synthase [7-16 mU mg[-1) protein) and hexokinase [1.2-2.4 mU mg[-1) protein). This study showed that 10 weeks of electrical stimulation training of human paralyzed muscle induces concurrent improvements in functional capacity and oxidative metabolism.

            • Pette D and Vrbova G (1999). What does chronic electrical stimulation teach us about muscle plasticity? Muscle Nerve. 22: 666-77. Faculty of Biology, University of Konstanz, Germany. The model of chronic low-frequency stimulation for the study of muscle plasticity was developed over 30 years ago. This protocol leads to a transformation of fast, fatigable muscles toward slower, fatigue-resistant ones. It involves qualitative and quantitative changes of all elements of the muscle fiber studied so far. The multitude of stimulation-induced changes makes it possible to establish the full adaptive potential of skeletal muscle. Both functional and structural alterations are caused by orchestrated exchanges of fast protein isoforms with their slow counterparts, as well as by altered levels of expression. This remodeling of the muscle fiber encompasses the major, myofibrillar proteins, membrane-bound and soluble proteins involved in Ca2+ dynamics, and mitochondrial and cytosolic enzymes of energy metabolism. Most transitions occur in a coordinated, time-dependent manner and result from altered gene expression, including transcriptional and posttranscriptional processes. This review summarizes the advantages of chronic low-frequency stimulation for studying activity-induced changes in phenotype, and its potential for investigating regulatory mechanisms of gene expression. The potential clinical relevance or utility of the technique is also considered.

            • Kern H, Hofer C, Modlin M, Forstner C, Raschka-Hogler D, Mayr W and Stohr H (2002). Denervated muscles in humans: limitations and problems of currently used functional electrical stimulation training protocols. Artif Organs. 26: 216-8. Ludwig Boltzmann Institute of Electrostimulation and Physical Rehabilitation, Department of Physical Medicine, Wilhelminenspital, Wien, Austria. helmut.kern@phys.wil.magwien.gv.at. Prior clinical work showed that electrical stimulation therapy with exponential current is able to slow down atrophy and maintain the muscle during nonpermanent flaccid paralysis. However, exponential currents are not sufficient for long-term therapy of denervated degenerated muscles (DDMs). We initiated a European research project investigating the rehabilitation strategies in humans, but also studying the underlying basic scientific knowledge of muscle regeneration from satellite cells or myoblast activity in animal experiments. In our prior study, we were able to show that high-intensity stimulation of DDMs is possible. At the beginning of training, only single muscle twitches can be elicited by biphasic pulses with durations of 120-150 ms. Later, tetanic contraction of the muscle with special stimulation parameters (pulse duration of 30-50 ms, stimulation frequency of 16-25 Hz, pulse amplitudes of up to 250 mA) can improve the structural and metabolic state of the DDMs. Because there are no nerve endings for conduction of stimuli, large-size, anatomically shaped electrodes are used. This ensures an even contraction of the whole muscle. Contrary to the current clinical knowledge, we were able to stimulate and train denervated muscle 15-20 years after denervation. The estimated amount of muscle fibers that have to be restored is about 2-4 million fibers in each m. quadriceps. To rebuild such a large number of muscle fibers takes up to 3-4 years. Despite constant stimulation parameters and training protocols, there is a high variation in the developed contraction force and fatigue resistance of the muscle during the first years of functional electrical stimulation.

            [This message was edited by Wise Young on 03-10-04 at 07:12 AM.]

            Comment


              #21
              Don, thanks for your measured response.


              Sen,
              The section you posted/quoted, only suggests that the potential may be there, using FES, but not currently, given "normal FES machines usually cannot deliver more thant 50-100 millijoules of electrical energy", much less than what Dr. Kern used and that any effects were with "enormous" amounts of energy, which have shown to be dangerous and possibly even harmful, from what was stated.
              Chick, I know. [img]/forum/images/smilies/smile.gif[/img] I posted that in response to Don's statement re FES could not reverse atrophy when in fact it can. Granted, Dr. Kern's work isn't practical or applicable because of the extreme and dangerous levels of current used and the high risk of muscle and tissue damage but nevertheless, he was able to elicit a response from muscles that were previously thought to be unresponsive to FES. Severely atrophied muscles can be restored, the challenge was to find the appropriate level of stimulation which just wasn't achieveable given the limitations of commercially available FES machines. The results of his research challenged the current dogma so for that reason alone, it's important. Whether it leads to advances in the field depends, I suppose, on how relevant it's considered.

              [This message was edited by seneca on 03-10-04 at 12:54 AM.]

