Effects of Intermittent Electrical Stimulation on superficial pressure, tissue oxygenation, and discomfort levels for the prevention of Deep Tissue Injury

Effects of Intermittent Electrical Stimulation on superficial pressure, tissue oxygenation, and discomfort levels for the prevention of Deep Tissue Injury

Solis et al, 2010 [n=12; Male and female; from 20 to 42 years old] aimed to develop effective methods for the prevention of DTI in adult able-bodied volunteers. Each test trial consisted of applying one IES protocol, a voluntary contraction, or a chair push-up, and each trial was replicated three times. The natural bodyweight (BW) condition was tested by asking the volunteers to sit upright on an office chair. The increased loading condition (BW + 30%) was implemented by asking the volunteers to wear a weighted vest. The application of IES was performed through rectangular (50 × 100 mm) selfadhesive electrodes (Pure Care, Sherwood Park, Alberta, Canada) placed bilaterally on the surface of the skin, over the motor points of the gluteus maximus muscles. A commercially available stimulator (BioStim NMS+, BioMedical Life Systems, California, USA) was used. Stimulation pulses were square, biphasic, and charge balanced. Stimulation frequency and pulse width were held constant at 40 Hz and 250 μs, respectively. Pulse amplitude was set to the level required to elicit a strong fused contraction in each volunteer. The required stimulator intensity level ranged from levels 3–8 (out of 10 levels) depending on the volunteer. The four IES protocols tested were: (1) Bilateral continuous: This consisted of a 10 s bout of stimulation (“ON” phase) applied to both the left and right gluteus maximus muscles. The “ON” phase was followed by a 7 min no stimulation period (“OFF” phase). (2) Bilateral bursting: In this protocol, the “ON” phase was composed of three short bouts (3 s) of stimulation applied simultaneously to both the left and right gluteus muscles, with two short periods (2 s) of rest between each bout to elicit three bilateral short contractions in near succession. This “ON” phase was followed by a 7 min “OFF” phase. (3) Alternating continuous and (4) Alternating bursting: These were like the bilateral continuous and bilateral bursting protocols, respectively, with the exception that the “ON” phase of IES was first applied to one side of the buttocks, followed by the other. This generated contractions in one side followed immediately by contractions in the other. The author’s concluded that IES significantly reduced pressure around the tuberosities, produced significant and long-lasting elevations in tissue oxygenation, and significantly reduced discomfort produced by prolonged sitting. IES performed as well or better than both voluntary contractions and chair push-ups. The results suggest that IES may be an effective means for the prevention of DTI.
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  • Solis LR, Gyawali S, Seres P, Curtis C, Chong SL, Thompson RB, et al. Effects of Intermittent Electrical Stimulation on superficial pressure, tissue oxygenation, and discomfort levels for the prevention of Deep Tissue Injury.

    Ann Biomed Eng. 2011;

    39:649–663. Available at: https://doi.org/10.1007/s10439-010-0193-1