Method and apparatus for applying neuromuscular electrical stimulation

• US 8,620,438 B1
• Filed: 02/13/2007
• Issued: 12/31/2013
• Est. Priority Date: 02/13/2007
• Status: Active Grant

• Current Assignee: DJO LLC (Enovis Corp.)
• Original Assignee: Encore Medical Asset Corporation (Enovis Corp.)
• Inventors: Wijting, Yorick, Pohl, Jeffrey K.
• Primary Examiner(s): Patel, Niketa
• Assistant Examiner(s): FAIRCHILD, MALLIKA DIPAYAN
• Application Number:
  US11/706,455
• Time in Patent Office: 2,513 Days
• Field of Search: 607/48, 607/49
• US Class Current: 607/48
• CPC Class Codes: A61N 1/0452 Specially adapted for transcutaneous muscle stimulation [TMS]
• CPC Class Codes: A61N 1/36003 of motor muscles, e.g. for walking assistance
• CPC Class Codes: A61N 1/36034 specified by the stimulation parameters
• CPC Class Codes: A61N 2007/0026 Stimulation of nerve tissue
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092

Abstract

A method and apparatus for applying neuromuscular electrical stimulation to an agonist/antagonist muscle pair to move a limb about a joint includes generating a first pattern of neuromuscular electrical stimulation pulses for output through a first channel to a first pair of electrodes and generating a second pattern of neuromuscular stimulation pulses for output through a second channel to a second pair of electrodes. The first pair of electrodes are attached to the agonist muscle of the agonist/antagonist muscle pair, and the second pair of electrodes are attached to the antagonist muscle. A first pattern of electrical stimulation pulses is transmitted through the first pair of electrodes to the agonist muscle at a first intensity level to initiate contraction of the agonist muscle, and then at a second intensity level which is less than the first intensity level to continue contraction of the agonist muscle. A second pattern of electrical stimulation pulses is transmitted through the second pair of electrodes to the antagonist muscle at a first intensity level to reduce the acceleration of the limb, and then at a second intensity level which is less than the first intensity level to regulate the movement of the limb.

Claims

1. A method for applying neuromuscular electrical stimulation to an agonist/antagonist muscle pair to move a limb about a joint, which method comprises:

providing a device for generating a first pattern of neuromuscular electrical stimulation pulses for output through a first channel to a first pair of electrodes attached to an agonist muscle of an agonist/antagonist muscle pair and a second pattern of neuromuscular stimulation pulses, different from the first pattern, for output through a second channel to a second pair of electrodes attached to an antagonist muscle of the agonist/antagonist muscle pair;

automatically generating, for each burst period of a plurality of burst periods, the first pattern of electrical stimulation pulses for transmission through the first pair of electrodes to the agonist muscle;

(i) at a constant first current amplitude level for a period sufficient to initiate contraction of the agonist muscle;

(ii) consecutive to the period of the first current amplitude level, at a constant second current amplitude level less than the first current amplitude level for a period sufficient to continue contraction of the agonist muscle;

automatically generating, for each burst period of the plurality of burst periods, the second pattern of electrical stimulation pulses for transmission through the second pair of electrodes to the antagonist muscle;

(i) at a constant third current amplitude level for a period sufficient to reduce the acceleration of the limb;

(ii) consecutive to the period of the third current amplitude level, at a constant fourth current amplitude level less than the third current amplitude level for a period sufficient to regulate the movement of the limb;

wherein each burst period of the plurality of burst periods;

(i) represents a predetermined period of time during which electrical stimulation is applied to the agonist/antagonist muscle pair, and

(ii) is followed by a predetermined rest period during which electrical stimulation is not applied to the agonist/antagonist muscle pair.

2. The method of claim 1 wherein:

the second current amplitude level is 75-90% of the first current amplitude level; and

the fourth current amplitude level is 10-30% of the third current amplitude level.

3. The method of claim 1 wherein:

the period of the second current amplitude level is at least three times greater than the period of the first current amplitude level; and

the period of the fourth current amplitude level is 5-15 times greater than the period of the third current amplitude level.

4. The method of claim 1 wherein:

the first pattern of electrical stimulation pulses comprises a series of pulses, each of which has a pulse duration that is within the range of 20-400 μ

sec; and

the second pattern of electrical stimulation pulses comprises a series of pulses, each of which has a pulse duration that is within the range of 20-400 μ

sec.

5. The method of claim 1 wherein:

the first pattern of electrical stimulation pulses comprises a series of pulses generated at a frequency that is within the range of 20-80 Hz; and

the second pattern of electrical stimulation pulses comprises a series of pulses generated at a frequency that is within the range of 20-80 Hz.

