Macrocurrent
and Microcurrent Electrostimulation in Sport
Mel C Siff PhD
(Note: This article drew extensively on material from the textbook,
Siff MC & Verkhoshansky YV Supertraining 1999. Anyone
requiring further information on this topic should consult Chapter 4 of this
book.)
The use of electric current on the human body
largely has been restricted to use by physiotherapists to facilitate the healing
of musculoskeletal injuries and
control pain. It is fairly
arbitrarily applied in two broad categories:
Macrocurrent Stimulation (currents
over about 1 milliamp)
Microcurrent Stimulation (currents
below about 1 milliamp)
The former usually refers to Faradic,
Interferential, Galvanic and TENS (Transcutaneous Electrical Nerve Stimulation)
devices, whereas the latter refers to specialised microcurrent devices
for application either to the musculoskeletal system or as a non-invasive form
of electroacupuncture via the acupuncture points of the body or the auricular
points of the ears. The differences
between these applications will be discussed later in this article.
The concept of electrostimulation for physical
conditioning is not new, and for years has been used by physical therapists in
clinical applications such as muscle rehabilitation, relief of muscular spasm,
reduction of swelling and pain control. Its possible value in sports training is
still considered controversial. In
strength conditioning, the potential applications of electrostimulation fall
into the following broad categories:
Imposition of local physical stress to stimulate supercompensation
Local restoration after exercise or injury
General central nervous and endocrine restoration after exercise or
injury
Neuromuscular stimulation for pain control or movement patterning
Electrostimulation usually involves feeding the
muscles low current electrical impulses via moistened electrode pads placed
firmly on the skin. The effectiveness, comfort and depth of excitation depends
on factors such as pulse shape, frequency, duration, intensity and modulation
pattern. The resulting number of possible stimulation combinations immediately
emphasizes how difficult it is to determine the optimum balance of variables
and compare the results of different researchers.
The typical clinical machine supplies pulsating
direct (galvanic) and/or alternating (faradic) current in the form of brief
pulses. The frequency of faradic current is most commonly chosen in the range of
about 50-100 Hz, while pulse duration (width) ranges from about 100 microseconds
to several hundred milliseconds. This brevity of pulse duration is important for
minimising skin irritation and tissue damage. However, the duration at any
particular intensity of faradic stimulation should not be too brief.
Although they may be suitable for decreasing pain, pulses that are too
brief will supply insufficient energy to cause full, tetanic muscle contraction.
Machines are designed to apply alternating currents
directly at a preset or selected frequency (conventional faradism), or in the
form of low frequency currents superimposed on a medium frequency (2000 to 5000
Hz) carrier wave. A variation of the latter method, using two pairs of
electrodes each supplying medium frequency waves carrying low frequency waves
differing slightly in frequency, forms the basis of what is called
interferential stimulation. A major advantage of using a higher frequency
carrier wave is that impedance between the electrodes and skin is lowered,
enhancing comfort and effectiveness.
American interest in electrostimulation as a
training adjunct was aroused in 1971, when Kots in Russia reported increases of
more than 20% in muscle strength, speed and power produced by several weeks of
electrotraining. Unable to produce comparable results, the Canadians invited him
to lecture at Concordia University in 1977. Armed with the new information that Kots employed a
sinusoidally modulated 2500 Hz current source applied in a sequence of 10
seconds of contraction followed by 50 seconds of relaxation, they again tried to
duplicate Russian claims.
Applications
of Macrocurrent Stimulation
A literature review reveals the following major
uses of macrocurrent stimulation in the realm of therapy. A more detailed discussion or the citations are not quoted
here, but appear in my review on this topic [Siff M C (1990)
Applications of electrostimulation in physical conditioning: a review
J of Appl Sports Science Res 4
(1) : 20-26 ], as well as in the textbook: Siff MC & Verkhoshansky YV (1999)
Supertraining, Ch 4.
1. Increase in muscle
strength
2. Re-education of muscle
action
3. Facilitation of muscle
contraction in dysfunctional or unused muscle
4. Increase of muscular and
general endurance
5. Increase in speed of
muscle contraction
6. Increase in local blood
supply
7. Provision of massage
8. Relief of pain
9. Reduction of muscle spasm
10.
Promotion of relaxation and recuperation
11.
Increase in range of movement
12.
Reduction of swelling
13.
Reduction of musculoskeletal abnormalities
14.
Preferential recruitment of specific muscle groups
15.
Acute increase in strength
16.
Improvement in metabolic efficiency
The
Emergence of Microcurrent Stimulation
Recent research and clinical experience have
revealed that electric currents as much as 1000 times smaller than that of all
the traditional physical therapy modalities can be far more successful than
the latter in achieving many of the benefits outlined in the previous section.
Currents as low as 10 microamps (millionths of an
amp) pulsating at between 0.1 to 400Hz are too weak to cause muscle contraction,
block pain signals or cause local heating, yet their effectiveness and safety is
often superior in many applications to that of faradism, interferentialism and
conventional TENS (Matteson & Eberhardt, 1985).
The steps to satisfactorily modify the existing
paradigm for ES may be sought in the research findings quoted earlier
in the section: 'Reasons for conflicting research'. There, it was learned
that cellular and subcellular processes not involving cell discharge, propagated
electrical impulses, or muscle contraction, appear to be involved with cellular
growth and repair.
Some studies have produced findings which offer
partial answers to the questions posed by microstimulation. For instance, work
by Becker and others suggests that small, steady or slowly varying currents can
cause sub-threshold modulation of the electric fields across nerve and glial
cells, thereby directly regulating cell growth and communication (Becker, 1974;
Becker & Marino, 1982). In this respect, some of Becker's applications
included the acceleration of wound healing, partial regeneration of amphibian
and rat limbs, and induction of narcosis with transcranial currents. Nordenström
maintains that these electric currents can stimulate the flow of ions along the
blood vessels and through the cell membranes which constitute the body's closed
electric circuits postulated by his theory (Nordenström, 1983).
