US20110071418A1 - Apparatus for diagnosing muscular pain and method of using same - Google Patents
Apparatus for diagnosing muscular pain and method of using same Download PDFInfo
- Publication number
- US20110071418A1 US20110071418A1 US12/906,698 US90669810A US2011071418A1 US 20110071418 A1 US20110071418 A1 US 20110071418A1 US 90669810 A US90669810 A US 90669810A US 2011071418 A1 US2011071418 A1 US 2011071418A1
- Authority
- US
- United States
- Prior art keywords
- waveform
- electrode
- housing
- stimulating
- electrical signal
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4824—Touch or pain perception evaluation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
- A61B5/4519—Muscles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2560/00—Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
- A61B2560/04—Constructional details of apparatus
- A61B2560/0406—Constructional details of apparatus specially shaped apparatus housings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/36014—External stimulators, e.g. with patch electrodes
- A61N1/36021—External stimulators, e.g. with patch electrodes for treatment of pain
Definitions
- the present invention relates to apparatus for diagnosing muscle pain and, more particularly, to apparatus that employ electrical stimulation to accurately diagnose the source of muscle pain.
- a common type of musculoskeletal pain is myofascial pain syndrome, which is pain that emanates from muscles and corresponding connective tissue.
- Myofascial pain syndrome is often caused by myofascial pain generators called “trigger points.”
- Trigger points are discrete, focal, irritable spots located in a taut band of skeletal muscle, i.e., a ropey thickening of the muscle tissue.
- a trigger point is often characterized by a “referred pain” pattern that is similar to the patient's pain complaint. Referred pain is felt not at the site of the trigger point origin, but remote from it. The pain is often described as spreading or radiating.
- a trigger point develops due to any number of causes, such as sudden trauma or injury to musculoskeletal tissue, fatigue, excessive exercising, lack of activity, tension or stress, and nutritional deficiencies.
- a problem in treating myofascial pain syndrome is locating the trigger point, since pain is typically felt remote from the trigger point.
- a common technique for locating a trigger point is palpation. That is, a physician palpates a muscle region suspected of having a trigger point by applying manual pressure to the region with his finger tips and kneading the muscles. As the physician palpates the muscles, the patient verbally indicates the existence of any pain or sensitivity and whether it increases or decreases as the physician moves his fingers within the suspected region.
- a shortcoming of this manual technique is that it can only locate a trigger point with a slight degree of certainty, and cannot typically locate the specific muscle that contains the trigger point. In addition, there is no standard unit of pressure to exert when palpitating a muscle, which could lead to a misdiagnosis.
- the Marcus '063 Patent discloses a method for locating myofascial trigger points (the “Marcus Method”) by applying an electrical stimulus in a suspected muscle area containing a trigger point. As the electrical stimulus is moved about the muscle area, the patient indicates an increase or decrease in the level of pain and sensitivity. Once the maximum pain location has been located, the trigger point has been identified and, thus, it can be treated appropriately.
- the Marcus '063 Patent does not disclose in detail a particular electrical stimulator device that can be appropriately used in connection with the Marcus Method.
- TENS trans-cutaneous electroneural stimulation
- U.S. Pat. No. 4,697,599 to Woodley et al. discloses a handheld meter for locating and detecting pain based on the measurement of conductance of skin in the area of perceived pain.
- the meter includes a housing, two concentric electrodes that extend from the housing, an electrical circuit connected to the electrodes, and a speaker.
- the electrodes are placed against a patient's skin at the location where a measurement is desired.
- the electrical circuit generates an electrical signal having a pulse frequency that varies according to the measured conductance of the skin.
- the conductance is measured aurally by a speaker, which translates the pulses into audible sounds, i.e., “clicks”.
- the clicks increase in frequency as the conductance of the patient's skin increases, which indicates the location of pain.
- the Woodley '599 Patent does not disclose any correlation between increased conductance and the location of myofascial trigger points; and, therefore, the device is not effective at locating same.
- U.S. Pat. No. 5,558,623 to Cody discloses a therapeutic ultrasonic device, which includes a hammer-shaped applicator having a head with two diametrically-opposed diaphragms. A piezoelectric crystal is connected to each of the diaphragms, which convert electrical energy into ultrasonic energy.
- the handle is connected electrically (i.e., hard-wired) to a control console, which allows a user to control the operational functions of the applicator, such as frequency, intensity, mode of operation, etc.
- the Cody '623 Patent relates to the THERAMINITM 3C brand clinical stimulator/ultrasound combination unit manufactured by Rich-Mar Corporation.
- the device disclosed in the Cody '623 Patent utilizes ultrasound signals for therapeutic purposes, and is not equipped for diagnostic purposes. In addition, the device is not portable; and, therefore, its ease of use in a clinical setting is limited.
- the problems and disadvantages associated with the prior art are overcome by the present invention, which includes an electro-neural stimulator for locating myofascial pain trigger points.
- the stimulator includes a housing, an electrical signal generator mounted within the housing, and a pair of electrodes, one of which is mounted to one end of the housing and the other of which is mounted to an opposite end of the housing.
- Each of the electrodes stimulates muscles with an electrical signal generated by the generator.
- a patient's response to such stimulus i.e., whether such stimulus causes pain or sensitivity
- One of the electrodes has a relatively small surface area for diagnosing smaller muscles or muscle groups, while the other electrode has a relatively large surface area for diagnosing, larger muscles or muscle groups.
- the stimulator is a self-contained, wireless unit and is highly maneuverable. These characteristics allow a user to quickly and easily diagnose a source of muscle pain.
- the housing is sized and shaped for mounting on a user's arm, while one of the electrodes is attached to a ring that is worn on the user's finger. This configuration allows the user to alternate quickly and easily between manual palpation of the subject muscle with his hand and fingertips and electrical stimulation of the muscle with the electrode.
- the generator may include an analog waveform generator or a digital signal processor.
- the properties of the electrical signal generated by the generator such as waveform, amplitude, frequency and duty cycle, is selectable by the user.
- the present invention has been adapted for use in diagnosing the existence of myofascial trigger points.
- the present invention can be utilized to diagnose other sources of muscle pain, such as muscle tender points and tension.
- FIG. 1 is a top perspective view of an electro-neural stimulator constructed in accordance with one exemplary embodiment of the present invention
- FIG. 2 is a top plan view of the stimulator shown in FIG. 1 , with an access panel employed by the stimulator removed therefrom and a grounding electrode employed by the stimulator attached thereto;
- FIG. 3 is a perspective view of the stimulator shown in FIG. 1 being applied to a patient's forearm;
- FIG. 4 is a perspective view of an electro-neural stimulator constructed in accordance with another exemplary embodiment of the present invention.
- FIG. 5 is a perspective view of the stimulator shown in FIG. 4 strapped to a physician's arm and being applied to a patient's forearm;
- FIG. 6 is an electrical block diagram of a digital signal processor (DSP) employed by the stimulators shown in FIGS. 1-5 in accordance with another exemplary embodiment of the present invention.
- DSP digital signal processor
- an electro-neural stimulator 10 includes a hexagonal-shaped housing 12 having a first end 14 and a second end 16 opposite the first end 14 .
- a first electrode 18 is mounted on the first end 14 of the housing 12
- a second electrode 20 is mounted on the second end 16 of the housing 12 .
- the first electrode 18 includes a circular-shaped head 22 having a contact surface 24 and a centrally located cylindrical-shaped pin 26 extending outwardly from the head 22 .
- the second electrode 20 includes a circular-shaped head 28 having a contact surface 30 , and a centrally located cylindrical-shaped pin 32 extending outwardly from the head 28 .
- the first end 14 of the housing 12 includes a cylindrical-shaped aperture 34 that extends axially therethrough 12 .
- the second end 16 of the housing 12 includes a circular-shaped aperture 36 that extends axially therethrough.
- the aperture 34 is sized and shaped to receive the pin 26 of the first electrode 18
- the aperture 36 is sized and shaped to receive the pin 32 of the second electrode 20 .
- the first and second electrodes 18 , 20 are secured to the housing 12 by friction fit or an adhesive.
- each of the pins 26 , 32 of the first and second electrodes 18 , 20 may include external threads
- each the apertures 34 , 36 of the housing 12 may include internal threads such that the pins 26 , 32 threadedly engage the apertures 34 , 36 , respectively (not shown in the Figures).
- the diameter of the head 28 of the second electrode 20 is greater than the diameter of the head 22 of the first electrode 18 .
- the diameter of the head 28 of the second electrode 20 can be smaller than the diameter of the head 22 of the first electrode 18 , or the diameters of both heads 22 , 28 can be equal.
- the functions of the electrodes 18 , 20 will be described hereinafter.
- the housing 12 includes a compartment 38 having a rectangular-shaped first chamber 40 , a rectangular-shaped second chamber 42 positioned intermediate the first chamber 40 and the aperture 34 , and a rectangular-shaped third chamber 44 positioned intermediate the first chamber 40 and the aperture 36 .
- the aperture 34 extends from the first end 14 of the housing 12 to the second chamber 42 and the aperture 36 extends from the second end 16 of the housing 12 to the third chamber 44 .
- the second chamber 42 need not be included and, in such case, the aperture 34 may extend from the first end 14 of the housing 12 to the first chamber 40 .
- the housing 12 includes a hexagonal-shaped access panel 46 that is sized and shaped to enclose the compartment 38 .
- the housing 12 includes a plurality of apertures 48 having internal threads (not shown in the Figures), while the panel 46 includes a plurality of apertures (not shown in the Figures), each of which correspond with one of the apertures 48 of the housing 12 .
- Each of the apertures 48 of the housing 12 and each of a corresponding one of the apertures of the panel 46 receives one of a plurality of screws 50 , which secure the panel 46 to the housing 12 (not shown in FIG. 2 , but see FIG. 1 ).
- the panel 46 can be secured to the housing 12 by other means known in the art, such as adhesives or by the use of snap-tabs formed on the panel 46 and corresponding tab slots formed in the housing 12 (not shown in the Figures).
- the stimulator includes a printed circuit board 52 that is positioned within the first chamber 40 of the housing 12 , and a power supply 54 that which is positioned within the third chamber 44 of the housing 12 and is connected electrically to the printed circuit board 52 .
- a wire 56 runs through the aperture 34 and the second chamber 42 and electrically connects the first electrode 18 to the printed circuit board 52 and the power supply 54 .
- a wire 58 runs through the second aperture 36 and the third chamber 44 and electrically connects the second electrode 20 to the printed circuit board 52 and the power supply 54 .
- the printed circuit board 52 includes a first potentiometer 60 and a second potentiometer 62 that extend upwardly therefrom, a third potentiometer 64 and a fourth potentiometer 66 that extend outwardly from one side 68 of the housing 12 , and a slide switch 70 .
