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Chattanooga Physio Manual

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REHAB/THETA/PHYSIO EN
16. HOW TO USE THE REHAB/THETA/PHYSIO ON SPECIFIC
INDICATIONS
... Results
By gradually increasing the current, an incomplete dorsal flexing movement of the ankle is seen as well as
a hint of an eversion movement of the foot.
CONCLUSION
Our patient has paresis of the lateral popliteal nerve with partial denervation of the muscles of the antero-
external part of the leg; there is hope of reinnervation for the denervated fibres.
PRACTICAL THERAPEUTIC APPROACH
With a denervated muscle, several therapeutic choices are available to the rehabilitating physiotherapist.
See Choice of pulse shape and parameters (Denervated muscles – Theory).
Depending on the clinical circumstances and the school we subscribe to, we can work on the innervated
part of the muscle using the short duration rectangular biphasic pulses supplied by the Neurostimulation
programmes.
However, it seems necessary to try to prevent atrophy and limit the phenomenon of sclerosis of
denervated fibres. To do this, use the sloped pulses of the Partial automatic or Partial manual programmes.
... Protocol
Partial automatic or Partial manual.
Unless the exact stimulation parameters are known (for that one would have to have the precise results of
a recent electromyograph), it is recommended that the Partial automatic programme be used (Physio will
work with default figures).
... Choice and position of the electrodes
Self-adhesive electrodes are not very suitable for the stimulation of denervated muscles. It is preferable to
use soft carbon electrodes, the sizes of which should be chosen so that the electrodes cover all the fibres
of the muscle you need to stimulate.
In the Denervated programme, we work in bipolar mode, i.e. the positive and negative poles are
immaterial.
After being coated with gel, the two electrodes will be positioned crosswise on the fleshy part of the
muscle (therefore avoiding the tendinous parts); their size will previously have been determined so that
they cover the muscle fibres as much as possible. They must therefore cover the full width of the muscle.
… 279


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