              [This message was edited by seneca on 03-10-04 at 12:58 AM.]

              Comment


                #22
                Don Quixote-

                You're tilting at windmills again.

                Since we can't exercise the muscles the way we would prefer, we do it the passive way. It's the only game in town. Even if all we develop is inferior type I muscle tissue it serves to: pad our bony butts,(lowering the risk of pressure sores), fill out our spindly legs, (vanity is not a bad thing), keep our joints from freezing up, give our underworked hearts a challenge,(heart disease rates are high in sci circles), stimulate circulation to the extremities (so our toes don't fall off), makes us tired (so we can sleep), decrease osteoporosis (so our bones don't just melt). I have a feeling you haven't considered all of these horrors or you would know why we try.

                I join the others in wondering what your connection to the sci community might be. One other thing...do you have a better idea?

                C5/6 incomplete, injured Aug. 2000
                Blog:
                Does This Wheelchair Make My Ass Look Fat?

                Comment


                  #23
                  I feel the future in e-stim will be Bions.

                  Comment


                    #24
                    Don Quixote,

                    Dr. Young has many times answered questions that I and others have had on these forums(and I really appreciate that Dr. Young). Many times, the things he is trying to explain are complicated, but he manages to convey issues in a manner in which I can understand.
                    I still am unable to understand why you are so against FES, and you didn't ackowledge my direct question to you to explain whatever it is you are advocating.
                    I did a little research and found some studies in which FES reversed muscle atrophy...here's one:
                    Belanger M, Stein R. B., Wheeler G.D., Gordon T., Leduc B (2000)
                    Electrical Stimulation, can it increase muscle strength and reverse osteopenia in spinal cord injured individuals?
                    Arch. Phys. Med. Rehab. 80, 1090-1098
                    Abstract: OBJECTIVE:
                    To study the extent to which atrophy of muscle and progressive weakening of the long bones after spinal cord injury can be reversed by functional electrical stimulation and resistance training.
                    DESIGN: A with-in subject, contralateral limb and matching design
                    SETTING: Research laboratories in university settings
                    PARTICIPANTS: 14 patients with SCI (C5 to T5) and 14 control subjects volunteered for this study.
                    INTERVENTIONS: The left quadriceps were stimulated to contract against an isokinetic load (resisted) while the right quadriceps contracted against gravity(unresisted) for 1 hour a day, 5 days a week, for 24 weeks.
                    MAIN OUTCOME MEASURES: Bone mineral density (BMD) of SCI subjects was lower than that of controls. After training, the distal femur and proximal tibia had recovered nearly 30% of the bone lost, compared with the controls. There was no difference in the mid-tibia or between the sides at any level. There was a large strength gain, with the rate of increase being substantially greater on the resisted side.
                    CONCLUSION: Osteopenia of the distal femur and proximal tibia and the loss of strength of the quadriceps can be partly reversed by regular FES-assisted Training.
                    .............................................
                    This is only one study. From everything that I've read, and our own personal experience, it appears my husband is doing the right thing. If you disagree, once again I invite you to explain. I also am curious to know if you have a spinal cord injury, or a family member that is injured and how it is you know that what you are recommending is better than FES. Is it from personal experience? What is your expertise? I mean it's obvious you know the terminology of electricity and muscles, but anyone can use big words. As for the website you mentioned...why should I believe that versus everything else that I have read? As I stated to begin with, there are many different views and contradictory issues regarding SCI. What about people that have had a stroke? Forced-use training is done to re-educate the muscles...right? FES is just one means of doing so for people that have a spinal cord injury. Once again, I'm not claiming FES is a cure. I don't claim to have found one.

                    [This message was edited by hope2findacure on 03-10-04 at 09:22 AM.]
                    I forgot to mention, in my reading I came across something that said Type II muscle fibers are the ones that respond to training...I found this on a weight training, body building website. However, a person with big muscles is not necessarily as strong or stronger than a person without big huge muscles. A strong muscle and a big muscle are two different things. Body builders know that size and endurance are two completely different things.

                    [This message was edited by hope2findacure on 03-10-04 at 09:48 AM.]

