Neuro 4 Microcard - A guide to aid in programme selection

1. ABDOMINAL AND PELVIC FLOOR
The muscles, which sag most as we go through life, are the muscles of the pelvic floor and the lower abdomen. Working together they keep us “fit inside”. They are essential to keep us dry during cough, sneeze and jumping activities. The pelvic floor card makes use of the extra channel by allowing for concurrent stimulation of the Transversus Abdominis along with the pelvic muscle work. The programmes vary from a preventative workout to increase strength prior to pregnancy or menopause or simply to improve your general health and love life. The longer programme addresses pelvic floor problems and helps to rebuild the muscles to specifications of good health.

2. ARTHRITIS
In arthritis a cycle of disuse develops due to pain and swelling. The disuse will lead to muscle atrophy despite the presence of a nerve supply. Trophic stimulation initially increases blood flow to the area allowing the build-up of fluid to be removed. Then the red muscle surrounding the joint is built up to promote stability allowing appropriate weight bearing exercise. It can be used to prepare muscle before joint replacement speeding up the transition to use following surgery. Maintaining red muscle and hence stability is vital for the well-being of the new joint.
This chip can be used for all types of arthritis, following joint replacement or for extensive muscle wastage e.g. following cancer treatments.

3. BRACHIAL PLEXUS
The Brachial Plexus card is used to maintain the muscle in the arm during the long nerve regrowth process following injury. It speeds up the overall recovery time by making the transition from first flicker to functional movement quicker. The programme has successfully been used for children with Erbs palsy and may support nerve transplant surgery where this has been indicated.
The sequential frequency programmes are particularly good for the sensory problems particularly associated with injuries to the arm and shoulder.

4. CHRONIC NEUROLOGICAL
Applied to “chronic neurological” disturbances of the CNS including Stroke, Cerebral Palsy, Muscular Dystrophy and Parkinson syndrome. The brain and the spinal cord respond to the quality of information available to them. In conditions where the input to the CNS is confusing i.e. where the muscle tone is low or joints are stiff and difficult to move, the motor programming is also defective. Can decrease muscle tension and spasticity such that the physiotherapy session following can be more productive. The treatment plans are less intensive and are applied as part of the hands on treatment package to induce the feel of normal and correct the motor response.

5. DROPFOOT
This card is suitable for any mode of onset from pressure on the nerves in the lower back to long periods of confinement in bed or even as a result of a stroke. Muscle wasting can be limited to the calf muscles or affect the whole leg depending upon the site of the problem. Trophic Electrical Stimulation can help even a number of years after recovery has appeared to have plateaued since nerve may have regrown into an area of wasted muscle. Use programme 1 until there is a flicker of movement and then move through the programmes.

6. FACIAL
The facial card is ideal for treating floppy faces following Bells Palsy, Ramsey Hunt, Acoustic Neuroma removal etc. It is also suitable for congenital conditions i.e. Moebius Syndrome where the 4 channels allows simultaneous treatment of both sides of the face.

7. SYNKINESIS
The synkinesis card addresses the mass movement patterns that often occur in nerves in facial paralysis. The decreasing frequencies reduce overactivity particularly at rest. It is common for patients to swap to this card from the facial card as their recovery progresses.

8. M.S.
The programmes on the MS card are deliberately kept short. The longer programmes could induce fatigue. The short programmes have proved invaluable in reducing spasticity, spasms, and pain in stiff joints. As well as build the muscle and retaining functional use of limbs for longer periods.

9. PAINFUL FEET/POST SURGICAL FEET
After surgery to the bones and the joints of the foot a syndrome of painful weight bearing can develop and become very debilitating. In this instance the stimulation promotes circulation to the small muscles in the base of the foot and prevents cycles of disuse of developing. Building up these muscles resolves much pain and puts the bounce back in your step. Also for treating foot problems generally stemming from prolonged inactivity i.e. bed-rest or prolonged standing.

