Petrofsky J, Schwab E
Department of Physical Therapy, Loma Linda University, Loma Linda, 92350, California. USA.
J Med Eng Technol. 2007 Jan-Feb;31(1):62-74. doi: 10.1080/03091900600687698.
Electrical stimulation has been used for exercise, healing wounds, relieving pain, and strengthening muscle. The assumption is that current will flow predictably between electrodes and, therefore, there will be predictability in the clinical response to electrical stimulation. This may not be the case. The present investigation shows that considerable channelling of current occurs when the skin is heated or when there is a wound between the electrodes. By studying current movement in nutrient agar (a homogenous medium), blood agar and layered blood and nutrient agar to simulate areas of increased blood flow, it was found that areas of high or low resistance, especially in the surface layer, caused significant current movement toward (low resistance area) or away (high resistance area) from those areas. When a resister model was used to measure dispersion characteristics of current in a three-dimensional array, it was shown that if even a single resister value was lowered by 20% in the upper layer, current sinking occurred in all three layers of the array. The results seem to imply that where the tissue is non homogeneous due to injury or inflammation, electrode design or current delivery systems need to be modified appropriately to have the intended effect of the electrical stimulation.
电刺激已被用于运动、伤口愈合、止痛和增强肌肉。假设电流会在电极之间可预测地流动,因此,对电刺激的临床反应也具有可预测性。但实际情况可能并非如此。目前的研究表明,当皮肤受热或电极之间存在伤口时,电流会发生相当程度的分流。通过研究电流在营养琼脂(一种均匀介质)、血琼脂以及分层的血液和营养琼脂中的移动情况来模拟血流增加的区域,发现高电阻或低电阻区域,尤其是表层区域,会导致电流显著流向(低电阻区域)或远离(高电阻区域)这些区域。当使用电阻模型测量三维阵列中电流的分散特性时,结果表明,如果上层中哪怕只有一个电阻值降低20%,阵列的所有三层都会出现电流下沉现象。结果似乎意味着,在由于损伤或炎症导致组织不均匀的情况下,需要适当修改电极设计或电流输送系统,以使电刺激达到预期效果。