                    Comment


                      #25
                      Don,

                      When will the "Coming Soon" portion of the website be completed? Also, there is no contact info listed. under most cirucumstances, this would be a red flag for me. I'd think if you wanted to promote this device, for whatever reason it is you do, you would have made info on it easily accessible to those who might show interest via your post here. I also think you would have made yourself easily accessible through that website. Third, any good salesman knows, you do not sell a product by critizing another product, but rather by praising your own. soooo...it light of these things that come to mind as I read your posts, i must say, and no offense intended here, i'm a bit sceptical of your motives and this device. perhaps you should have made your announcement after the website was completed. the air of mystery conveyed here makes me leery. it may not be your intention to be a mystery. i'm not accusing you of anything here, other than a lack of information on something you seem to want to convince us here is useful. So, no harm intended, just expressing my thoughts. I'm interested in such as this, just i've found in life that when someone appears to be hiding something, i.e. identity, contact info, etc., they usually are. not say YOU are TRYING to hide something, just this whole situation makes it APPEAR that you are. Could you explain more, give up more info on who you are and why you want to promote this device? thank you.

                      [This message was edited by Blundy on 03-10-04 at 10:37 AM.]

                      Comment


                        #26
                        I really dont have time to examine all the minutia of Don's theory, so I did my usual skimming over what was presented. One thing caught my eye, Don's statement of the relevence of reflex arcs as quoted here:

                        "Apparently Dr. Young still believes that spasticity is a result of the firing of reflex arcs."

                        I would be curious how Don would explain the following: Last night when I was in the shower, I noticed quite a bit of spasticity in my left leg and hips, where there normally are trace amounts while doing the same activity. I was sitting there watching what was going on kind of puzzled why this was happening. Maybe I was sitting too long? A pressure releaf didnt fix that. After about 3 minutes of this, I finally noticed that hot water leaking from the hot water faucet was pouring out onto my big toe on my left leg. After I moved my foot, the spasticity stopped. I would be curious how this would be explained if there was no validity to the currently believed function of a neuromuscular reflex arc.

                        Comment


                          #27
                          Andy, I said that there is no way an alleged 'reflex arc,' that is, an afferent impulse arcing in the cord to become an efferent to make the muscle twitch, could act upon a severely atrophic muscle, and that therefore the spasticity of the handicapped is due to blood chemistry or LOCAL CONDITIONS. You specified what those local conditions were, hot water on your toes. Consider the likening of the cathode to ice, and the anode to fire. The anode triggers far stronger contractions in the muscle then the cathode because the anode is what is called cholinergic, that is, it works in conjunction with the neurotransmitter acetylcholine, while the cathode is termed adrenergic since it triggers the secretion of adrenalin and noradrenalin. Consider, you touch something very hot and your arm jerks back quite quickly, yet when you touch something extremely cold and just as damaging to tissue, your response is much slower. Now eliminate the neural inputs from the brain. Your body or limb will still respond DIRECTLY to the hot, harmful stimulus far more violently then it will if you put your leg in ice water or liquid nitrogen. Reflex arcs were the invention of Sir Charles Sherrington who codified them in a publication called Reflex Activity of the Spinal Cord in 1906. Like the Bell-Magendie Law, the one which states that the dorsal horn cells of the spinal cord are for sensation while the ventral horn cells are for motor activity, the idea that there are such things as reflex arcs has been passed down as knowledge in neurology circles not because it is true but because of the socio-political traditions of that field. The Bell-Magendie law was based on the vivisection of dogs done in the 1820s and 1830s. It has been upheld as doctrine, like reflex arcs, not because of any clinical value it might have, for it has none. It is not coincidence that the clinical poverty of neuroscience is co-extensive with the institutionalization of these alleged facts. In 1983 Sir Peter Medawar, Nobel laureate in medicine for his work in immunology, and philosopher and historian of science, noted in his essay "Osler's Razor," that neurology was into its second century of clinical inconsequence, and historically focused on diagnosis, never treatment. The Razor part was an allusion to William of Occam, known for Occam's Razor, which said that explanation was preferred which depended upon the fewest assumptions. The Osler part was for William Osler, the founder of 'scientific medicine' at Johns-Hopkins at the end of the 19th century who introduced the Hippocratic Oath to medicine. The oath was to discourage doctors from causing more harm in their attempts to minister to the injured and diseased. Osler became the founder of what became known as the 'school of therapeutic nihilism', called that because there was nothing that the new scientific medicine could do for treatment except set bones and excise tumors.