- the potentiometer 64 is connected electrically to the first electrode 18 and the printed circuit board 52
- the potentiometer 66 is connected electrically to the second electrode 20 and the printed circuit board 52 .
- the functions of the potentiometers 60 , 62 , the potentiometers 64 , 66 , and the switch 70 shall be described hereinafter.
- a first light emitting diode (LED) 72 and a second LED 74 are mounted on the printed circuit board 52 .
- Each of the LEDs 72 , 74 protrude through a corresponding aperture formed within the panel 46 (not shown in the Figures) when the panel 46 is fastened to the housing 12 (not shown in FIG. 2 , but see FIG. 1 ).
- the stimulator 10 includes a grounding wire 76 , one end of which is connected to the printed circuit board 52 , and the other end of which includes a connecting pin 78 .
- a grounding electrode 80 which includes a rectangular-shaped pad 82 and a wire 84 having a connecting pin 86 , is connected to the grounding wire 76 , such that the pins 78 , 86 are sized and shaped to mechanically and electrically connect with one another.
- the pad 82 of the grounding electrode 80 has a self-adhesive surface (not shown in the Figures). The function of the grounding electrode 80 shall be described hereinafter.
- the housing 12 and the panel 46 are each hexagonal in shape.
- the housing 12 and the panel 46 may each consist of other shapes and sizes, such as rectangular, elliptical or conical in shape.
- the electrodes 18 , 20 are, preferably, circular, in shape, but they can consist of other shapes and sizes, such as square, rectangular, elliptical or triangular in shape.
- the housing 12 is manufactured from an injection-molded polymer plastic material. Alternatively, the housing 12 can be manufactured from other materials.
- the electrodes 18 , 20 are preferably manufactured from an electrically conductive and biocompatible material, such as stainless steel or aluminum. Alternatively, the electrodes 18 , 20 can be made from other materials.
- the printed circuit board 52 is obtained commercially from Johari Digital Healthcare Ltd.'s (of Bengal, India; web site joharidigital.com) TENS 2500 device, model number ZZA250T.
- the printed circuit board 52 can be supplied by other manufacturers and/or be characterized by other model and part numbers.
- the power supply 54 consists of a standard 9-volt battery.
- the power supply 54 can consist of other types of batteries, such as, for example, a button style “watch” battery, which can be mounted on or off the printed circuit board 52 .
- the grounding electrode 80 is commercially available and may be obtained from a healthcare supplier or pharmacy. Alternatively, the grounding electrode 80 may consist of other brands and models and/or may be obtained from other manufacturers.
- the pad 82 of the grounding electrode 80 should be at least 2′′ ⁇ 2′′ and flat, but it may consist of other shapes and sizes.
- the stimulator 10 is implemented in conjunction with the Marcus Method disclosed in the Marcus '063 Patent, which patent has been incorporated by reference herein in its entirety.
- the settings of the stimulator 10 are adjusted by a user by employing the potentiometer 60 to adjust the frequency of the applied electrical stimulus waveform, while employing the potentiometer 62 to adjust of the duty cycle of the applied stimulus waveform.
- the switch 70 enables a user to change the “mode” of operation of the stimulator 10 between a continuous waveform output, a burst mode which delivers a short burst of a waveform, and a modulation mode in which a continuous waveform carrier signal is amplitude modulated.
- the output current of the stimulator 10 can vary from 0 mA to about 200 mA.
- optimal detection of pain varies from person to person, with generally larger and heavier people requiring more current to obtain the same results as a smaller and lighter person.
- the waveform that produces the best response is a continuous square wave, with a 50% duty cycle and a frequency in the range from about 100 Hz to about 150 Hz.
- the output waveform frequency of the stimulator 10 can be adjusted over a range of 0 Hz to about 200 Hz with variable duty cycle.
- the electrical signal generated by the stimulator 10 is not limited to the shape of a square wave for the output waveform.
- the output waveform can be any periodic waveform, such as square waveform, a triangular waveform, a sinusoidal waveform, or a saw tooth waveform, or any combination thereof.
- the output waveform can be amplitude modulated.
- the carrier frequency can be a sinusoidal waveform falling within a frequency range of about 1500 Hz to about 5000 Hz amplitude modulated with a sinusoidal waveform which produces a beat frequency in the range of about 1 Hz to about 200 Hz.
- the carrier waveform can be any periodic waveform, such as a square waveform, a triangular waveform, a sinusoidal waveform, or a saw tooth waveform
- the amplitude modulating waveform can be any periodic waveform, such as a square waveform, a triangular waveform, a sinusoidal waveform, or a saw tooth waveform, or any combination thereof.
- the pin 86 of the grounding electrode 80 is attached to the pin 78 of the grounding wire 76 .
- the pad 82 is adhered to the skin of a patient, such as on the patient's arm 88 (see FIG. 3 ).
- the grounding electrode 80 is placed in the vicinity of the suspected trigger point and should be properly secured in order to maximize patient comfort.
- the grounding electrode 80 acts as a negative terminal for the stimulator 10 .
- the first electrode 18 which is, preferably, the smaller of the electrodes 18 , 20
- the second electrode 20 which is, preferably, the larger of the electrodes 18 , 20
- the trapezius muscle which is located in the upper back
- the second electrode 20 can be used to establish the general location of a muscle group containing a potential myofascial pain trigger point, while the electrode 18 can be used to find a particular muscle within the muscle group that is the source of the myofascial pain trigger point.
- the heads 22 , 28 of the electrodes 18 , 20 are preferably sized and shaped to meet the present FDA approved contact area to field strength requirements.
- the head 22 of the electrode 18 is, preferably, 1 inch in diameter and approximately 0.785 square inches in surface area
- the head 28 of the second electrode 20 is, preferably, 1.5 inches in diameter and approximately 1.767 square inches in surface area. These sizes are used in order to minimize the possibility of a patient experiencing a burning sensation as would be the case with an electrode having small surface area.
- the diameter and surface area of the heads 22 , 28 of the electrodes 18 , 20 can each be greater or smaller than those previously listed.
- the user turns the potentiometer 64 in order to turn on and increase or decrease the power (i.e., current) of a signal to be applied to the first electrode 18 .
- the second electrode 20 is to be used for diagnosis, then the user turns the potentiometer 66 in order to turn on and increase or decrease the power (i.e., current) of a signal to be applied to the second electrode 20 .
- the power supply 54 generates an electrical current to each of the electrodes 18 , 20 .
- Each of the electrodes 18 , 20 act as a positive terminal of the stimulator 10 .
- the LED 72 functions as an on/off indicator of the stimulator 10
- the LED 74 functions as a low battery indicator.
- the stimulator 10 need not include either or both of the LEDs 72 , 74 , or the stimulator may, include additional LEDs used for other types of indicators (not shown in the Figures).
- conductive gel (not shown in the Figures) is applied to the general area of suspected pain.
- the electrode 18 is placed on an easily contracted muscle (i.e., a reference muscle), which for large muscles, can be, for example, the trapezius (upper back muscle).
- the potentiometer 64 is turned in order to increase the amperage of the electrode 18 to the minimal amount to induce a muscle contraction from the reference muscle.
- the user can utilize the Marcus Method of locating trigger points. More particularly, the user places the contact surface 24 of the electrode 18 on the skin of the patient in the suspected location of trigger points and moves the stimulator around the suspected area of pain.
- the electrical stimulus from the stimulator 10 will prompt a pain response from the patient, which is then recorded.
- the stimulator 10 is then moved to a nearby area. If the patient indicates a decrease in pain, then the location of the trigger point has been determined. It is noted that the same technique is used in connection with the second electrode 20 when diagnosing trigger points in larger muscles or muscle groups.
- the second electrode 20 can be used to diagnose the general location of a trigger point within a muscle group, while the second electrode 18 can be used to diagnose the specific location of the trigger point within a particular muscle of the muscle group.
- the stimulator 10 is wireless, it is highly maneuverable and can be placed on any part of the patient's body. Furthermore, the stimulator 10 is lightweight and ergonomically designed, thereby enabling a user to use it comfortably and easily in a clinical setting.
- the stimulator 10 allows a physician to easily detect the responses to electrical stimuli, resulting in an accurate diagnosis of the location of pain. This provides the physician with a better understanding of the pain conditions in a patient so that medicine, massage, injections, or other appropriate remedies can be more accurately directed.
- Medical physicians can use the stimulator 10 for performing routine checkups or when diagnosing complaints of muscle pain in patients. Pain management specialists and physical therapists can accurately and precisely pinpoint pain and accurately and precisely direct therapies (ultrasound, electro-neural stimulation therapy, thermal therapy, massage) and therapeutic exercises.
- Sports medicine practitioners and physical trainers can use the stimulator 10 to diagnose and characterize injuries sustained during rigorous physical activity either in a clinical setting or outdoor/athletic environments.
- Pharmaceutical researchers can utilize the stimulator 10 to accurately and precisely identify pain states in the source muscle in test subjects to achieve high levels of repeatability for analgesic/pain-killer drug development.
- FIG. 4 Another exemplary embodiment of the present invention is illustrated in FIG. 4 .
- Elements illustrated in FIG. 4 that correspond to the elements described above with reference to FIGS. 1 through 3 have been designated by corresponding reference numerals increased by two hundred (200).
- elements illustrated in FIGS. 1 through 3 that do not correspond to the elements described herein with reference to FIGS. 1 through 3 are designated by odd reference numbers starting with reference numeral 211 .
- the embodiment of FIG. 4 operates in the same manner as the embodiment of FIGS. 1 through 3 , unless it is otherwise stated.
- an electro-neural stimulator 210 includes a rectangular-shaped housing 212 having a first surface 211 and a concave-shaped second surface 213 opposite the first surface 211 , whose function shall be described hereinafter.
- the housing 212 houses a printed circuit board (not shown in the Figures), the components of which are identical or similar to the components of printed circuit board 52 of the stimulator 10 described above.
- the first surface 211 of the housing 12 includes various controls and indicators, such as an LCD display 215 , an amperage toggle switch 217 , a mode select button 219 ; and a pair of LED indicators 272 , 274 .
- the stimulator includes a circular-shaped electrode 218 having a contact surface 224 mounted to a circular-shaped ring 221 .
- the functions of the electrode 218 and the ring 221 shall be described hereinafter.
- a wire 223 electrically connects the electrode 218 to the printed circuit board (not shown in the Figures).
- One end of a grounding wire 276 is connected to the printed circuit board (not shown in the Figures), while a connecting pin 278 is connected to the other end of the grounding wire 276 .
- a grounding electrode 280 which includes a rectangular-shaped pad 282 and a wire 284 having a pin 286 , is connected to the grounding wire 276 , such that the pins 278 , 286 are sized and shaped to mechanically and electrically connect with one another.