Pilla (1974) has paid particular attention to
electrochemical information transfer across cell membranes. The model in this
case hypothesizes that the molecular structure of the cell membrane reflects
its current genetic activity. Here, the function of a cell at any instant is
determined by feedback between DNA in the cell nucleus and a macromolecule
inducer liberated from the membrane by means of a protein (enzyme) regulator
derived from messenger RNA activity within the cell. The activity of these
membrane-bound proteins is strongly modulated by changes in the concentration of
divalent ions (such as calcium Ca++) absorbed on the membrane. ES
may elicit these ionic changes and thereby modify cell function.
It has
been shown that ES at 5Hz stimulates synthesis of DNA in chick cartilage cells
and rat bone by as much as 27%, but not in chick skin fibroblasts or rat spleen
lymphocytes (Rodan et al, 1978). Not only does the effect of ES appear to be
tissue-specific, but the increase in DNA synthesis occurs 4-6 hours after 15
minutes of ES. The process of membrane depolarisation carried by sodium ions
seems to be followed by an increase in intracellular Ca++
concentration,
thereby triggering DNA synthesis in cells susceptible to the particular
stimulus. Further work by Pilla (1981) has confirmed the existence of cellular
'windows' which open most effectively to certain frequencies, pulse widths and
pulse amplitudes. To attune the ES signal to these parameters, monitoring of
tissue impedances is preferable, a system employed by so-called 'Intelligent
TENS' devices.
In addition, Cheng et al (1982) have shown that
stimulation with currents from 50-1000 microamps can increase tissue ATP
concentrations in rats by 300-500%, and enhances amino acid transport through
the cell membrane and consequent protein synthesis by as much as 40%.
Interestingly, the same study reported that increasing the current above only
one milliamp was sufficient to depress tissue ATP and protein synthesis - and
traditional ES most commonly applies currents exceeding 20 milliamps, at which
stage this depression being nearly 50%.
An
Integrated Theory of Electrostimulation
Therefore, it appears as if macrocurrent
stimulation (MACS - currents exceeding one milliamp) acts as a physiological
stressor, which in the short term causes the typical alarm response described
by Selye (1975). This is supported by the work of Eriksson et al (1981), who
found that the acute effects of traditional ES are similar to those found for
intense voluntary exercise. Furthermore, Gambke et al (1985) have found in
animal studies that long-term MACS causes some muscle fibres to degenerate and
be replaced by newly formed fibres from satellite cell proliferation. This fibre
necrosis occurs a few days after application of ES and seems to affect mainly
the FT fibres. The fact that the various muscle fibres do not transform at the
same time may be due to different thresholds of each fibre to the stimulus that
elicits the transformation. Possibly, the earlier changes might induce
subsequent ones.
Thus, if Selye's General Adaptation Syndrome model
is applied to MACS-type stimulation, the body would have to draw on its
superficial adaptation energy stores and adapt to the ES-imposed stress by
increasing strength or endurance, or by initiating transformation of muscle
fibre types. If the ES is too intense, too prolonged or inappropriately used to
augment a weight training programme, adaptation might not occur or it might
increase the proportion of slow twitch fibres and thereby reduce strength. This
could explain some of the negative research findings discussed earlier.
Furthermore, excessively demanding MACS conceivably
might cause the body to draw on its deep adaptation energy and lead to permanent
tissue damage. Consequently, any athlete who may derive definite performance
benefits from MACS should not assume that increased dosage will lead to further
improvement. The contrary may well prove to be true.
Microcurrent stimulation (MICS - currents below one
milliamp), on the other hand, would not act as a stressor. Instead, the evidence
implies that it elicits biochemical changes associated with enhanced adaptation,
growth and repair. Since MICS appears to operate more on the basis of resonant
attunement of the stimulus to cellular and subcellular processes, the specific
therapeutic effects are determined by how efficiently the stimulation parameters
match the electrical characteristic of the different cells, in particular, their
impedance at different frequencies.
MICS may be applied in several ways to facilitate restoration:
locally
over specific soft tissues
transcranially
via electrodes on the earlobes or on sites on the surface of the skull
at
acupuncture points on the body, hands or ears.
It is generally entirely safe to apply MICS
anywhere on the body, because the current and energy transmitted is too low to
produce any thermal or electrolytic effects on vital tissues. Under no circumstances should MACS be applied across the
brain, as it can cause serious harm. It
is generally not advisable to apply any form of ES to epileptics, pregnant
women, cardiac patients or persons with heart pacemakers.
The
Validity of Microcurrent Application?
There has been considerable debate about the value
of microcurrent (small electrical currents of less than 1 ampere) in physical
therapy, with its supporters claiming consistently good results and its
detractors claiming that any benefits are probably due to a placebo effect.
Some therapists have stated that there is scant evidence of any research
and practical evidence of the value of microcurrent, so, for their interest and
that of others conducting research into microcurrent therapy, I have compiled a
lengthy, but incomplete, list of English language references that relate to the
theoretical foundations and clinical applications of microcurrent.
My own interest in this field was piqued while I
was gathering research information for my M.Sc into the mechanisms underlying
the electroencephalogram (EEG) in brain research.
While browsing in the old science library located in the physics building at the University of the
Witwatersrand, South Africa during 1971, I encountered a few fascinating texts:
one edited by Barnothy (1969) and another by Presman (1970), as well as several
articles by Robert Becker, with whom I later had periodic contact over the years
(these are all referenced below).
Microcurrent
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Mel C Siff PhD
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mcsiff@aol.com
July 2000