User manual

15
COMPEX 3 User Manual
2 - Body position
4 - Level progression
3 - Adjusting stimulation energies
(neurostimulation programmes)
Refer to the pictograms and pictures in the
electrode placement booklet to determine
the stimulation position for your patient
depending on the placement of the
electrodes and the chosen program.
.
This position will vary depending on the
position of the electrodes, the muscle group
you wish to stimulate, and the programme
you are using.
When working with programmes involving
muscle contractions (prolonged, or tetanic,
contractions), always make the muscle work
isometrically as this will prevent cramps and
serious muscle soreness after the session.
For example, when stimulating the
quadriceps, place the patient in a seated
position with his ankles strapped in place to
prevent him from extending his knees. For
programmes that do not involve muscle
contractions (Analgesic programmes, for
example), make sure that the patient is as
comfortable as possible.
The number of fibres recruited in a
stimulated muscle depends on the
stimulation energies used. It is therefore
extremely important to use maximum
stimulation energies where possible in order
to recruit the maximum number of fibres. If
the stimulation energy is too low, too few
fibres will be obliged to work and the
improvement in muscle quality will be
negligible.
The more fibres that are recruited, the
greater the improvement that will be seen.
For example, if only 10% of the fibres in a
muscle are stimulated, only this 10% will
improve. The improvement will obviously be
much greater if 60%, 70%, or even 80% of
the fibres are stimulated. It is crucial
therefore to work with maximum stimulation
energy levels, i.e. the maximum levels that a
patient can tolerate. It takes at least
3 sessions to reach this maximum energy
level. The first few sessions serve to
introduce progressive increments in
stimulation energy (and muscle contraction)
levels and to help the patient to become used
to the method.
After an initial warm-up period, which should
produce very clear muscle twitches, increase
the stimulation energies gradually,
contraction by contraction, for the duration
of the session. Also seek to progressively
increase energy levels from session to
session.
Generally speaking, it is not advisable to try
and reach maximum stimulation levels too
quickly. The different levels in each
stimulation programme are designed to
reeducate the muscle gradually.
We recommend you prioritize the
stimulation energies at each level to recruit
as many fibres as possible before moving
on to the next level.
Ideally, therefore, you should start at level 1,
maintain this level for an entire stimulation
cycle, and only move up to the next level
when you start a new cycle.
For maintenance purposes, it is a good idea
to hold one session per week with the
energy level you used in the previous cycle.