- a strap 225 having a first end 227 and a second end 229 opposite the first end 227 is fastened to the housing 212 .
- the ends 227 , 229 include VELCRO® brand fasteners 231 so that the ends 227 , 229 may be fastened to one another.
- Other fastening means known in the art may be utilized to fasten the ends 227 , 229 of the strap 225 to one another, such as snaps, adjustable belts and buckles, etc.
- the stimulator 210 operates in the following manner.
- the stimulator 210 is attached to the forearm 233 of a user and is secured thereto by the fastening the ends 227 , 229 of the strap 225 .
- the stimulator 210 can also be strapped any other portion of the user's body, such as around the tricep or the waist, as desired.
- the housing 212 may employ a belt clip for securing it to a user's belt (not shown in the Figures).
- the concave surface 213 of the housing 212 is sized and shaped so that it contours with the arm 231 of the user, thereby providing a more comfortable fit.
- the ring 221 is slipped on a finger 233 of the user, whereby the contact surface 224 of the electrode 218 is positioned distal from the back side of the user's hand.
- the electrode 218 can be positioned on the palm side of the hand (not shown in the Figures).
- the wire 223 is of sufficient length such that the electrode 218 may be positioned on the user's hand in a comfortable manner.
- the output current of the stimulator 210 can vary from 0-200 mA and is manually selected by depressing the amperage toggle switch 217 .
- the output waveform frequency of the stimulator 210 can be set by depressing the mode selected button 219 .
- the LCD screen 215 provides a visual display of the selected amperage, mode, and other pertinent indicators.
- the LED 272 functions as an on/off indicator of the stimulator 210
- the LED 274 functions as a low battery indicator.
- the stimulator 210 need not include either or both of the LEDs 272 , 274 and such information can be displayed on the LCD screen 215 , or the stimulator may also include additional LEDs used for other types of indicators (not shown in the Figures).
- the pin 286 of the grounding electrode 280 is attached to the pin 278 of the grounding wire 276 of the housing 212 .
- the pad 282 is adhered to the skin of a patient, such as on the patient's arm 302 .
- the grounding electrode 280 is placed in the vicinity of the suspected trigger point and should be properly secured in order to maximize patient comfort.
- conductive gel (not shown in the Figures) is applied to the general area of suspected pain.
- the contact surface 224 of the electrode 218 is placed on a reference muscle, such as the trapezius.
- the amperage toggle switch 217 is depressed in order to achieve the desired amperage of the electrode 218 to the minimal amount to induce a muscle contraction from the reference muscle.
- the user can utilize the Marcus Method by placing the contact surface 224 of the electrode 218 on the skin of the patient in the suspected location of trigger points and move the stimulator around the suspected area of pain. If a trigger point is within such area, the electrical stimulus from the stimulator 210 will prompt a pain response from the patient, which is then recorded. The stimulator 210 is then moved to a nearby area. If the patient indicates a decrease in pain, then the location of the trigger point has been determined and appropriate treatment can be initiated.
- the stimulator 210 is wireless, highly maneuverable and can be used to diagnose any part of the patient's body. Furthermore, the stimulator 210 is lightweight and ergonomically designed, thereby enabling a physician to use it comfortably and easily in a clinical setting. It is also noteworthy that the position of the electrode 218 on the physician's hand as shown in FIG. 5 allows the physician to freely alternate between manual palpation of the patient's muscles with his fingertips and the application of the electrode 218 for applying electrical stimulus to the patient's muscles. Accordingly, the stimulator 210 gives the physician maximum flexibility in diagnosing trigger points.
- FIG. 6 an alternate embodiment of the circuitry employed in the electro-neural stimulators 10 , 210 shown in FIGS. 1 through 5 .
- Elements illustrated in FIG. 6 that correspond to the elements described above with reference to FIGS. 1 through 3 have been designated by corresponding reference numerals increased by four hundred (400).
- elements illustrated in FIG. 6 that do not correspond to the elements described herein with reference to FIGS. 1 through 5 are designated by odd reference numbers starting with reference numeral 411 .
- the embodiment of FIG. 6 operates in the same manner as the embodiment of FIGS. 1 through 5 , unless it is otherwise stated.
- FIG. 6 is an electrical block diagram of alternate electrical components of the stimulators 10 , 210 constructed in accordance with another exemplary embodiment of the present invention.
- the stimulator includes a circuit 411 which employs a digital signal processor (DSP) 413 to simulate a digital version of the waveform generator.
- DSP digital signal processor
- the circuitry surrounding the DSP 413 includes an analog multiplexer 415 , a frequency selector 417 , a duty cycle selector 419 and a mode selector 421 , each of which is electrically connected to the multiplexer 415 , an analog-to-digital converter (A/D) 423 electrically connected to the multiplexer 415 , an optional shift register 425 electrically connected to the A/D 423 and to the DSP 413 , a memory module 427 electrically connected to the DSP 413 , a digital-to-analog converter (D/A) 429 electrically connected to the DSP 413 , a filter bank 431 electrically connected to the D/A 429 , a pair of power amplifiers 433 , 435 each of which is electrically connected to the filter bank 431 , a first amplitude selector 437 electrically connected to the power amplifier 433 , and a second amplitude selector 439 electrically connected to the power amplifier 435 .
- the output voltages of each of the frequency selector 417 , the duty cycle selector 419 , and the mode selector 421 are sampled in a time-division multiplexed fashion by the multiplexer 415 .
- the output of the multiplexer 415 is sampled by the analog-to-digital converter (A/D) 423 .
- the shift register 425 converts the parallel outputs of the A/D converter 423 to a serial bit stream, which is input to the DSP 413 .
- the DSP 413 interfaces with the memory 427 , which may be a combination of random access memory for storing intermediate calculations and executing a waveform generation program, and a non-volatile FLASH portion of the memory 427 , which may store waveforms and/or a program for forming the waveforms.
- the output of the DSP 413 applies a discrete version of the waveforms to be applied, which is converted to analog form by the D/A converter 429 .
- the output of the D/A converter 429 is fed to the filter bank 431 , which can filter out quantization noise and other distortions.
- the output of the filter bank 431 is fed to the power amplifiers 433 , 435 , which outputs a signal capable of applying RMS currents in the range of 0-200 mA to the electrodes 418 , 420 by adjusting the amplitude selectors 437 , 439 .
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- Biophysics (AREA)
- Pathology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- General Health & Medical Sciences (AREA)
- Physics & Mathematics (AREA)
- Veterinary Medicine (AREA)
- Molecular Biology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Dentistry (AREA)
- Radiology & Medical Imaging (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Rheumatology (AREA)
- Hospice & Palliative Care (AREA)
- Pain & Pain Management (AREA)
- Psychiatry (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Electrotherapy Devices (AREA)
Abstract
Description
- This application claims the benefit of U.S. Provisional Patent Application No. 60/663,125 filed Mar. 18, 2005, entitled “Dynamic Mode Surface Electra-Neural Stimulator for Diagnosis of Muscle Pain,” the disclosure of which is incorporated herein by reference in its entirety.
- The present invention relates to apparatus for diagnosing muscle pain and, more particularly, to apparatus that employ electrical stimulation to accurately diagnose the source of muscle pain.
- A common type of musculoskeletal pain is myofascial pain syndrome, which is pain that emanates from muscles and corresponding connective tissue. Myofascial pain syndrome is often caused by myofascial pain generators called “trigger points.” Trigger points are discrete, focal, irritable spots located in a taut band of skeletal muscle, i.e., a ropey thickening of the muscle tissue. A trigger point is often characterized by a “referred pain” pattern that is similar to the patient's pain complaint. Referred pain is felt not at the site of the trigger point origin, but remote from it. The pain is often described as spreading or radiating. A trigger point develops due to any number of causes, such as sudden trauma or injury to musculoskeletal tissue, fatigue, excessive exercising, lack of activity, tension or stress, and nutritional deficiencies.
- A problem in treating myofascial pain syndrome is locating the trigger point, since pain is typically felt remote from the trigger point. A common technique for locating a trigger point is palpation. That is, a physician palpates a muscle region suspected of having a trigger point by applying manual pressure to the region with his finger tips and kneading the muscles. As the physician palpates the muscles, the patient verbally indicates the existence of any pain or sensitivity and whether it increases or decreases as the physician moves his fingers within the suspected region. A shortcoming of this manual technique is that it can only locate a trigger point with a slight degree of certainty, and cannot typically locate the specific muscle that contains the trigger point. In addition, there is no standard unit of pressure to exert when palpitating a muscle, which could lead to a misdiagnosis.
- Other techniques to locate trigger points include the use of a palpation index, pressure threshold meters, thermographic measuring devices, and electromyographic identification. However, these techniques are difficult to learn and use and are not always reliable.
- U.S. Pat. No. 6,432,063 to Marcus (hereinafter “the Marcus '063 Patent”), the entirety of which is incorporated herein by reference, discloses a method for locating myofascial trigger points (the “Marcus Method”) by applying an electrical stimulus in a suspected muscle area containing a trigger point. As the electrical stimulus is moved about the muscle area, the patient indicates an increase or decrease in the level of pain and sensitivity. Once the maximum pain location has been located, the trigger point has been identified and, thus, it can be treated appropriately. However, the Marcus '063 Patent does not disclose in detail a particular electrical stimulator device that can be appropriately used in connection with the Marcus Method.
- There are numerous trans-cutaneous electroneural stimulation (TENS) portable devices available in the marketplace. However, the leads (i.e., the electrodes) of these devices are designed for static and therapeutic purposes, rather than dynamic diagnosis purposes. As a result, TENS devices are not appropriate for locating myofascial trigger points.
- U.S. Pat. No. 4,697,599 to Woodley et al. (the “Woodley '599 Patent”) discloses a handheld meter for locating and detecting pain based on the measurement of conductance of skin in the area of perceived pain. The meter includes a housing, two concentric electrodes that extend from the housing, an electrical circuit connected to the electrodes, and a speaker. The electrodes are placed against a patient's skin at the location where a measurement is desired. The electrical circuit generates an electrical signal having a pulse frequency that varies according to the measured conductance of the skin. The conductance is measured aurally by a speaker, which translates the pulses into audible sounds, i.e., “clicks”. The clicks increase in frequency as the conductance of the patient's skin increases, which indicates the location of pain. However, the Woodley '599 Patent does not disclose any correlation between increased conductance and the location of myofascial trigger points; and, therefore, the device is not effective at locating same.