                          Blundy, I am not trying to sell a product. I am trying to sell an idea. I wish I could say when the coming soon portions of the website will be finished. I am having the outlawed machines manufactured overseas, and will have them available at cost plus shipping and handling when I receive them in 3 or four months. I wanted to wait until then before I started attracting attention to the site so that I could equip those who were interested. For years the dissemination of this information and the practice of what I call 'galvanic revivification' was impeded by the lack of equipment so that others could try it. I have hired engineers to come up with the plans and drawings needed by a manufacturer. Until now I have worked with machines I have made myself but which I had not desire to create one-at-a-time to meet the meager demand. Since I have already gotten one person out of a wheelchair and he has gotten others interested, I decided it was time to throw what little money I have into the pot. What awaits on the web page is complete instructions on how to use the machine safely since the untrained can cause minor damage to the skin. I hope to have a tutorial on the role of electrochemistry from the origins of life to the present also on the web, and it may be there by late next week. This tutorial alone, without the text you will find in the Academic's Corner, will make it clear why direct current stimulation has the affects it does since it will make clear the nature of bioenergetics and the pressures which acted upon living organisms to develop what is called gastrulation (digestion) to capture energy. As for who I am and my qualifications, see the essay on the website that deals with the development of the theory of 'galvanic revivification.'

                          Hoe2findacure, thank you for the study citation. Look closely at it. It is done by doctors of physical medicine who talk about stimulation of muscle to contraction using FES. There were no biopsies done to measure the increase of cross-sectional are of the type II muscle fiber. In the conclusion it is stated that 'loss of strength of the quadricep can be partly reversed by regular FES-assisted Training', yet nothing is said about how the strength of a paralyzed limb is measured. Instead we are told about how osteopenia, the loss of bone mass, is affected in the lower leg. The study is sloppily done, so sloppily that it is worthless. Its conclusions might warm the heart of a salesman of FES equipment, but whatever minimal affects it may have had could easily be attributed, as with your husband, to the effort he made, not to the equipment. Note that the manufacturers of FES equipment do not tout it for restoring bone density, and, once again, the experiments were done on the handicapped, not the healthy. If the equipment did what its researchers claim, then NASA would be first in line to use it since osteopenia is, like disuse atrophy, a really big problem for the astronaut even if he exercises. The handicapped are being used as test animals, and the results are nowhere near what one should see if, as Dr. Kern suggests in the posting by Seneca yesterday, direct current were used to restore the type II muscle fiber.
                          As for my background experience, read the essay cited to Blundy above on the discovery of galvanic revivification. With regard to stroke, there is absolutely no excuse for its resulting in motor impairment except that the neurologists, not having a clue about the electrochemical nature of the nervous system, can do nothing to maintain muscles during the acute phase, and dismiss all resulting motor impairment as a symptom of enduring brain damage when the actual problem is disuse atrophy which advances during the acute phase.
                          Your observations on muscle size and strength are perceptive. Yes, the type II fibers respond to training, and it is their response that should be measured by biopsies, not bogus definitions of 'strength' as observed by an optimistic doctor of physical medicine. When a muscle atrophies it first becomes larger, puffier, then it sags, and takes on a wasted look. A healthy muscle is a dense muscle, one that will sink in water rather than float. I've seen lots of people with big, weak muscles who floated easily, and I've seen people with small, powerful muscles who would struggle to stay afloat.

                          Seneca, I was amused by the claims of whoever's post you edited that spoke of Dr. Kern's 'extreme and dangerous levels of current.' These extreme and dangerous levels were discussed by Dr. Young and some of his colleagues after the reported conversation, and it would have been a riot to have been a fly on the wall during these discussions. What was so charming was these experts, whose opinions and council are sought by people like yourself, demonstrated stunning ignorance as to how electrical energy is measured. I discussed this yesterday. Until they familarize themselves with the language and physics of electricity and electromagnetism, I suggest you relegate their advice about the wonders of FES and the dangers of galvanic current to the trash. Keep in mind that charlatanry is defined as the making of money on claims to knowledge that are not true, whether or not the charlatan knows this.