6. The method of claim 1 wherein:

the electrical stimulation pulses in the first pattern of electrical stimulation pulses are generated at current amplitudes within the range of 10-150 mA; and

the electrical stimulation pulses in the second pattern of electrical stimulation pulses are generated at current amplitudes within the range of 10-150 mA.

7. The method of claim 1 wherein:

the first pattern of electrical stimulation pulses comprises a waveform selected from the group consisting of symmetrical biphasic, asymmetrical biphasic, high volt and premodulated; and

the second pattern of electrical stimulation pulses comprises a waveform selected from the group consisting of symmetrical biphasic, asymmetrical biphasic, high volt and premodulated.

8. The method of claim 1 wherein each burst period of the plurality of burst periods has a duration within the range of 200-5000 msec.

9. The method of claim 1 wherein each burst period is followed by a predetermined rest period during which electrical stimulation is not applied to the agonist/antagonist muscle pair, and each rest period has a duration at least 2-5 times the duration of the immediately preceding burst period.

10. A method for applying neuromuscular electrical stimulation to an agonist/antagonist muscle pair to move a limb about a joint, which method comprises:

providing a device for generating a first pattern of neuromuscular electrical stimulation pulses for output through a first channel to a first pair of electrodes attached to an agonist muscle of an agonist/antagonist muscle pair and a second pattern of neuromuscular stimulation pulses, different from the first pattern, for output through a second channel to a second pair of electrodes attached to an antagonist muscle of the agonist/antagonist muscle pair;

automatically generating, for each burst period of a plurality of burst periods, a first pattern of electrical stimulation pulses for transmission through the first pair of electrodes to the agonist muscle;

(i) at a constant first intensity level for a period sufficient to initiate contraction of the agonist muscle;

(ii) consecutive to the period of the first intensity level, at a constant second intensity level, less than the first intensity level, for a period sufficient to continue contraction of the agonist muscle, the second intensity level period consecutive to the first intensity level period;

(iii) consecutive to the period of the second intensity level, at a constant third intensity level, greater than the second intensity level, for a period sufficient to complete contraction of the agonist muscle, the third intensity level period consecutive to the second intensity level period;

automatically generating, for each burst period of the plurality of burst periods, a second pattern of electrical stimulation pulses for transmission through the second pair of electrodes to the antagonist muscle;

(i) at a constant fourth intensity level for a period sufficient to reduce the acceleration of the limb;

(ii) consecutive to the period of the fourth intensity level, at a constant fifth intensity level, less than the fourth intensity level, for a period sufficient to regulate the movement of the limb, the fifth intensity level period consecutive to the fourth intensity level period;

(iii) consecutive to the period of the fifth intensity level, at a constant sixth intensity level, greater than the fifth intensity level for a period sufficient to stop the movement of the limb, the sixth intensity level period consecutive to the fifth intensity level period;

wherein each burst period of the plurality of burst periods;

(i) represents a predetermined period of time during which electrical stimulation is applied to the agonist/antagonist muscle pair; and

(ii) includes generating the first pattern of electrical stimulation pulses during a first burst period and generating the second pattern of electrical stimulation pulses during a second burst period that begins after the beginning of the first burst period and ends no later than the end of the first burst period.

11. The method of claim 10 wherein the second burst period ends at the same time that the first burst period ends.

12. The method of claim 10 wherein:

the second intensity level is 75-90% of the first intensity level;

the third intensity level is approximately equal to the first intensity level;

the fifth intensity level is 10-30% of the fourth intensity level; and

the sixth intensity level is approximately equal to the fourth intensity level.

13. The method of claim 10 wherein:

the period of the second intensity level of the first pattern of electrical stimulation pulses is at least three times greater than the period of the first intensity level of the first pattern of electrical stimulation pulses;

the period of the third intensity level of the first pattern of electrical stimulation pulses is not greater than the period of the first intensity level of the first pattern of electrical stimulation pulses; and

the period of the fifth intensity level of the second pattern of electrical stimulation pulses is 5-15 times greater than the period of the fourth intensity level of the second pattern of electrical stimulation pulses; and

the period of the sixth intensity level of the second pattern of electrical stimulation pulses is not more than three times greater than the period of the fourth intensity level of the second pattern of electrical stimulation pulses.

14. The method of claim 10 wherein:

the second intensity level of the first pattern of electrical stimulation pulses includes a first phase

which has an intensity level about 85% of the first intensity level for a period that is no shorter than the period of the first intensity level, and a second phase which has an intensity level about 80% of the first intensity level for a period sufficient to continue contraction of the agonist muscle.