- U.S. Pat. No. 5,558,623 to Cody (the “Cody '623 Patent) discloses a therapeutic ultrasonic device, which includes a hammer-shaped applicator having a head with two diametrically-opposed diaphragms. A piezoelectric crystal is connected to each of the diaphragms, which convert electrical energy into ultrasonic energy. The handle is connected electrically (i.e., hard-wired) to a control console, which allows a user to control the operational functions of the applicator, such as frequency, intensity, mode of operation, etc. The Cody '623 Patent relates to the THERAMINI™ 3C brand clinical stimulator/ultrasound combination unit manufactured by Rich-Mar Corporation. However, the device disclosed in the Cody '623 Patent utilizes ultrasound signals for therapeutic purposes, and is not equipped for diagnostic purposes. In addition, the device is not portable; and, therefore, its ease of use in a clinical setting is limited.
- Until now, there is no current device that effectively locates a myofascial trigger point. As a result, this has contributed to ignoring muscles as a major cause of most common pain problems and, unfortunately, has led to unnecessary testing, injections and medications, and surgeries. Accordingly, there is a need for a device that can accurately diagnose and locate trigger points, which is portable and ergonomically designed.
- The problems and disadvantages associated with the prior art are overcome by the present invention, which includes an electro-neural stimulator for locating myofascial pain trigger points. The stimulator includes a housing, an electrical signal generator mounted within the housing, and a pair of electrodes, one of which is mounted to one end of the housing and the other of which is mounted to an opposite end of the housing. Each of the electrodes stimulates muscles with an electrical signal generated by the generator. A patient's response to such stimulus (i.e., whether such stimulus causes pain or sensitivity) is indicative of the existence or lack of a trigger point within the muscle. One of the electrodes has a relatively small surface area for diagnosing smaller muscles or muscle groups, while the other electrode has a relatively large surface area for diagnosing, larger muscles or muscle groups. The stimulator is a self-contained, wireless unit and is highly maneuverable. These characteristics allow a user to quickly and easily diagnose a source of muscle pain.
- In accordance with another aspect of the present invention, the housing is sized and shaped for mounting on a user's arm, while one of the electrodes is attached to a ring that is worn on the user's finger. This configuration allows the user to alternate quickly and easily between manual palpation of the subject muscle with his hand and fingertips and electrical stimulation of the muscle with the electrode.
- In accordance with another aspect of the present invention, the generator may include an analog waveform generator or a digital signal processor. The properties of the electrical signal generated by the generator, such as waveform, amplitude, frequency and duty cycle, is selectable by the user.
- Specifically, the present invention has been adapted for use in diagnosing the existence of myofascial trigger points. However, the present invention can be utilized to diagnose other sources of muscle pain, such as muscle tender points and tension.
- Further features and advantages of the invention will appear more clearly on a reading of the following detailed description of the exemplary embodiments of the invention, which are given below by way of example only with reference to the accompanying drawings.
- For a more complete understanding of the present invention, reference is made to the following detailed description of the exemplary embodiments considered in conjunction with the accompanying drawings, in which:
-
FIG. 1 is a top perspective view of an electro-neural stimulator constructed in accordance with one exemplary embodiment of the present invention; -
FIG. 2 is a top plan view of the stimulator shown inFIG. 1 , with an access panel employed by the stimulator removed therefrom and a grounding electrode employed by the stimulator attached thereto; -
FIG. 3 is a perspective view of the stimulator shown inFIG. 1 being applied to a patient's forearm; -
FIG. 4 is a perspective view of an electro-neural stimulator constructed in accordance with another exemplary embodiment of the present invention; -
FIG. 5 is a perspective view of the stimulator shown inFIG. 4 strapped to a physician's arm and being applied to a patient's forearm; and -
FIG. 6 is an electrical block diagram of a digital signal processor (DSP) employed by the stimulators shown inFIGS. 1-5 in accordance with another exemplary embodiment of the present invention. - Referring to
FIGS. 1 and 2 , an electro-neural stimulator 10 includes a hexagonal-shapedhousing 12 having afirst end 14 and asecond end 16 opposite thefirst end 14. Afirst electrode 18 is mounted on thefirst end 14 of thehousing 12, while asecond electrode 20 is mounted on thesecond end 16 of thehousing 12. With particular reference toFIG. 2 , thefirst electrode 18 includes a circular-shapedhead 22 having acontact surface 24 and a centrally located cylindrical-shapedpin 26 extending outwardly from thehead 22. Similarly, thesecond electrode 20 includes a circular-shapedhead 28 having acontact surface 30, and a centrally located cylindrical-shapedpin 32 extending outwardly from thehead 28. Thefirst end 14 of thehousing 12 includes a cylindrical-shapedaperture 34 that extends axially therethrough 12. Similarly, thesecond end 16 of thehousing 12 includes a circular-shapedaperture 36 that extends axially therethrough. Theaperture 34 is sized and shaped to receive thepin 26 of thefirst electrode 18, while theaperture 36 is sized and shaped to receive thepin 32 of thesecond electrode 20. The first andsecond electrodes housing 12 by friction fit or an adhesive. Alternatively, each of thepins second electrodes apertures housing 12 may include internal threads such that thepins apertures - Preferably, the diameter of the
head 28 of thesecond electrode 20 is greater than the diameter of thehead 22 of thefirst electrode 18. Alternatively, the diameter of thehead 28 of thesecond electrode 20 can be smaller than the diameter of thehead 22 of thefirst electrode 18, or the diameters of bothheads electrodes - Referring to
FIG. 2 , thehousing 12 includes acompartment 38 having a rectangular-shapedfirst chamber 40, a rectangular-shapedsecond chamber 42 positioned intermediate thefirst chamber 40 and theaperture 34, and a rectangular-shapedthird chamber 44 positioned intermediate thefirst chamber 40 and theaperture 36. Theaperture 34 extends from thefirst end 14 of thehousing 12 to thesecond chamber 42 and theaperture 36 extends from thesecond end 16 of thehousing 12 to thethird chamber 44. Alternatively, thesecond chamber 42 need not be included and, in such case, theaperture 34 may extend from thefirst end 14 of thehousing 12 to thefirst chamber 40. - Referring to
FIG. 1 , thehousing 12 includes a hexagonal-shapedaccess panel 46 that is sized and shaped to enclose thecompartment 38. Referring toFIG. 2 , thehousing 12 includes a plurality ofapertures 48 having internal threads (not shown in the Figures), while thepanel 46 includes a plurality of apertures (not shown in the Figures), each of which correspond with one of theapertures 48 of thehousing 12. Each of theapertures 48 of thehousing 12 and each of a corresponding one of the apertures of thepanel 46 receives one of a plurality ofscrews 50, which secure thepanel 46 to the housing 12 (not shown inFIG. 2 , but seeFIG. 1 ). Alternatively, thepanel 46 can be secured to thehousing 12 by other means known in the art, such as adhesives or by the use of snap-tabs formed on thepanel 46 and corresponding tab slots formed in the housing 12 (not shown in the Figures). - Referring to
FIG. 2 , the stimulator includes a printedcircuit board 52 that is positioned within thefirst chamber 40 of thehousing 12, and apower supply 54 that which is positioned within thethird chamber 44 of thehousing 12 and is connected electrically to the printedcircuit board 52. Awire 56 runs through theaperture 34 and thesecond chamber 42 and electrically connects thefirst electrode 18 to the printedcircuit board 52 and thepower supply 54. Similarly, awire 58 runs through thesecond aperture 36 and thethird chamber 44 and electrically connects thesecond electrode 20 to the printedcircuit board 52 and thepower supply 54. - Still referring to
FIG. 2 , the printedcircuit board 52 includes afirst potentiometer 60 and asecond potentiometer 62 that extend upwardly therefrom, athird potentiometer 64 and afourth potentiometer 66 that extend outwardly from oneside 68 of thehousing 12, and aslide switch 70. Thepotentiometer 64 is connected electrically to thefirst electrode 18 and the printedcircuit board 52, while thepotentiometer 66 is connected electrically to thesecond electrode 20 and the printedcircuit board 52. The functions of thepotentiometers potentiometers switch 70 shall be described hereinafter. - Referring to
FIGS. 1 and 2 , a first light emitting diode (LED) 72 and asecond LED 74 are mounted on the printedcircuit board 52. Each of theLEDs panel 46 is fastened to the housing 12 (not shown inFIG. 2 , but seeFIG. 1 ). Thestimulator 10 includes agrounding wire 76, one end of which is connected to the printedcircuit board 52, and the other end of which includes a connectingpin 78. A groundingelectrode 80, which includes a rectangular-shapedpad 82 and awire 84 having a connectingpin 86, is connected to thegrounding wire 76, such that thepins pad 82 of the groundingelectrode 80 has a self-adhesive surface (not shown in the Figures). The function of the groundingelectrode 80 shall be described hereinafter. - Preferably, the
housing 12 and thepanel 46 are each hexagonal in shape. However, thehousing 12 and thepanel 46 may each consist of other shapes and sizes, such as rectangular, elliptical or conical in shape. Theelectrodes - Preferably, the
housing 12 is manufactured from an injection-molded polymer plastic material. Alternatively, thehousing 12 can be manufactured from other materials. Theelectrodes electrodes - Preferably, the printed
circuit board 52 is obtained commercially from Johari Digital Healthcare Ltd.'s (of Rajasthan, India; web site joharidigital.com) TENS 2500 device, model number ZZA250T. Alternatively, the printedcircuit board 52 can be supplied by other manufacturers and/or be characterized by other model and part numbers. - Preferably, the
power supply 54 consists of a standard 9-volt battery. Alternatively, thepower supply 54 can consist of other types of batteries, such as, for example, a button style “watch” battery, which can be mounted on or off the printedcircuit board 52. - The grounding
electrode 80 is commercially available and may be obtained from a healthcare supplier or pharmacy. Alternatively, the groundingelectrode 80 may consist of other brands and models and/or may be obtained from other manufacturers. Thepad 82 of the groundingelectrode 80 should be at least 2″×2″ and flat, but it may consist of other shapes and sizes. - Referring to
FIGS. 1 through 3 , thestimulator 10 is implemented in conjunction with the Marcus Method disclosed in the Marcus '063 Patent, which patent has been incorporated by reference herein in its entirety. In this regard, the settings of thestimulator 10 are adjusted by a user by employing thepotentiometer 60 to adjust the frequency of the applied electrical stimulus waveform, while employing thepotentiometer 62 to adjust of the duty cycle of the applied stimulus waveform. Theswitch 70 enables a user to change the “mode” of operation of thestimulator 10 between a continuous waveform output, a burst mode which delivers a short burst of a waveform, and a modulation mode in which a continuous waveform carrier signal is amplitude modulated. - The output current of the
stimulator 10 can vary from 0 mA to about 200 mA. Experiments have shown that optimal detection of pain varies from person to person, with generally larger and heavier people requiring more current to obtain the same results as a smaller and lighter person. Experiments have also shown that the waveform that produces the best response (i.e., the most accurate location of the pain source) is a continuous square wave, with a 50% duty cycle and a frequency in the range from about 100 Hz to about 150 Hz. The output waveform frequency of thestimulator 10 can be adjusted over a range of 0 Hz to about 200 Hz with variable duty cycle. - The electrical signal generated by the
stimulator 10 is not limited to the shape of a square wave for the output waveform. For instance, the output waveform can be any periodic waveform, such as square waveform, a triangular waveform, a sinusoidal waveform, or a saw tooth waveform, or any combination thereof. In addition, the output waveform can be amplitude modulated. For example, the carrier frequency can be a sinusoidal waveform falling within a frequency range of about 1500 Hz to about 5000 Hz amplitude modulated with a sinusoidal waveform which produces a beat frequency in the range of about 1 Hz to about 200 Hz. Alternatively, the carrier waveform can be any periodic waveform, such as a square waveform, a triangular waveform, a sinusoidal waveform, or a saw tooth waveform, and likewise the amplitude modulating waveform can be any periodic waveform, such as a square waveform, a triangular waveform, a sinusoidal waveform, or a saw tooth waveform, or any combination thereof. - Next, the
pin 86 of the groundingelectrode 80 is attached to thepin 78 of thegrounding wire 76. Thepad 82 is adhered to the skin of a patient, such as on the patient's arm 88 (seeFIG. 3 ). Preferably, the groundingelectrode 80 is placed in the vicinity of the suspected trigger point and should be properly secured in order to maximize patient comfort. The groundingelectrode 80 acts as a negative terminal for thestimulator 10. - At this stage, a user must determine which of the