                          Dr. Young, I have been waiting to hear from you again. Let's look at the studies you cite to support the idea that electrical stimulation can increase the cross-sectional area of the type II muscle fiber without passing current, without protein synthesis in the muscle, without affecting biochemistry, something only possible when current is passed. First we'll consider Baldi et al. Oh!? I don't see the results of any biopsies on the type II muscle fiber! But I do see that FES-isometric contractions did not prevent atrophy. Again, no biopsies. How was hypertrophy and atrophy measured? By a tape measure? By water displacement? Did the muscles become usable? I'm sorry. This study doesn't cut it. It or studies like it have been done in the past, with the same conclusion. This study will be done again and again and again and again, always without consequence. This is the story of neuroscience. Let's look at the other study.
                          You precede it with the fatuous argument about efficiency and effectiveness of voluntary exercises over electrical stimulation. How are these terms defined? What does it mean to be a more efficient or more effective exercise? We're talking science here, not sanctimony and the appeal to authority. Marqueste et al. recorded muscle force? No biopsies? "...they found that FES improved muscle function and activation." As indicated by what parameters? Did the muscle become usable? This study is also useless.
                          "I agree that surface FES stimulation with commercial devices does not increase type II fiber diameters." That's all you have to say. The discrimination between fast and slow twitch fibers serves only to obscure some important things. I ask you now, are slow twitch fibers those of smooth muscle or striated muscle? The fast and slow twitch thing makes no sense to me. What is the twitch? You even say, "On the other hand, there may be some benefits to transforming fast fatigable muscles towards slower, fatigue-resistant ones (Pette & Vrbova, 1999)." Do you mean to say that these fibers can be transformed from fast to slow twitch? What is this twitch thing? Smooth muscle is known to have electrical synapses which maintain cytoplasmic continuity between all of the muscle cells at which the electrical synapses form gap junctions. I insist this same arrangement is true of striated muscle, and that the type II fibers, both a and b, are what make up this system of electrical synapses. The type II fiber doesn't twitch, but conducts the nerve impulse, once it crosses the synapse via a dumping of acetylcholine, out to the individual muscle cells that do the actual contracting. It is this system of electrical synapses which amplify the power of the nerve impulse according to the equations of electricity governing resistance, conductor cross sectional area, and the definition of electrical power (P=IW). But these same equations are not available to the neuroscientists who see ion flow as I in V=IR rather than R, as a physicist would. But you would know nothing of this. It isn't taught in medical school. The orthodox treatment of muscles and fiber types has been around for a long time, and is highly respected amongst muscle physiologists. It does absolutely nothing for patients, being instead like the Bell-Magendie Law or the theory of reflex arcs.
                          At last, something to fasten onto, your discussion of Kern and electricity. Current strengths needed to restore muscle by electric charge passed transcutaneously do not need to be any greater than 30 mamp. Depth of penetration is controlled by voltage, which never has to exceed 90 volts DC. This is not great, it is not dangerous, it is not permitted by the FDA. You must discriminate between atrophy and denervation.. Finally, pulses introduced in this manner are superior in efficiency and speed to any form of resistance exercise, being able to overload a muscle and trigger growth in one second at 900 Hz if delivered to the neuromuscular junction.
                          In the Greve study we see, "The two samples from each patient were analysed measuring the fibres' diameters and their index of atrophy, and counting the total number of each type of fibre in each sample. The mean total number of fibres in each sample was 256 +/- 12.3. The results showed that the sizes of the three types of fibres were not modified with the use of FES.
                          The restoration of muscle atrophic and paralyzed for a year takes around three years to restore to a functional level, exercising every other day. Let's look at the Crameri study, done in Denmark. ."Six individuals with a spinal cord injury performed 10 weeks of electrical stimulation leg cycle training>" Ten weeks! That's not enough time if these people have been hurt for over 3 weeks to restore muscle function lost to disuse. What did they find out? "The paralyzed vastus lateralis muscle showed significant alterations in skeletal muscle characteristics after the training, indicated by an improvement in total work output (52-112 kJ; P &lt; 0.05), an increase in fiber cross-sectional area [18 to 41 x 10[2)..." Work output? These muscles were usable after ten weeks? I don't think so. The increase in cross-sectional area of fibers is interesting, but the authors say nothing about the type of current used, or what fibers increased in cross-sectional area. They do say, "This study showed that 10 weeks of electrical stimulation training of human paralyzed muscle induces concurrent improvements in functional capacity and oxidative metabolism." Functional capacity? After ten weeks? Again, I don't think so. I can believe improved oxidative metabolism, however.
                          The Kern study is revealing. He worked on denervated, flaccid muscles, however. However, he uses biphasic pulses, not monophasic, so he wasn't using electrochemistry even if the current strength was 250 mamp. Biphasic means he switched the poles back and forth with each pulse. Furthermore, ". Because there are no nerve endings for conduction of stimuli [the muscles were denervated], large-size, anatomically shaped electrodes are used. This ensures an even contraction of the whole muscle". And this is not how the body works. This study did not involved the simulation of nervous system trophism, and so is irrelevant to what we are talking about here. You're just throwing crap at me now rather than trying to understand the issues.

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                            #28
                            thank you for answering my questions Don

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                              #29
                              I guess I dont get a reply

                              T-10 complete
                              10/08/01


                              T-10 complete
                              10/08/01
                              "Life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well-preserved body, but rather to skid in sideways, chocolate in one hand, martini in the other, body thoroughly used up, totally worn out and screaming 'WOO HOO' what a ride!"

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                                #30
                                Don, where is your data? Wise.

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