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The following information was presented by Dr. Joe Gallo of Salem State University and is reprinted here with his permission.
Two two edema management protocols are outlined below. Both are based on producing muscle contractions submaximal muscle contractions around the muscles surrounding the swollen knee joint. You can use two electodes or 4. Generally we put the electrodes over the anterior lateral and anterior medial aspect of the knee. Also attaching an article on how to add NMES for the quadriceps as an addition to standard care/rehab. A clinician may want to use this approach to reactivate the weak inhibited quad and accelerate quad strength recovery - this will also help to move some swelling and address the issue of quad weakness and atrophy that can happen after ACL surgery. The parameters below can all be programmed into the Intensity Select Combo II.
Electrical Stimulation for Edema Management Protocols
Option #1: Contract-Relax Muscle Pump Protocol (pulsed current)
Waveform: Symmetrical Biphasic
Phase Duration: 200µs
Frequency: 35-50 pps
Amplitude: Visible submaximal motor (approx.. 10% MVC)
On Time: 2-5 seconds
Off Time: 2-5 seconds
Ramp: at least 1 second
Duration of Rx: 20-30 minutes, 2-3 times per day
Clinical Application Notes:
- Indicated for sub-acute or chronic swelling
- Electrode placement over proximal muscle belly and or muscles surrounding draining veins.
- Indicated for edema due to lack of muscle contraction in the local area
References (Contract-Relax Muscle Pump Protocol):
Shapiro S, Ocelnik. Electrical currents for tissue healing. In M.H. Cameron (ed.), Physical agents in rehabilitation: from research to practice 4th edition. St. Louis, MO: Elsevier; 2013; 267-272.
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Option #2: Continuous Twitch Muscle Pump Protocol (pulsed Current)
Waveform: Symmetrical Biphasic
Phase Duration: 200-300 µs
Frequency: 2 pps
Amplitude: Submaximal Motor with rhythmical twitching (approx 10% MVC)
On/Off Time: None
Duration of Rx: 20 minutes 2-3 x's per day
Clinical Application Notes:
- Indicated for sub-acute or chronic swelling
- Electrode placement over proximal muscle belly and or muscles surrounding draining veins.
- Indicated for edema due to lack of muscle contraction in the local area
- Increase intensity to “tremor like” twitching
- Similar parameters to Motor TENS. In addition to potentially moving swelling, patient will also receive benefits of opiate level pain modulation.
References (Continuous Twitch Muscle Pump Protocol):
Starkey C. Therapeutic Modalities. 3rd ed. Philadelphia, Pa: F.A. Davis; 2004.
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Additional resource:
Andrea Gulick- Customer Care says...
The Revitive is not an item we are familiar with, and are not able to offer much information as to how the product works for edema. I would definitely stick with the recommendations of your cardiologist and wish you the best for your treatment!
On February 07, 2020
J Baker says...
I have discussed the Revitive EMS with my Cardiologist and he is not opposed to the ides providing I have no deep vein clots and he is having my legs tested to make sure. I want to try the Revitive because I am in A-Fib, hence edema and Revitive claimes it can improve edema and varicose veins, which I also have.
Any first hand knowledge of the edema and varicose vein improvements will be valued. Thanks
On February 07, 2020