electrodes first electrode 18, which is, preferably, the smaller of theelectrodes second electrode 20, which is, preferably, the larger of theelectrodes second electrode 20 can be used to establish the general location of a muscle group containing a potential myofascial pain trigger point, while theelectrode 18 can be used to find a particular muscle within the muscle group that is the source of the myofascial pain trigger point. - It is noted that the
heads electrodes head 22 of theelectrode 18 is, preferably, 1 inch in diameter and approximately 0.785 square inches in surface area, while thehead 28 of thesecond electrode 20 is, preferably, 1.5 inches in diameter and approximately 1.767 square inches in surface area. These sizes are used in order to minimize the possibility of a patient experiencing a burning sensation as would be the case with an electrode having small surface area. However, it is noted that the diameter and surface area of theheads electrodes - If the
first electrode 18 is to be used for diagnosis, then the user turns thepotentiometer 64 in order to turn on and increase or decrease the power (i.e., current) of a signal to be applied to thefirst electrode 18. Similarly, if thesecond electrode 20 is to be used for diagnosis, then the user turns thepotentiometer 66 in order to turn on and increase or decrease the power (i.e., current) of a signal to be applied to thesecond electrode 20. Thepower supply 54 generates an electrical current to each of theelectrodes electrodes stimulator 10. - The
LED 72 functions as an on/off indicator of thestimulator 10, while theLED 74 functions as a low battery indicator. Alternatively, thestimulator 10 need not include either or both of theLEDs - Once the desired settings of the
stimulator 10 are set, conductive gel (not shown in the Figures) is applied to the general area of suspected pain. Theelectrode 18 is placed on an easily contracted muscle (i.e., a reference muscle), which for large muscles, can be, for example, the trapezius (upper back muscle). Thepotentiometer 64 is turned in order to increase the amperage of theelectrode 18 to the minimal amount to induce a muscle contraction from the reference muscle. Once this is determined, the user can utilize the Marcus Method of locating trigger points. More particularly, the user places thecontact surface 24 of theelectrode 18 on the skin of the patient in the suspected location of trigger points and moves the stimulator around the suspected area of pain. If a trigger point is within such area, the electrical stimulus from thestimulator 10 will prompt a pain response from the patient, which is then recorded. Thestimulator 10 is then moved to a nearby area. If the patient indicates a decrease in pain, then the location of the trigger point has been determined. It is noted that the same technique is used in connection with thesecond electrode 20 when diagnosing trigger points in larger muscles or muscle groups. In addition, thesecond electrode 20 can be used to diagnose the general location of a trigger point within a muscle group, while thesecond electrode 18 can be used to diagnose the specific location of the trigger point within a particular muscle of the muscle group. - Because the
stimulator 10 is wireless, it is highly maneuverable and can be placed on any part of the patient's body. Furthermore, thestimulator 10 is lightweight and ergonomically designed, thereby enabling a user to use it comfortably and easily in a clinical setting. Thestimulator 10 allows a physician to easily detect the responses to electrical stimuli, resulting in an accurate diagnosis of the location of pain. This provides the physician with a better understanding of the pain conditions in a patient so that medicine, massage, injections, or other appropriate remedies can be more accurately directed. Medical physicians can use thestimulator 10 for performing routine checkups or when diagnosing complaints of muscle pain in patients. Pain management specialists and physical therapists can accurately and precisely pinpoint pain and accurately and precisely direct therapies (ultrasound, electro-neural stimulation therapy, thermal therapy, massage) and therapeutic exercises. Sports medicine practitioners and physical trainers can use thestimulator 10 to diagnose and characterize injuries sustained during rigorous physical activity either in a clinical setting or outdoor/athletic environments. Pharmaceutical researchers can utilize thestimulator 10 to accurately and precisely identify pain states in the source muscle in test subjects to achieve high levels of repeatability for analgesic/pain-killer drug development. - Another exemplary embodiment of the present invention is illustrated in
FIG. 4 . Elements illustrated inFIG. 4 that correspond to the elements described above with reference toFIGS. 1 through 3 have been designated by corresponding reference numerals increased by two hundred (200). In addition, elements illustrated inFIGS. 1 through 3 that do not correspond to the elements described herein with reference toFIGS. 1 through 3 are designated by odd reference numbers starting withreference numeral 211. The embodiment ofFIG. 4 operates in the same manner as the embodiment ofFIGS. 1 through 3 , unless it is otherwise stated. - Referring to
FIG. 4 , an electro-neural stimulator 210 includes a rectangular-shapedhousing 212 having afirst surface 211 and a concave-shapedsecond surface 213 opposite thefirst surface 211, whose function shall be described hereinafter. Thehousing 212 houses a printed circuit board (not shown in the Figures), the components of which are identical or similar to the components of printedcircuit board 52 of thestimulator 10 described above. Thefirst surface 211 of thehousing 12 includes various controls and indicators, such as anLCD display 215, anamperage toggle switch 217, a modeselect button 219; and a pair of LED indicators 272, 274. - Still referring to
FIG. 4 , the stimulator includes a circular-shapedelectrode 218 having acontact surface 224 mounted to a circular-shapedring 221. The functions of theelectrode 218 and thering 221 shall be described hereinafter. Awire 223 electrically connects theelectrode 218 to the printed circuit board (not shown in the Figures). One end of agrounding wire 276 is connected to the printed circuit board (not shown in the Figures), while a connectingpin 278 is connected to the other end of thegrounding wire 276. Agrounding electrode 280, which includes a rectangular-shapedpad 282 and awire 284 having apin 286, is connected to thegrounding wire 276, such that thepins - Still referring to
FIG. 4 , astrap 225 having afirst end 227 and asecond end 229 opposite thefirst end 227 is fastened to thehousing 212. The ends 227, 229 include VELCRO® brand fasteners 231 so that the ends 227, 229 may be fastened to one another. Other fastening means known in the art may be utilized to fasten theends strap 225 to one another, such as snaps, adjustable belts and buckles, etc. - Referring to
FIGS. 4 and 5 , thestimulator 210 operates in the following manner. First, thestimulator 210 is attached to theforearm 233 of a user and is secured thereto by the fastening theends strap 225. Thestimulator 210 can also be strapped any other portion of the user's body, such as around the tricep or the waist, as desired. Alternatively, thehousing 212 may employ a belt clip for securing it to a user's belt (not shown in the Figures). Theconcave surface 213 of thehousing 212 is sized and shaped so that it contours with thearm 231 of the user, thereby providing a more comfortable fit. Next, thering 221 is slipped on afinger 233 of the user, whereby thecontact surface 224 of theelectrode 218 is positioned distal from the back side of the user's hand. Alternatively, theelectrode 218 can be positioned on the palm side of the hand (not shown in the Figures). Thewire 223 is of sufficient length such that theelectrode 218 may be positioned on the user's hand in a comfortable manner. - Next, the settings of the
stimulator 210 are adjusted. The output current of thestimulator 210 can vary from 0-200 mA and is manually selected by depressing theamperage toggle switch 217. The output waveform frequency of thestimulator 210 can be set by depressing the mode selectedbutton 219. TheLCD screen 215 provides a visual display of the selected amperage, mode, and other pertinent indicators. The LED 272 functions as an on/off indicator of thestimulator 210, while the LED 274 functions as a low battery indicator. Alternatively, thestimulator 210 need not include either or both of the LEDs 272, 274 and such information can be displayed on theLCD screen 215, or the stimulator may also include additional LEDs used for other types of indicators (not shown in the Figures). - Next, the
pin 286 of thegrounding electrode 280 is attached to thepin 278 of thegrounding wire 276 of thehousing 212. Thepad 282 is adhered to the skin of a patient, such as on the patient's arm 302. Preferably, thegrounding electrode 280 is placed in the vicinity of the suspected trigger point and should be properly secured in order to maximize patient comfort. - Once the desired settings of the
stimulator 10 are set, conductive gel (not shown in the Figures) is applied to the general area of suspected pain. Thecontact surface 224 of theelectrode 218 is placed on a reference muscle, such as the trapezius. Theamperage toggle switch 217 is depressed in order to achieve the desired amperage of theelectrode 218 to the minimal amount to induce a muscle contraction from the reference muscle. Once this is determined, the user can utilize the Marcus Method by placing thecontact surface 224 of theelectrode 218 on the skin of the patient in the suspected location of trigger points and move the stimulator around the suspected area of pain. If a trigger point is within such area, the electrical stimulus from thestimulator 210 will prompt a pain response from the patient, which is then recorded. Thestimulator 210 is then moved to a nearby area. If the patient indicates a decrease in pain, then the location of the trigger point has been determined and appropriate treatment can be initiated. - The
stimulator 210 is wireless, highly maneuverable and can be used to diagnose any part of the patient's body. Furthermore, thestimulator 210 is lightweight and ergonomically designed, thereby enabling a physician to use it comfortably and easily in a clinical setting. It is also noteworthy that the position of theelectrode 218 on the physician's hand as shown inFIG. 5 allows the physician to freely alternate between manual palpation of the patient's muscles with his fingertips and the application of theelectrode 218 for applying electrical stimulus to the patient's muscles. Accordingly, thestimulator 210 gives the physician maximum flexibility in diagnosing trigger points. - Referring to
FIG. 6 , an alternate embodiment of the circuitry employed in the electro-neural stimulators FIGS. 1 through 5 . Elements illustrated inFIG. 6 that correspond to the elements described above with reference toFIGS. 1 through 3 have been designated by corresponding reference numerals increased by four hundred (400). In addition, elements illustrated inFIG. 6 that do not correspond to the elements described herein with reference toFIGS. 1 through 5 are designated by odd reference numbers starting withreference numeral 411. The embodiment ofFIG. 6 operates in the same manner as the embodiment ofFIGS. 1 through 5 , unless it is otherwise stated. -
FIG. 6 is an electrical block diagram of alternate electrical components of thestimulators circuit 411 which employs a digital signal processor (DSP) 413 to simulate a digital version of the waveform generator. The circuitry surrounding theDSP 413 includes ananalog multiplexer 415, afrequency selector 417, aduty cycle selector 419 and amode selector 421, each of which is electrically connected to themultiplexer 415, an analog-to-digital converter (A/D) 423 electrically connected to themultiplexer 415, anoptional shift register 425 electrically connected to the A/D 423 and to theDSP 413, amemory module 427 electrically connected to theDSP 413, a digital-to-analog converter (D/A) 429 electrically connected to theDSP 413, afilter bank 431 electrically connected to the D/A 429, a pair ofpower amplifiers filter bank 431, afirst amplitude selector 437 electrically connected to thepower amplifier 433, and asecond amplitude selector 439 electrically connected to thepower amplifier 435. Thepower amplifier 433 is electrically connected to afirst electrode 418, while thepower amplifier 435 is electrically connected to asecond electrode 420. - The output voltages of each of the
frequency selector 417, theduty cycle selector 419, and themode selector 421 are sampled in a time-division multiplexed fashion by themultiplexer 415. The output of themultiplexer 415 is sampled by the analog-to-digital converter (A/D) 423. Theshift register 425 converts the parallel outputs of the A/D converter 423 to a serial bit stream, which is input to theDSP 413. TheDSP 413 interfaces with thememory 427, which may be a combination of random access memory for storing intermediate calculations and executing a waveform generation program, and a non-volatile FLASH portion of thememory 427, which may store waveforms and/or a program for forming the waveforms. The output of theDSP 413, applies a discrete version of the waveforms to be applied, which is converted to analog form by the D/A converter 429. The output of the D/A converter 429 is fed to thefilter bank 431, which can filter out quantization noise and other distortions. The output of thefilter bank 431 is fed to thepower amplifiers electrodes amplitude selectors - It will be understood that the embodiments described herein are merely exemplary and that a person skilled in the art may make many variations and modifications without departing from the spirit and scope of the invention. All such variations and modifications are intended to be included within the scope of the present invention as defined in the appended claims.