15. A device for applying neuromuscular electrical stimulation to an agonist/antagonist muscle pair to move a limb about a joint, said device comprising a main simulator controller and a pulse pattern generating circuitry in communication with the main stimulator controller, wherein the main stimulator controller is configured to control said pulse pattern generating circuitry to:

automatically generate, for each burst period of a plurality of burst periods, a first pattern of electrical stimulation pulses for transmission through a first pair of electrodes to the agonist muscle;

(i) at a constant first intensity level for a period sufficient to initiate contraction of the agonist muscle;

(ii) at a constant second intensity level, less than the first intensity level, for a period sufficient to continue contraction of the agonist muscle, the second intensity level period consecutive to the first intensity level period;

(iii) at a constant third intensity level, greater than the second intensity level, for a period sufficient to complete contraction of the agonist muscle, the third intensity level period consecutive to the second intensity level period;

automatically generate, for each burst period of the plurality of burst periods, a second pattern of electrical stimulation pulses, different from the first pattern, for transmission through the second pair of electrodes to the antagonist muscle;

(i) at a constant fourth intensity level for a period sufficient to reduce the acceleration of the limb;

(ii) at a constant fifth intensity level, less than the fourth intensity level, for a period sufficient to regulate the movement of the limb, the fifth intensity level period consecutive to the fourth intensity level period;

(iii) at a constant sixth intensity level, greater than the fifth intensity level, for a period sufficient to stop the movement of the limb, the sixth intensity level period consecutive to the fifth intensity level period;

wherein each burst period of the plurality of burst periods;

(i) represents a predetermined period of time during which electrical stimulation is applied to the agonist/antagonist muscle pair, and

(ii) includes generating the first pattern of electrical stimulation pulses during a first burst period and generating the second pattern of electrical stimulation pulses during a second burst period that begins after the beginning of the first burst period and ends no later than the end of the first burst period.

16. The device of claim 15 wherein:

the second intensity level is 75-90% of the first intensity level; and

the fifth intensity level is 10-30% of the fourth intensity level.

17. The device of claim 15 wherein:

the period of the second intensity level is at least three times greater than the period of the first intensity level; and

the period of the fifth intensity level is 5-15 times greater than the period of the fourth intensity level.

18. The device of claim 15 wherein:

the first pattern of electrical stimulation pulses comprises a series of pulses, each of which has a pulse duration within the range of 20-400 μ

sec; and

the second pattern of electrical stimulation pulses comprises a series of pulses, each of which has a pulse duration within the range of 20-400 μ

sec.

19. The device of claim 15 wherein:

the a first pattern of electrical stimulation pulses comprises a series of pulses generated at a frequency within the range of 20-80 Hz; and

the second pattern of electrical stimulation pulses comprises a series of pulses generated at a frequency within the range of 20-80 Hz.

20. The device of claim 15 wherein:

the electrical stimulation pulses in the first pattern are generated at current amplitudes within the range of 10-150 mA; and

the electrical stimulation pulses in the second pattern are generated at current amplitudes within the range of 10-150 mA.

21. The device of claim 15 wherein:

the first pattern of electrical stimulation pulses comprises a waveform selected from the group consisting of symmetrical biphasic, asymmetrical biphasic, high volt and premodulated; and

the second pattern of electrical stimulation pulses comprises a waveform selected from the group consisting of symmetrical biphasic, asymmetrical biphasic, high volt and premodulated.

22. The device of claim 15 wherein:

the second pattern of electrical stimulation pulses is generated during a second burst period that begins after the beginning of the first burst period and ends at the same time that the first burst period ends.

23. The device of claim 15 wherein:

the second intensity level is 75-90% of the first intensity level;

the third intensity level is approximately equal to the first intensity level;

the fifth intensity level is 10-30% of the fourth intensity level; and

the sixth intensity level is approximately equal to the fourth intensity level.

24. The device of claim 15 wherein:

the period of the second intensity level is at least three times greater than the period of the first intensity level;

the period of the third intensity level is not greater than the period of the first intensity level;

the period of the fifth intensity level is 5-15 times greater than the period of the fourth intensity level; and

the period of the sixth intensity level is not more than three times greater than the period of the fourth intensity level.

25. The device of claim 15 wherein each burst period of the plurality of burst periods has a duration within the range of 200-5000 msec.

26. The device of claim 15 wherein each burst period is followed by a predetermined rest period during which electrical stimulation is not applied to the agonist/antagonist muscle pair, and each rest period has a duration at least 2-5 times the duration of the immediately preceding burst period.