Method and apparatus for applying neuromuscular electrical stimulation

• US 9,352,151 B2
• Filed: 12/30/2013
• Issued: 05/31/2016
• 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): FAIRCHILD, MALLIKA DIPAYAN
• Application Number:
  US14/144,256
• Publication Number:
  US 20140188013A1
• Time in Patent Office: 883 Days
• US Class Current: 1/1
• 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 device for applying neuromuscular electrical stimulation to an agonist/antagonist muscle pair to move a limb about a joint, said device comprising a main stimulator 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 current amplitude level for a period sufficient to initiate contraction of the agonist muscle,

(ii) 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, the second current amplitude level period consecutive to the first current amplitude 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 third current amplitude level for a period sufficient to reduce acceleration of the limb,

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

wherein each burst period of the plurality of burst periods represents a predetermined period of time during which electrical stimulation is applied to the agonist/antagonist muscle pair.

2. The device of claim 1, wherein each burst period of the plurality of burst periods is followed by a predetermined rest period during which electrical stimulation is not applied to the agonist/antagonist muscle pair.

3. The device of claim 1, wherein each burst period of the plurality of burst periods further 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 a beginning of the first burst period and ends no later than an end of the first burst period.

4. The device of claim 1, wherein the second current amplitude level is 75-90% of the first current amplitude level, and wherein the fourth current amplitude level is 10-30% of the third current amplitude level.

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

6. The device 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 a range of 20-400 μ

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

sec.

7. The device of claim 1, wherein the first pattern of electrical stimulation pulses comprises a series of pulses generated at a frequency that is within a range of 20-80 Hz, and wherein the second pattern of electrical stimulation pulses comprises a series of pulses generated at a frequency that is within a range of 20-80 Hz.

8. The device of claim 1, wherein the electrical stimulation pulses in the first pattern of electrical stimulation pulses are generated at current amplitudes within a range of 10-150 mA, and wherein the electrical stimulation pulses in the second pattern of electrical stimulation pulses are generated at current amplitudes within a range of 10-150 mA.

9. The device of claim 1 wherein the first pattern of electrical stimulation pulses comprises a waveform selected from a group consisting of symmetrical biphasic, asymmetrical biphasic, high volt and premodulated, and wherein the second pattern of electrical stimulation pulses comprises a waveform selected from a group consisting of symmetrical biphasic, asymmetrical biphasic, high volt and premodulated.

10. The device of claim 1 wherein each burst period of the plurality of burst periods has a duration between 200 and 5000 msec.

11. The device 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 of a duration of the immediately preceding burst period.

12. A system for applying neuromuscular electrical stimulation to an agonist/antagonist muscle pair to move a limb about a joint,

wherein the system includes a main stimulator controller and a stimulation module comprising a pulse pattern generating circuitry in communication with the main stimulator controller,

wherein the stimulation module comprises patterns of electrical stimulation pulses, and 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 current amplitude level for a period sufficient to initiate contraction of the agonist muscle,

(ii) 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, the second current amplitude level period consecutive to the first current amplitude 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 third current amplitude level for a period sufficient to reduce acceleration of the limb,

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

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.

13. The system of claim 12, wherein each burst period of the plurality of burst periods further 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 a beginning of the first burst period and ends no later than an end of the first burst period.

14. The system of claim 12, wherein each rest period has a duration at least 2-5 times of a duration of the immediately preceding burst period.

15. The device of claim 12, wherein the second current amplitude level is 75-90% of the first current amplitude level, and wherein the fourth current amplitude level is 10-30% of the third current amplitude level.

16. The device of claim 12, 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 wherein the period of the fourth current amplitude level is 5-15 times greater than the period of the third current amplitude level.

17. The device of claim 12, wherein the first pattern of electrical stimulation pulses comprises a series of pulses, each of which has a pulse duration that is within a range of 20-400 μ

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

sec.

18. The device of claim 12, wherein the first pattern of electrical stimulation pulses comprises a series of pulses generated at a frequency that is within a range of 20-80 Hz, and wherein the second pattern of electrical stimulation pulses comprises a series of pulses generated at a frequency that is within a range of 20-80 Hz.

19. The device of claim 12, wherein the electrical stimulation pulses in the first pattern of electrical stimulation pulses are generated at current amplitudes within a range of 10-150 mA, and wherein the electrical stimulation pulses in the second pattern of electrical stimulation pulses are generated at current amplitudes within a range of 10-150 mA.

20. The device of claim 12 wherein the first pattern of electrical stimulation pulses comprises a waveform selected from a group consisting of symmetrical biphasic, asymmetrical biphasic, high volt and premodulated, and wherein the second pattern of electrical stimulation pulses comprises a waveform selected from a group consisting of symmetrical biphasic, asymmetrical biphasic, high volt and premodulated.

21. The device of claim 12 wherein each burst period of the plurality of burst periods has a duration between 200 and 5000 msec.