Claims (37)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US12/906,698 US20110071418A1 (en) | 2005-03-18 | 2010-10-18 | Apparatus for diagnosing muscular pain and method of using same |
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US66312505P | 2005-03-18 | 2005-03-18 | |
US11/384,131 US7826900B2 (en) | 2005-03-18 | 2006-03-17 | Apparatus for diagnosing muscular pain and method of using same |
US12/906,698 US20110071418A1 (en) | 2005-03-18 | 2010-10-18 | Apparatus for diagnosing muscular pain and method of using same |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/384,131 Continuation US7826900B2 (en) | 2005-03-18 | 2006-03-17 | Apparatus for diagnosing muscular pain and method of using same |
Publications (1)
Publication Number | Publication Date |
---|---|
US20110071418A1 true US20110071418A1 (en) | 2011-03-24 |
Family
ID=36557516
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/384,131 Expired - Fee Related US7826900B2 (en) | 2005-03-18 | 2006-03-17 | Apparatus for diagnosing muscular pain and method of using same |
US12/906,698 Abandoned US20110071418A1 (en) | 2005-03-18 | 2010-10-18 | Apparatus for diagnosing muscular pain and method of using same |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/384,131 Expired - Fee Related US7826900B2 (en) | 2005-03-18 | 2006-03-17 | Apparatus for diagnosing muscular pain and method of using same |
Country Status (6)
Country | Link |
---|---|
US (2) | US7826900B2 (en) |
EP (2) | EP1861005A1 (en) |
JP (1) | JP2008532713A (en) |
BR (1) | BRPI0609144A2 (en) |
CA (1) | CA2601666A1 (en) |
WO (1) | WO2006102142A1 (en) |
Cited By (19)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20090186321A1 (en) * | 2007-11-30 | 2009-07-23 | Beyo Gmgh | Reading Device for Blind or Visually Impaired Persons |
CN104042212A (en) * | 2013-03-15 | 2014-09-17 | 潘晶 | Non-fixed-contact-type myoelectric acquisition system and myoelectric acquisition method thereof |
WO2015160964A1 (en) * | 2014-04-15 | 2015-10-22 | Norman Marcus | Method and system for muscle pain diagnosis |
US20160038072A1 (en) * | 2014-08-08 | 2016-02-11 | Medtronic Xomed, Inc. | Wireless Nerve Integrity Monitoring Systems and Devices |
EP3007619A4 (en) * | 2013-06-13 | 2017-07-05 | DyAnsys, Inc. | Method and apparatus for autonomic nervous system sensitivity-point testing |
US20170281074A1 (en) * | 2014-09-04 | 2017-10-05 | Active4D, Inc. | Shoulder Monitoring and Treatment System |
US10039915B2 (en) | 2015-04-03 | 2018-08-07 | Medtronic Xomed, Inc. | System and method for omni-directional bipolar stimulation of nerve tissue of a patient via a surgical tool |
US10052257B2 (en) | 2013-06-13 | 2018-08-21 | Dyansys, Inc. | Method and apparatus for stimulative electrotherapy |
US10130275B2 (en) | 2013-06-13 | 2018-11-20 | Dyansys, Inc. | Method and apparatus for autonomic nervous system sensitivity-point testing |
US10339273B2 (en) | 2015-11-18 | 2019-07-02 | Warsaw Orthopedic, Inc. | Systems and methods for pre-operative procedure determination and outcome predicting |
US10445466B2 (en) | 2015-11-18 | 2019-10-15 | Warsaw Orthopedic, Inc. | Systems and methods for post-operative outcome monitoring |
US10849517B2 (en) | 2016-09-19 | 2020-12-01 | Medtronic Xomed, Inc. | Remote control module for instruments |
US11026627B2 (en) | 2013-03-15 | 2021-06-08 | Cadwell Laboratories, Inc. | Surgical instruments for determining a location of a nerve during a procedure |
US11177610B2 (en) | 2017-01-23 | 2021-11-16 | Cadwell Laboratories, ino. | Neuromonitoring connection system |
US11253182B2 (en) | 2018-05-04 | 2022-02-22 | Cadwell Laboratories, Inc. | Apparatus and method for polyphasic multi-output constant-current and constant-voltage neurophysiological stimulation |
US11443649B2 (en) | 2018-06-29 | 2022-09-13 | Cadwell Laboratories, Inc. | Neurophysiological monitoring training simulator |
US11980465B2 (en) | 2015-04-03 | 2024-05-14 | Medtronic Xomed, Inc. | System and method for omni-directional bipolar stimulation of nerve tissue of a patient via a bipolar stimulation probe |
US11992339B2 (en) | 2018-05-04 | 2024-05-28 | Cadwell Laboratories, Inc. | Systems and methods for dynamic neurophysiological stimulation |
EP4291083A4 (en) * | 2021-02-12 | 2024-07-24 | Norman Marcus D/B/A Norman Marcus Pain Inst | Muscle and fascia pain identification by electrical stimulus |
Families Citing this family (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CA2601666A1 (en) * | 2005-03-18 | 2006-09-28 | The Trustees Of The Stevens Institute Of Technology | Apparatus for diagnosing muscular pain and method of using same |
JP2012502699A (en) * | 2008-09-19 | 2012-02-02 | ムーア、テリー・ウィリアム・バートン | Method and device for reducing muscle tension through electrical manipulation |
US8761874B2 (en) * | 2009-10-28 | 2014-06-24 | James M. Mantle | Electro-optical tissue stimulator and method of use |
TR201902855T4 (en) * | 2009-11-05 | 2019-03-21 | Koninklijke Philips Nv | Electrical muscle stimulation. |
US8805519B2 (en) | 2010-09-30 | 2014-08-12 | Nevro Corporation | Systems and methods for detecting intrathecal penetration |
RU2455929C1 (en) * | 2011-02-28 | 2012-07-20 | Федеральное государственное учреждение "Российский научный центр "Восстановительная травматология и ортопедия" имени академика Г.А. Илизарова" Министерства здравоохранения и социального развития Российской Федерации | Method of estimating ischialgia intensity in case of discogenic radicular syndrome |
DE102013102275A1 (en) * | 2012-06-22 | 2013-12-24 | Alan E. Baklayan | Therapy device and method for controlling such |
US9974597B2 (en) * | 2014-03-19 | 2018-05-22 | Boston Scientific Scimed, Inc. | Systems and methods for assessing and treating tissue |
US11089996B2 (en) | 2016-12-14 | 2021-08-17 | Episcan Global, LLC | System and method for the objective evaluation of sympathetic nerve dysfunction |
WO2018209495A1 (en) * | 2017-05-15 | 2018-11-22 | 东莞市棒棒糖电子科技有限公司 | Muscle fatigue monitoring system |
KR102495358B1 (en) * | 2017-09-25 | 2023-02-02 | 삼성전자주식회사 | Neuromimetic stimulating apparatus and method thereof |
HRP20230412T1 (en) | 2018-11-20 | 2023-07-07 | Nuenerchi, Inc. | Electrical stimulation device for applying frequency and peak voltage having inverse relationship |
Citations (33)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4177819A (en) * | 1978-03-30 | 1979-12-11 | Kofsky Harvey I | Muscle stimulating apparatus |
US4431002A (en) * | 1981-06-08 | 1984-02-14 | Empi Inc. | Modulated deep afferent stimulator |
US4580570A (en) * | 1981-01-08 | 1986-04-08 | Chattanooga Corporation | Electrical therapeutic apparatus |
US4667513A (en) * | 1981-03-18 | 1987-05-26 | Konno Yoshio | Method and apparatus for detecting muscle fatigue |
US4697599A (en) * | 1984-04-11 | 1987-10-06 | William Woodley | Apparatus for locating and detecting pain |
US4759368A (en) * | 1986-12-02 | 1988-07-26 | Medical Designs, Inc. | Transcutaneous nerve stimulator |
US5425751A (en) * | 1993-07-30 | 1995-06-20 | Medtronic, Inc. | Method and apparatus for optimum positioning of a muscle stimulating implant |
US5514167A (en) * | 1994-10-24 | 1996-05-07 | Mgb Technologies Corporation | Hand holdable human skin treatment apparatus |
US5558623A (en) * | 1995-03-29 | 1996-09-24 | Rich-Mar Corporation | Therapeutic ultrasonic device |
US5653739A (en) * | 1995-09-13 | 1997-08-05 | Empi, Inc. | Electronic pain feedback system and method |
US5674261A (en) * | 1996-04-03 | 1997-10-07 | Smith; Cleveland S. | S-shaped electrotherapy massage stick |
US5797854A (en) * | 1995-08-01 | 1998-08-25 | Hedgecock; James L. | Method and apparatus for testing and measuring current perception threshold and motor nerve junction performance |
USD403421S (en) * | 1995-03-29 | 1998-12-29 | Rich-Mar Corporation | Ultrasonic applicator |
US5938690A (en) * | 1996-06-07 | 1999-08-17 | Advanced Neuromodulation Systems, Inc. | Pain management system and method |
US6044303A (en) * | 1995-09-13 | 2000-03-28 | Empi Corp. | TENS device with electronic pain intensity scale |
US6146334A (en) * | 1996-01-02 | 2000-11-14 | Laserow; Kay | Measurement of pain |
US6292701B1 (en) * | 1998-08-12 | 2001-09-18 | Medtronic Xomed, Inc. | Bipolar electrical stimulus probe with planar electrodes |
US6330476B1 (en) * | 1996-01-08 | 2001-12-11 | Impulse Dynamics N.V. | Electrical muscle controller using a non-excitatory electric field |
US20020042590A1 (en) * | 1997-11-20 | 2002-04-11 | Hubbard David R. | Multi electrode and needle injection device for diagnosis and treatment of muscle injury and pain |
