RehabMedic Pro Stim 4 Manual Del Usuario página 54

to the skin), the electrostimulator brings immediately the intensity to 0 mA. Therefore, before
starting a program, make sure that the cables are connected to the device and that the electrodes
are not worn, as this could decrease their conduction capacity.
NOTE: Use the Microcurrents programs only on channels 1 and 3 with the gray cables supplied.
If the cables are not connected or they are of the wrong type, the program will not start. Check
the cables and the connections.
TENS
Transcutaneous Electrical Nerve Stimulation (TENS) is a selective stimulation of the large fibers of
the peripheral nerves favoring the closing of the gate entrance for the pain pulses and increasing
the release of endorphinic substances, reducing in this way the pain intensity. Therefore with
TENS we want to treat the severe and chronic pain due to the main musculoskeletal pains.
The pain decrease following to the TENS currents application is due to these factors:
a. Gate control theory
b. Endorphin secretion
c. Different sedative effects in relation with the frequency
GATE THEORY
If the electric signals that lead to the brain information about pain are stopped, also the pain
perception is eliminated. If, for instance, we hit our head into an object the first thing we do
is massaging the area affected by the trauma. In this way we stimulate the receptors related
to touch and pressure. TENS in continuous mode and in frequency modulation can be used to
generate signals similar to the ones of touch and pressure. If their intensity is enough, their
priority is so high that it prevails on the pain signals. Once the priority is gained, the gate related
to the sensory signals is opened and the pain one is closed, impeding in this way the passage of
these signals to the brain.
ENDORPHIN SECRETION
When a nervous signal proceeds from the pain area to the brain, it spreads through a chain of
connections joined together called synapse. The synapse can be seen as the space between the
end of a nerve and the start of another. When an electric signal reaches the end of a nerve, it
produces some substances called neurotransmitters that pass through the synapse and activate
the start of the next nerve. This process repeats for all the length needed to the signal to reach
the brain. The opioids involved in the pain reduction have the task to insinuate in the synapse
space and impede the neurotransmitter propagation. In this way a chemical block of the pain
signals occurs. The endorphins are opioids naturally produced by the body to tackle the pain and
they can act both on the marrow and on the brain, in this way they are effective analgesics. TENS
can increase the natural production of endorphins and, thereby, they act decreasing the pain
perception.
DIFFERENT EFFECTS IN RELATION WITH THE FREQUENCY
Depending on the frequency used, it can occur antalgic effects of immediate effect but with
no long duration (higher frequencies), or more progressive effects but also longer in time (low
frequencies).
MICROCURRENTS
Compared with conventional electrostimulation, which uses electrical current in the milliampere
(mA) range, microcurrent electrostimulation uses currents whose intensity is included between
10 and 500 µA (microamperes,i.e. an ampere millionth). Numerous studies showed that the
currents in microamperes are the ones that increase the APT synthesis.
Usually the MENS therapy has two different phases, the first one has the aim to reduce the
pain sensation perceived from the patient, while the second one promotes the protein and APT
synthesis, accelerating the tissue reparative processes. Usually the treatment duration is included
between 15 and 30 minutes as for the first phase and between 5 and 10 minutes as for the second
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