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1 NeuroTrac electrode placement Manual1 NeuroTrac electrode PlacementManualVisit our website: fordetailed application protocolsNeuroTrac electrode placement Manual2 ContentsPageIntroduction4 Muscle profile4 Classification of the various types of muscular fibres5 Hows does the muscle contract5 Red muscle fibre type 18 White muscle fibre type IIa8 White muscle fibre type IIb9 Type IIm fibres9 Limitations of the present fibre classifications9 Muscle fibre distribution10 Muscle Profile (trained muscle)11 Types of muscle fibres11 Selection of parameters12 Pulse width selection13 Channel selection13 Work / Rest selection13 Selectrion of electrode sizes14 electrode placement15 Abdominals15 Bieast16 Intestinal tension16 Waist line shaping17 Pectorials17 Relaxation18 Deltoids18 Neck19 Upper back19 Shoulders20 Latimus dorsi20 Trapezius21 Lower back21 Erector spinalis22 Elbows22 ContentsRevised Issue Date: 06/06/2005 Document Number.

2 VM-ECS900-OM002-1 NeuroTrac electrode placement Manual3 ContentsPageTriceps23 Biceps23 Extenor of the wrist24 Flexor of the wrist24 Wrist25 Hand regeneration26 Hand stimulation27 Back & legs28 Gluteus28 Adductors29 Inner thigh29 Outside thigh30 Femoral biceps30 Ham strings31 Quadriceps31 Fluid tension32 Inner knee32 Calves33 Tibialis anterior33 Peroneus34 Knee34 Ankle malaize35 Ankles35 Metataraus36 Feet regeneration37 Feet stimulation38 Sole of foot39 Heel39 NeuroTrac electrode placement Manual4It has been shown that nerves control muscle by transmitting a neurologicalcode. This code or message occurs in two frequency ranges according to thetype of muscle fibre required. Postural fibres require a tonic feeding at the rateof 10 pulses per second [Hz]. If applied for periods of approx. one hour everyday, it is possible to support the essential characteristics of the stimulation can act as a life support until the normal function can beresumed.

3 This is achieved by preserving capillary bed density, muscle bulk andthe essential ability to use second frequency range occurs at 30 pulses per second [Hz]. Thisfrequency relays information to the fast muscle fibres, which supports powerto muscle movement. This feeding of the muscle occurs naturally in a phasicway. Electrical stimulation treatment protocols to promote these fibres aregiven for much shorter periods than the slow twitch physiological approach to neuromuscular stimulation also requires pulsesthat are shaped similar to the naturally occurring nerve signals that have verybrief pulse widths. By mimicking nature as accurately as possible, electricalstimulation has been used for long periods when required, without causing profileWhen the muscle receives an electrical impulse it starts to contract, whether thepulse originates from the brain or is produced by electrical stimulation.

4 A veryshort electrical stimulation burst, however only produces a short contraction or single shock after which the muscle immediately returns to its natural shapeand length when at rest. However, if the stimulation is repeated rapidly manytimes in succession, we observe that the effects of the contraction are additivedue to the superimposition of the contraction stages and the inability of themuscle to relax. This phenomenon is called incomplete tetanus. Neither singleshock nor incomplete tetanus is normally observed in voluntary action , a state of muscular contraction caused by repeated electricalstimulation of the motor nerves with a frequency sufficiently high to merge theindividual shocks and make them indistinguishable from each other is called complete tetanus In this scenario, the muscle contracts and becomes firm dueto the voltage generated within the muscle and, exerts a measurable force at itstendonous ends.

5 Almost all-muscular contractions normally occurring in humanmuscle have the characteristics of a complete electrode placement Manual5 Classification of the various types of muscular fibresThe skeletal muscles are composed of a collection of muscular fibres and havevarious shapes according to the mechanical functions they are required toperform; broad differences, however, may be discovered in a histologicalexamination of the fibres and these are strictly connected with the method bywhich a particular muscle is required to perform its task. Analysis of the fibresusing a chemical colouration technique has revealed the presence of variousdifferent anaerobic and anaerobic enzymes and the same technique haspermitted the various occurring in the activities of these enzymes to does the muscle contractSkeletal [striated] muscle is made of numerous long thin parallel filamentsnamed muscular fibres running between tendons by means of which they areconnected to the bones [see Figure 1]

6 NeuroTrac electrode placement Manual6 Figure 1 SARCOMEREACTINACTINMYOSINMYOFIBRICMUSCLE FIBREBUNDLE OFMUSCLE FIBRESMUSCLEN euroTrac electrode placement Manual7 Muscular fibres contain bundles of filaments, surrounded by thesarcoplasmatic network known as myofibril and each myofibril consists in turnof a sequence of many microscopic cylindrical elements, the sarcomeres,connected together longitudinally creating the contractile motor of the sarcomere has a structure of cylindrical form and inside it contains thisfilaments of actin that are connected at is ends [line Z] interspersed withthicker filaments of myosin {see Figure 2}Figure 2 When an electrical impulse reaches the muscle, an activated voltage travelsalong the perimeter of the cellular membrane and through the system of tubesat T penetrates deeply into the muscle cell creating the release of CAE ionsinside the sarcomere.

7 The release of calcium causes attachments of specificparts of the thick filament of myosin to the thin filaments of actin and theconstruction of bridges between molecules {acto-myosin bridges}The rotation that occurs on the distal portion of the bridge head produces asliding of the filaments between each other, which is the actual mechanism 3 ACTINMYOSINMYOSINACTINMYOSINACTINN euroTrac electrode placement Manual8 The rotation of the head of the myosin from position 2 to position 3 producesreciprocal motion of the filaments of actin and myosin; this mechanism is thebasis of all muscular contraction. The mutual sliding produces the lines Z toapproach each other and shortening of the sarcomeres, which being added tothat of all the sarcomeres placed in series, generates the overall shortening ofthe muscle that occurs in every muscular filaments do not change their length when the muscle contracts, but slidebetween each other changing their mutual positionRed muscle fibre type 1 These type of fibres are also called ST fibres [slow contracting fibres] or SOfibres [slow fibres with oxidative metabolism]The motor neurone that innervates them is tonic and has a low speed ofconduction.

8 Fibres of this nature are red in colour [the redness due to thepresence of the myoglobin molecule]. Inside them there is a large number ofmitochondria and oxidative enzymes that explains the reason why the majorityof the intermitochondrial oxidative phosphorilation process take place in thesefibres. A very high content of lipids and myoglobin is also associated withthese metabolic functions. These type 1 muscular fibres are highly resistant tofatigue since they are responsible for all types of activities of a tonic nature,slow acting and associated with maintaining posture. These slow fibres aresurrounded by a dense network of capillaries that permit optimumperformance of the aerobic metabolism in a prolonged activity associated withthe modest exertion of force. These red muscle fibres give the strength to themuscle and support the joint.

9 They are fibres that are very important in allendurance sports, such as cycling, running, swimming, tennis muscle fibre type IIaThese are called FTa [rapid contracting fibres] fibres of FOG [rapid fibres withoxidative-glycolytic metabolism] fibres. These fibres are innervated by a phasictype motor neurone, characterised by higher speed of conduction of the tonicmotor neurone. They are white in colour, due to absence of myoglobin and, arecharacterised by a mixed metabolic activity. These fibres are rich in glycogenand glycolytic enzymes, but also contain mitochondria enzymes; the overallmetabolism is more anaerobic than the aerobic electrode placement Manual9 These fibres are also provided with a network of capillaries that carry theoxygen required for the aerobic process. Type IIa fibres are therefore, able toperform rapid contractions characterised by a significant exertion of force,which is also sustained over time giving a relative resistance [endurance] muscle fibre type IIbThese fibres are called FTb [rapid contracting fibres] fibres or FG [rapid fibreswith glycolytic metabolism] fibres.

10 This type of fibre is innervated by a phasicmotor neurone with a cellular body and a very large axon that transmits pulsesto the muscle at very high speed. These fibres are white to look at and havevery high glycogen and glycolytic enzyme content in order to produce a veryhigh-energy output of the anaerobic type. Contraction is fairy rapid and createsa high level of force; the almost complete absence of mitochondria renders thesefibres incapable of sustaining protracted activity and therefore, easily fatiguedparticularly in the untrained muscle. Type IIb fibres play a very significantpart in all human activities requiring the exertion of explosive force and,naturally, in all powers and explosive sports such as sprinting, weight lifting,swimming, jumping IIm fibresA type of fibre that has been described with characteristics similar to those ofthe IIb type, but with a response to stimulation shifted to higher frequencies[approx.]