US6393328B1 (en) * | 2000-05-08 | 2002-05-21 | International Rehabilitative Sciences, Inc. | Multi-functional portable electro-medical device |
US6432063B1 (en) * | 1999-06-14 | 2002-08-13 | Norman Marcus Pain Institute | Method for direct diagnosis and treatment of pain of muscular origin |
US6445955B1 (en) * | 1999-07-08 | 2002-09-03 | Stephen A. Michelson | Miniature wireless transcutaneous electrical neuro or muscular-stimulation unit |
US20030045808A1 (en) * | 1999-11-24 | 2003-03-06 | Nuvasive, Inc. | Nerve proximity and status detection system and method |
US6584358B2 (en) * | 2000-01-07 | 2003-06-24 | Biowave Corporation | Electro therapy method and apparatus |
US20030171785A1 (en) * | 2002-02-11 | 2003-09-11 | Michael Duncan | Distributed functional electrical stimulation system |
US6692444B2 (en) * | 1997-07-01 | 2004-02-17 | Neurometrix, Inc. | Methods for the assessment of neuromuscular function by F-wave latency |
US6757558B2 (en) * | 2000-07-06 | 2004-06-29 | Algodyne, Ltd. | Objective pain measurement system and method |
US20040126746A1 (en) * | 2000-10-23 | 2004-07-01 | Toly Christopher C. | Medical physiological simulator including a conductive elastomer layer |
US20040236221A1 (en) * | 1999-05-03 | 2004-11-25 | Access Wellness And Physical Therapy | Soft tissue diagnostic apparatus and method |
US20040254610A1 (en) * | 2003-06-13 | 2004-12-16 | Hsin-Yi Lin | Miniature pocket electric stimulator |
US6871100B2 (en) * | 2000-12-23 | 2005-03-22 | Q Science Ltd | Apparatus for the diagnosis and therapy of neuro-muscular and other tissue disorders |
US20050154329A1 (en) * | 2003-12-16 | 2005-07-14 | Terumo Kabushiki Kaisha | Pain measurement system and method of measuring pain |
US7826900B2 (en) * | 2005-03-18 | 2010-11-02 | The Trustees Of The Stevens Institute Of Technology | Apparatus for diagnosing muscular pain and method of using same |
Family Cites Families (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0158336A3 (en) | 1984-04-11 | 1987-08-19 | William E. Woodley | Apparatus for locating and detecting pain |
DE4206245A1 (en) | 1992-02-28 | 1993-09-02 | Brudermueller Gmbh Handel Impo | Electrical contact esp. for therapeutic application to body - has conductive ceramic, rubber or plastic electrode pluggable into tip or underside of finger-stall |
JP2000342690A (en) * | 1999-06-09 | 2000-12-12 | Nippon Colin Co Ltd | Anesthetic depth monitoring device |
SE9902960D0 (en) * | 1999-08-20 | 1999-08-20 | Cefar Medical Ab | Apparatus for providing an indication of a sensation |
JP2002000613A (en) * | 2000-06-23 | 2002-01-08 | Munetaka Haida | Ultrasonic stimulation device |
JP2003126055A (en) * | 2001-10-19 | 2003-05-07 | Gosuke Muteki | Impedance measuring device for meridian |
US6887239B2 (en) * | 2002-04-17 | 2005-05-03 | Sontra Medical Inc. | Preparation for transmission and reception of electrical signals |
JP2004154481A (en) * | 2002-11-08 | 2004-06-03 | Osaka Industrial Promotion Organization | Muscle fatigue degree measuring device or method |
-
2006
- 2006-03-17 CA CA002601666A patent/CA2601666A1/en not_active Abandoned
- 2006-03-17 WO PCT/US2006/009840 patent/WO2006102142A1/en active Application Filing
- 2006-03-17 BR BRPI0609144-0A patent/BRPI0609144A2/en not_active IP Right Cessation
- 2006-03-17 EP EP06738844A patent/EP1861005A1/en not_active Withdrawn
- 2006-03-17 US US11/384,131 patent/US7826900B2/en not_active Expired - Fee Related
- 2006-03-17 EP EP09176229A patent/EP2156789A1/en not_active Withdrawn
- 2006-03-17 JP JP2008502117A patent/JP2008532713A/en active Pending
-
2010
- 2010-10-18 US US12/906,698 patent/US20110071418A1/en not_active Abandoned
Patent Citations (35)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4177819A (en) * | 1978-03-30 | 1979-12-11 | Kofsky Harvey I | Muscle stimulating apparatus |
US4580570A (en) * | 1981-01-08 | 1986-04-08 | Chattanooga Corporation | Electrical therapeutic apparatus |
US4667513A (en) * | 1981-03-18 | 1987-05-26 | Konno Yoshio | Method and apparatus for detecting muscle fatigue |
US4431002A (en) * | 1981-06-08 | 1984-02-14 | Empi Inc. | Modulated deep afferent stimulator |
US4697599A (en) * | 1984-04-11 | 1987-10-06 | William Woodley | Apparatus for locating and detecting pain |
US4759368A (en) * | 1986-12-02 | 1988-07-26 | Medical Designs, Inc. | Transcutaneous nerve stimulator |
US5425751A (en) * | 1993-07-30 | 1995-06-20 | Medtronic, Inc. | Method and apparatus for optimum positioning of a muscle stimulating implant |
US5514167A (en) * | 1994-10-24 | 1996-05-07 | Mgb Technologies Corporation | Hand holdable human skin treatment apparatus |
USRE36260E (en) * | 1994-10-24 | 1999-07-27 | Mgb Technologies Corp. | Hand holdable human skin treatment apparatus |
US5558623A (en) * | 1995-03-29 | 1996-09-24 | Rich-Mar Corporation | Therapeutic ultrasonic device |
USD403421S (en) * | 1995-03-29 | 1998-12-29 | Rich-Mar Corporation | Ultrasonic applicator |
US5797854A (en) * | 1995-08-01 | 1998-08-25 | Hedgecock; James L. | Method and apparatus for testing and measuring current perception threshold and motor nerve junction performance |
US5653739A (en) * | 1995-09-13 | 1997-08-05 | Empi, Inc. | Electronic pain feedback system and method |
US6044303A (en) * | 1995-09-13 | 2000-03-28 | Empi Corp. | TENS device with electronic pain intensity scale |
US6146334A (en) * | 1996-01-02 | 2000-11-14 | Laserow; Kay | Measurement of pain |
US6330476B1 (en) * | 1996-01-08 | 2001-12-11 | Impulse Dynamics N.V. | Electrical muscle controller using a non-excitatory electric field |
US5674261A (en) * | 1996-04-03 | 1997-10-07 | Smith; Cleveland S. | S-shaped electrotherapy massage stick |
US5938690A (en) * | 1996-06-07 | 1999-08-17 | Advanced Neuromodulation Systems, Inc. | Pain management system and method |
US6692444B2 (en) * | 1997-07-01 | 2004-02-17 | Neurometrix, Inc. | Methods for the assessment of neuromuscular function by F-wave latency |
US20020042590A1 (en) * | 1997-11-20 | 2002-04-11 | Hubbard David R. | Multi electrode and needle injection device for diagnosis and treatment of muscle injury and pain |
US6678550B2 (en) * | 1997-11-20 | 2004-01-13 | Myolink, Llc | Multi electrode and needle injection device for diagnosis and treatment of muscle injury and pain |
US6292701B1 (en) * | 1998-08-12 | 2001-09-18 | Medtronic Xomed, Inc. | Bipolar electrical stimulus probe with planar electrodes |
US20040236221A1 (en) * | 1999-05-03 | 2004-11-25 | Access Wellness And Physical Therapy | Soft tissue diagnostic apparatus and method |
US6432063B1 (en) * | 1999-06-14 | 2002-08-13 | Norman Marcus Pain Institute | Method for direct diagnosis and treatment of pain of muscular origin |
US6445955B1 (en) * | 1999-07-08 | 2002-09-03 | Stephen A. Michelson | Miniature wireless transcutaneous electrical neuro or muscular-stimulation unit |
US20030045808A1 (en) * | 1999-11-24 | 2003-03-06 | Nuvasive, Inc. | Nerve proximity and status detection system and method |
US6584358B2 (en) * | 2000-01-07 | 2003-06-24 | Biowave Corporation | Electro therapy method and apparatus |
US6393328B1 (en) * | 2000-05-08 | 2002-05-21 | International Rehabilitative Sciences, Inc. | Multi-functional portable electro-medical device |
US6757558B2 (en) * | 2000-07-06 | 2004-06-29 | Algodyne, Ltd. | Objective pain measurement system and method |
US20040126746A1 (en) * | 2000-10-23 | 2004-07-01 | Toly Christopher C. | Medical physiological simulator including a conductive elastomer layer |
US6871100B2 (en) * | 2000-12-23 | 2005-03-22 | Q Science Ltd | Apparatus for the diagnosis and therapy of neuro-muscular and other tissue disorders |
US20030171785A1 (en) * | 2002-02-11 | 2003-09-11 | Michael Duncan | Distributed functional electrical stimulation system |
US20040254610A1 (en) * | 2003-06-13 | 2004-12-16 | Hsin-Yi Lin | Miniature pocket electric stimulator |
US20050154329A1 (en) * | 2003-12-16 | 2005-07-14 | Terumo Kabushiki Kaisha | Pain measurement system and method of measuring pain |
US7826900B2 (en) * | 2005-03-18 | 2010-11-02 | The Trustees Of The Stevens Institute Of Technology | Apparatus for diagnosing muscular pain and method of using same |
Cited By (44)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8113841B2 (en) * | 2007-11-30 | 2012-02-14 | Beyo Gmbh | Reading device for blind or visually impaired persons |
US20090186321A1 (en) * | 2007-11-30 | 2009-07-23 | Beyo Gmgh | Reading Device for Blind or Visually Impaired Persons |
CN104042212A (en) * | 2013-03-15 | 2014-09-17 | 潘晶 | Non-fixed-contact-type myoelectric acquisition system and myoelectric acquisition method thereof |
US11026627B2 (en) | 2013-03-15 | 2021-06-08 | Cadwell Laboratories, Inc. | Surgical instruments for determining a location of a nerve during a procedure |
