C) Practical Therapeutic Approach - CefarCompex Physio 5 Bedienungsanleitung

means of a disuse atrophy treatment. If no response is observed in spite of
significant current strengths, the muscle can then be considered as completely
denervated; if, on the other hand, a contraction, even of low intensity, is
achieved, then the muscle is partly denervated.
C. Practical therapeutic approach
It is therefore actually easy to find out the two fundamental factors that will
guide our therapeutic approach:
• There is hope of re-innervation or, on the contrary, denervation is final.
• The muscle is partly or totally denervated.
Four situations can thus arise:
Denervation is total
Denervation is total
The practical therapeutic approach must be adapted to each situation:
Situation 1: Total denervation outside the time
Electrostimulation by means of the Denervated programmes is pointless, since a muscle
definitively without any innervation will always end up atrophying and sclerosing.
Situation 2: Partial denervation outside the time
It is not possible to avoid atrophy and sclerosis of muscle fibres that are definitively
denervated. Stimulation of these fibres by means of the Denervated programmes is
therefore not indicated here. It is possible, however, to work on the innervated part of the
muscle, by means of neurostimulation rectangular biphasic micropulses in order to achieve
compensatory hypertrophy of the innervated fibres.
Situation 3: Total denervation within the time
Pending possible re-innervation, it is important to prevent atrophy as much as possible and
limit the sclerosis phenomenon. Stimulation of muscles deprived of innervation, by means
of wide rectangular pulses in the Denervated programmes is the preferred technique here.
Situation 4: Partial denervation within the time
It is important to try and prevent atrophy and to limit the phenomenon of sclerosis of
the denervated fibres; to do this it is necessary to use the triangular gradient pulses in
the Denervated programmes. Depending on the circumstances it may also be worthwhile
working on the innervated part of the muscle using the rectangular biphasic micro-pulses in
the neurostimulation programmes.
We are OUTSIDE the re-innervation time
Denervation is partial
1
We are WITHIN the re-innervation time
Denervation is partial
3
2
4
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