10. REPEATED BACK INJURY
People with a history of back problems usually present with loss of red muscle through poor posture and cycles of disuse. Often this is also associated with poor abdominal tone.
The programmes allow the build-up of red muscle for joint protection, whilst the 4 channels allow simultaneous targeting of the abdominal muscle to address the muscle imbalance between these agonist antagonist muscles.
Trophic stimulation reduces the long standing aches and pains as well as acute problems allowing changes in posture, lifting and exercise to maintain gains into the future.
The loss of red muscle through pain/disuse cycles is present in chronic back injury. The loss of abdominal tone is also noted in this field. The programmes available here are to help build up joint protection when applied to the back muscles and to relieve long-standing aches and pains. The opportunity is also presented to address the muscle imbalance between the abdominal – back extensors using an agonist, antagonist reversal cycle.

11. SCI
Recovery following spinal cord injury is long and slow. Maintenance of good muscle tone is imperative, it prevents pressure sores, allows venous return from the legs, and if a flicker of movement returns allows the transition across to function.

12. SPORTS AND RECENT INJURIES
The sports and recent injury card can prevent injuries where there is muscle imbalance, for example football training, which works heavily on the quadriceps leaving the hamstrings relatively weak and prone to tears. Warming these muscles electronically can prevent tears and strains.
When injuries do occur application in the early stages effectively oxygenates the muscle thus speeding up the removal of waste products and thereby reducing bruising swelling and stiffness in the acute stages of an injury.
Initial applications were to maintain muscle bulk when training is rendered impossible. Targeting muscles notoriously difficult to pinpoint with exercise can aid in recovery and prevention.
Increasing the aerobic capacity of the anterior tibials where shin splints may prevent performance. Building up the extensor to resist the strains of weight lifting.

13. STROKE
To restart the signals of normal use from the affected side is described by many patients as comforting. Improvements include: warmer feet, decreased swelling to hand and foot, reduced spasticity, improved co-ordination of muscle to prevent them working against each other i.e. improving gait by preventing hamstrings and quadriceps working simultaneously. Effects are cumulative and the build up of muscle helps the physiotherapist move forward with the exercise programme.

14. PAIN RELIEF
The pain relief card has three programmes, each of which is advanced pain relief using sequential frequency to prevent accommodation. The treatment pads are placed either side of the pain area. Programme 1 is used for acute pain and is a first aid measure to settle the pain quickly. Programme 2 is for pain that persists or repeats itself, the type of pain arthritis would give you, for example. Programme 3 is for a sudden increase in day to day pain. Most people try all three options to see which suits their particular needs.

15. POST POLIO SYNDROME
Post polio syndrome is only now becoming widely recognised and diagnosed. Characterised by new health problems emerging after 15 plus years of functional stability in muscles previously thought unaffected by the polio. Including muscle weakness, unexplained fatigue, muscle atrophy and functional loss. Building up the red muscle prevents muscle wasting and the fatigue caused by overworking the white muscle fibres.

16. KNEE
The knee card is recommended for post surgical knee problems (i.e. post cruciate repair) and prolonged or repeated injuries to the knee joint. The small muscles around the knees are particularly hard to exercise without weight bearing and in these instances trophic stimulation allows a build-up of muscle without stressing the joint.
These techniques have proved invaluable during situations of joint bleeds for haemophiliacs. The intensity of stimulation is maintained at a low level and the joints are subject to minute pulls on the alternative tendons. This simulation of the walking sequence helps to circulate fluid within the knee and to resolve the acute episode. At the same time the knee is building up protection to prevent further injury and subsequent bleeds in the future.

17. LEG ULCER
The programmes on this card allow for a boost in circulation meaning more effective removal of poisons and waste products from the area. Chronic swelling decrease and the leg looks healthier and the foot warmer. The suppuration of the ulcer area is decreased and the ulcer gradually decreases in size and the start of healing occurs even after prolonged cycles of infection.

Please note the Neuro4 kit includes 1 microcard of your choice. Additional cards can be purchased for £39.95 each including appropriate leads and electrodes.
This list is intended to help guide your microcard selection, if you still have problems the staff at the Lindens Clinic will be happy to help you.

Produced by
D J Farragher OBE, FCSP, MSc, Grad Dip Phys. Dip TP.