1. Muscle Intelligence technology

2. CefarCompex Academy Medical
Annecy
11th – 13th of December 2007

3. A sensor measuring the mechanical response of muscle activity
How does it work?
A sensor measuring the mechanical response of muscle activity
The recorded signal is called a MECHANOMYOGRAM
We are going to stimulate the muscle according to what it has to say.

4. The sensor records the acceleration due to this movement
Electrical Impulse
sensor
Skin
Electrode
Motor nerve
If we consider the single twitch, the impulse triggers a muscle response and the volume of the muscle is modified and then the muscle goes back to its normal shape.
We can register this change of volume of the muscle and maesure the lateral displacement.
The sensor records the acceleration due to this movement

5. This very sensitive sensor is capable to detect any twitch
This record is done several times to correlate the different results
Due to its high calculation power, the device is capable to differentiate the stimulated twitches from the natural movements of the user.

6. This sensor allows the following functions
Evaluation of the motor nerve chronaxya
Voluntary control of the stimulation onset
Automatic control of energy level to avoid any muscle response during Tens program
The potential is huge with this technology but we can’t do everything at once so we have deliberately decided to limit the possible uses of this technology.
Mi-Scan is there to measure the chronaxia of the muscle
Mi-Energy is to get a better space recruitment, a better scale and something safer to avoid muscle injury.
Mi-Action to control the rhythm of the contraction and to get read of the imposed rhythm. The device is your slave and it is not the other way around.
Mi-Tens to make sure that we use the optimum intensity.
Useful energy level to low frequencies programs

7. It’s a precise measurement of the muscle excitability
It allows a automatic adjustment of the stimulation parameters

8. Be capable of exciting the muscle Minimum electrical parameters
Optimal impulse
Be capable of exciting the muscle
Comfortable
Minimum electrical parameters
Lapicque’s law
Once again, it’s never too much!
Our tool to excite the nerve is our Optimal Impulse, that has to be able to excite (Lapicque’s law) and be comfortable and safe (minimum electrical parameters.

9. LAPICQUE’S LAW I t Chronaxia 2 x Rheobasis Rheobasis
Let’s take a look again at this famous rule. I= Rh + q/t
Higher is the intenisty, shorter is the duration to get the excitation, Lower, longer.
We know that ca can summarize this law by the so called chronaxia.
The curve shape will remain the same but the position will change depending on the type of muscle or even the person, or for the same person & muscle, from day to day..
Chronaxia

10. LAPICQUE’S LAW
Which intensity should we use and during how much time to get a muscle response?
We need a minimum intensity to get a response
Higher the intensity and shorter the duration of the stimulation
Determinate the duration of the stimulation when the intensity is 2 times the minimum intensity
This duration is called Chronaxia

11. MAXIMUM COMFORT E = I ² x R x t E t Minimum energy level Chronaxia
Additional aspect is the Energy you send to someone.
The minimum energy you send to the customer is for a duration equals the chronaxia.
And if it is more comfortable, the customer can use more energy and recruit more fibers and get better results.
Chronaxia

12. The chronaxia has a strong impact on the stimulation comfort
This value, imposed by physiology, change every day on the same subject
Each muscle has its own chronaxia
We have to adapt the pulse width at every session to tally with the chronaxia

13. = 0 Optimal impulse Rectangular I Width = chronaxia
Symetrical compensated with electrical mean = 0
= 0
Constant current generator
The O.I. has to be rectangular, the impulse width should be equal to the chronaxia, compensated to avoid burns and produced by a constant generator.
The only parameter the electronic can’t do is define the right duration. There is no other way than to introduce the value of the chronaxia.
Mi-Scan is able to define this value.
Chronaxia

14. Calculation of the I/t curve
At the beginning of each session we will send different impulses and analyze the muscle response.
We need to position the curve and we will look for the Rheobase, and then the second point so as to draw the curve thanks to the mathematic formula.

15. ADVANTAGES OF Precise measurement of the chronaxia
Precise and automatic adjustment of the pulse width
Parameters of stimulation adapted to each excitability
MORE COMFORT
MORE EFFICIENCY

16. Voluntary control of the stimulation onset
MI action detects the beginning of a voluntary contraction and then immediately activates the electrical stimulation
You master the device and decides when the contraction should come.

17. Associates electrical stimulation with voluntary contraction
2 main ways of using it
Associates electrical stimulation with voluntary contraction
Activates the electrical stimulation
Two ways to use this system.
Or you just trigger.
Or you are going to sustain your active contraction during the whole EMS contraction.

18. Voluntary activation of the stimulation
Absolute control of the rest period
Complete control of the work rest cycle
You have a complete control of the rest period so you are free from the programme, free from the standard rhythm of contraction/rest.
You also have a full control of the cycle and you change the ratio contraction/rest you change the type for the work. For a resistance programme you need to shorten the rest period, for a strength oriented programme you will lengthen the rest period.
You can get different new levels of stimulation.
Freedom and an infinity of programmes.
More freedom

19. Association of electrical stimulation with voluntary contraction
Better spatial recruitment
Better coordination Better transfer
We need time to integrate muscle improvement in the complete motion, this is the coordination. This process will be faster if you combine those two ways of contracting muscles.

20. How does it work?
The Tens effect appears in the spinal cord

21. Back horn
Spinal Cord
BACK
FRONT

22. PAIN Tactile sensibility Tactile sensibility
Blocks the flow of pain at the entrance of the spinal cord by stimulation of the Aβ-fibres
It’s an analgesic programme that adresses the nerves, not the muscles.
It is interesting for sportsmen to get this analgesic programme for day to day minor injuries.
Cross section of a spinal cord.
The afferent arrives in the spinal cord by the posterior horn.
The tactile sensibity because it arrives in the same gate, you can close the gate and limit the entry of the pain. Gate Control

23. Using electro-stimulation we need to generate a tickling sensation by covering with electrodes the painful area
During the treatment the body get used to this sensation which tend to disappear
We have to increase the intensity to recreate this tickling sensation
But be careful !
By increasing to much the intensity we will have a muscle contraction
THAT MUST BE IMPERATIVELY AVOIDED !

24. Thanks to the sensor we are capable to detect in a very sensitive way any muscle response
Any muscle response? Automatic decrease of the stimulation intensity
Benefit :
The user who doesn’t know well this technique is sure to use the Tens program in the best condition
The physiotherapist can entrust the device to his patient without finding him with a contraction!

25. MI RANGE A low frequency function : From 1 to 9 hz
With these frequencies we get twitches
We advice to increase the intensity until getting « good » twtches.
Problem : What are good twitches?

26. Thanks to the sensor :
we determine the low level of energy to be efficient
We determine the max level