US10052257B2 (en) | 2013-06-13 | 2018-08-21 | Dyansys, Inc. | Method and apparatus for stimulative electrotherapy |
EP3007619A4 (en) * | 2013-06-13 | 2017-07-05 | DyAnsys, Inc. | Method and apparatus for autonomic nervous system sensitivity-point testing |
US10130275B2 (en) | 2013-06-13 | 2018-11-20 | Dyansys, Inc. | Method and apparatus for autonomic nervous system sensitivity-point testing |
CN108433705A (en) * | 2013-06-13 | 2018-08-24 | 迪彦希斯有限公司 | Method and apparatus for the test of autonomic nerves system sensitive spot |
WO2015160964A1 (en) * | 2014-04-15 | 2015-10-22 | Norman Marcus | Method and system for muscle pain diagnosis |
US11801005B2 (en) | 2014-08-08 | 2023-10-31 | Medtronic Xomed, Inc. | Wireless sensors for nerve integrity monitoring systems |
US20160038072A1 (en) * | 2014-08-08 | 2016-02-11 | Medtronic Xomed, Inc. | Wireless Nerve Integrity Monitoring Systems and Devices |
US9918669B2 (en) * | 2014-08-08 | 2018-03-20 | Medtronic Xomed, Inc. | Wireless nerve integrity monitoring systems and devices |
US10123731B2 (en) * | 2014-08-08 | 2018-11-13 | Medtronic Xomed, Inc. | Wireless sensors for nerve integrity monitoring systems |
US20160038073A1 (en) * | 2014-08-08 | 2016-02-11 | Medtronic Xomed, Inc. | Wireless Sensors for Nerve Integrity Monitoring Systems |
US11583219B2 (en) | 2014-08-08 | 2023-02-21 | Medtronic Xomed, Inc. | Wireless stimulation probe device for wireless nerve integrity monitoring systems |
US10368793B2 (en) | 2014-08-08 | 2019-08-06 | Medtronic Xomed, Inc. | Wireless nerve integrity monitoring systems and devices |
US10398369B2 (en) | 2014-08-08 | 2019-09-03 | Medtronic Xomed, Inc. | Wireless stimulation probe device for wireless nerve integrity monitoring systems |
US11638549B2 (en) | 2014-08-08 | 2023-05-02 | Medtronic Xomed, Inc. | Wireless nerve integrity monitoring systems and devices |
US11696719B2 (en) | 2014-08-08 | 2023-07-11 | Medtronic Xomed, Inc. | Wireless sensors for nerve integrity monitoring systems |
US20170281074A1 (en) * | 2014-09-04 | 2017-10-05 | Active4D, Inc. | Shoulder Monitoring and Treatment System |
US11872051B2 (en) * | 2014-09-04 | 2024-01-16 | Active4D, Inc. | Shoulder monitoring and treatment system |
US20210267537A1 (en) * | 2014-09-04 | 2021-09-02 | Active4D, Inc. | Shoulder monitoring and treatment system |
US11064936B2 (en) * | 2014-09-04 | 2021-07-20 | Active4D, Inc. | Shoulder monitoring and treatment system |
US11980465B2 (en) | 2015-04-03 | 2024-05-14 | Medtronic Xomed, Inc. | System and method for omni-directional bipolar stimulation of nerve tissue of a patient via a bipolar stimulation probe |
US10987506B2 (en) | 2015-04-03 | 2021-04-27 | Medtronic X omed, Inc. | System and method for omni-directional bipolar stimulation of nerve tissue of a patient via a surgical tool |
US10039915B2 (en) | 2015-04-03 | 2018-08-07 | Medtronic Xomed, Inc. | System and method for omni-directional bipolar stimulation of nerve tissue of a patient via a surgical tool |
US11980752B2 (en) | 2015-04-03 | 2024-05-14 | Medtronic Xomed, Inc. | System and method for omni-directional bipolar stimulation of nerve tissue of a patient via a surgical tool |
US10665337B2 (en) | 2015-11-18 | 2020-05-26 | Warsaw Orthopedic, Inc. | Systems and methods for pre-operative procedure determination and outcome predicting |
US10445466B2 (en) | 2015-11-18 | 2019-10-15 | Warsaw Orthopedic, Inc. | Systems and methods for post-operative outcome monitoring |
US11200981B2 (en) | 2015-11-18 | 2021-12-14 | Warsaw Orthopedic, Inc. | Systems and methods for pre-operative procedure determination and outcome predicting |
US10339273B2 (en) | 2015-11-18 | 2019-07-02 | Warsaw Orthopedic, Inc. | Systems and methods for pre-operative procedure determination and outcome predicting |
US11749409B2 (en) | 2015-11-18 | 2023-09-05 | Warsaw Orthopedic, Inc. | Systems and methods for post-operative outcome monitoring |
US11145415B2 (en) | 2015-11-18 | 2021-10-12 | Warsaw Orthopedic, Inc. | Systems and methods for post-operative outcome monitoring |
US11942217B2 (en) | 2015-11-18 | 2024-03-26 | Warsaw Orthopedic, Inc. | Systems and methods for pre-operative procedure determination and outcome predicting |
US11998337B2 (en) | 2016-09-19 | 2024-06-04 | Medtronic Xomed, Inc. | Remote control module for instruments |
US10849517B2 (en) | 2016-09-19 | 2020-12-01 | Medtronic Xomed, Inc. | Remote control module for instruments |
US11949188B2 (en) | 2017-01-23 | 2024-04-02 | Cadwell Laboratories, Inc. | Methods for concurrently forming multiple electrical connections in a neuro-monitoring system |
US11177610B2 (en) | 2017-01-23 | 2021-11-16 | Cadwell Laboratories, ino. | Neuromonitoring connection system |
US11992339B2 (en) | 2018-05-04 | 2024-05-28 | Cadwell Laboratories, Inc. | Systems and methods for dynamic neurophysiological stimulation |
US11253182B2 (en) | 2018-05-04 | 2022-02-22 | Cadwell Laboratories, Inc. | Apparatus and method for polyphasic multi-output constant-current and constant-voltage neurophysiological stimulation |
US11998338B2 (en) | 2018-05-04 | 2024-06-04 | Cadwell Laboratories, Inc. | Systems and methods for dynamically switching output port cathode and anode designations |
US11978360B2 (en) | 2018-06-29 | 2024-05-07 | Cadwell Laboratories, Inc. | Systems and methods for neurophysiological simulation |
US11443649B2 (en) | 2018-06-29 | 2022-09-13 | Cadwell Laboratories, Inc. | Neurophysiological monitoring training simulator |
EP4291083A4 (en) * | 2021-02-12 | 2024-07-24 | Norman Marcus D/B/A Norman Marcus Pain Inst | Muscle and fascia pain identification by electrical stimulus |
Also Published As
Publication number | Publication date |
---|---|
US7826900B2 (en) | 2010-11-02 |
BRPI0609144A2 (en) | 2010-02-17 |
WO2006102142A1 (en) | 2006-09-28 |
JP2008532713A (en) | 2008-08-21 |
EP1861005A1 (en) | 2007-12-05 |
EP2156789A1 (en) | 2010-02-24 |
US20060224210A1 (en) | 2006-10-05 |
CA2601666A1 (en) | 2006-09-28 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US7826900B2 (en) | Apparatus for diagnosing muscular pain and method of using same | |
US20220143392A1 (en) | Nerve stimulation apparatus and method | |
AU2015243083B2 (en) | Non-invasive neuro stimulation system | |
US5797854A (en) | Method and apparatus for testing and measuring current perception threshold and motor nerve junction performance | |
EP0164016B1 (en) | Apparatus for treating neurovegatative disorders | |
US20070293917A1 (en) | Non-invasive neuro stimulation system | |
EP2510875A3 (en) | Treatment apparatus for applying electrical impulses to the body of a patient | |
JP2002345979A (en) | Pulse giving health instrument | |
WO2014127091A1 (en) | Transcranial ultrasound systems | |
US20120089206A1 (en) | Device using light energy to excite brain waves and method using the same | |
CN105592789B (en) | Method and apparatus for the test of autonomic nerves system sensitive spot | |
KR20180094541A (en) | Rehabilitation treatment device | |
CA2398530A1 (en) | Electrical stimulation apparatus and method | |
US20220184395A1 (en) | Current stimulation apparatus | |
RU103733U1 (en) | INSTALLATION FOR DIAGNOSIS AND TREATMENT OF THE PATIENT | |
WO2021177151A1 (en) | Beauty device, beauty device set, and beautification method | |
KR20160073112A (en) | Low-frequency stimulation for relaxation | |
US20070078482A1 (en) | Method and apparatus for pain management | |
US20200107748A1 (en) | Probe having multiple tips and an indicator for obtaining bioelectrical signals | |
CN109745671B (en) | Device for assisting active rehabilitation of elbow joint fracture | |
US20100324627A1 (en) | Method and apparatus for resistivity measurement, detection and treatment in living tissue | |
Arendt-Nielsen et al. | Electrophysiological assessment of pain | |
SE1551094A1 (en) | Device and method for generating sensory stimuli for the evaluation of neuropathy | |
JP3101753U (en) | Qigong tools | |
KR20050010215A (en) | Low frequency medical apparatus synchronized with skin resistance value and heart beat |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: THE TRUSTEES OF THE STEVENS INSTITUTE OF TECHNOLOG Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:STELLAR, RYAN M.;SHAH, JECKIN;REEL/FRAME:025765/0703 Effective date: 20060509 |
|
AS | Assignment |
Owner name: THE TRUSTEES OF THE STEVENS INSTITUTE OF TECHNOLOG Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:STELLAR, RYAN M.;SHAH, JECKIN;SILVA, DANIEL;AND OTHERS;SIGNING DATES FROM 20060509 TO 20060605;REEL/FRAME:027664/0890 |
|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |