| WHAT IS THE DIFFERENCE BETWEEN TRADITIONAL TREATMENT
AND THE ARP TREATMENT PHILOSOPHY? |
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PRINCIPLES OF ARP WAVE TREATMENT OF INJURY
ARP treatment of injury attacks the last phase
in the progression first. Maximal attention is paid to eliminating
nonproductive compensation patterns.
Application of the ARP wave allows the identification of muscles producing
the primary component of the compensation. Current is applied producing
an overload of those muscles and a subsequent detraining of the compensation.
Normal motor patterns are established early, eliminating the imprinting
of nonproductive compensation.
The combination of this detraining and the unique
effects of the ARP wave allows all 4 phases in the progression
to be treated simultaneously producing accelerated recovery:
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WHY DOES THE ARP TREATMENT WORK FASTER?
IT ELIMINATES QUICKLY THE NON PRODUCTIVE RESPONSES TO INJURY. |
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ARP:
The electrical stimulation device (the ARP) possesses specification characteristics
that are not found in any conventional therapeutic neuromuscular
electrical stimulator (interferential, microcurrent, galvanic, Russian
stim, iontophoresis).
The ARP uses direct current (DC) compounded with a high frequency double
exponential, patented background waveform. This background wave is harmonious
with the body and significantly reduces skin and fatty tissue impedance
allowing much deeper penetration of the direct current without the side
effects of skin burning.
Also, the unique waveform produces minimal inhibitory protective muscle
contractions allowing active range of motion during therapy and training.
This permits eccentric (lengthening) contractions to occur which are
critical to treatment.
TECHNICAL SPECIFICATIONS:
- Wave Form
Compound, double exponential asymmetric with high levels of direct
current.
- Power
High power with NO surface burning or surface pain at 0 to 2.5 watts.
- Main Pulse
40 to 500 pulses per second.
- Background Frequency
High-frequency carrier signal at 10,000 cycles per second. Polarity
Direction of electron flow is reversible.
- Depth of Penetration
Deepest soft tissue penetration resonates with the human system, causing
the body's natural resistance to drop out.
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ARP:
ARP treatment, however, is not defined simply by the device being used. ARP
protocols have been carefully created to enhance the tissue effects of the
ARP neuromuscular stimulator. By reducing inhibitory protective muscle contractions,
the protocols allow more voltage output to be delivered to the treated tissue.
Once maximum voltage is delivered, unique methodologies in strength training
are then used to accelerate recovery to injury, surgery, and training as well
as to improve performance.
Although the ARP can be used like a standard neuromuscular electrical stimulator
with standard physical therapy and strength training methods, the unique characteristics
of the device are best elicited and the subsequent response to treatment are
maximized when used in conjunction with the specific ARP protocols.
CUSTOMIZATION:
- ARPwave has designed hundreds of specific protocols
developed to treat a wide range of muscle injuries.
- Custom Protocols can also be designed to your specific
needs and requirements.
- Whether you need specific protocols to treat a muscle
injury or one designed to help you maximize perfromance in a particular
sport, we can help.
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ARP:
What is truly unique is that there is a seamless transition from the
treatment of muscle injury and training for elite competition.
The methodologies used initially for rehabilitation
are simply part of a progression that is expanded appropriately
to high intensity strength and speed training (ultra fit training).
Ultra fit training has been meticulously constructed
to decrease further risk of injury while at the same time producing
exponential gains in baseline strength and speed (supercompensation).
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INJURY & PAIN:
ARP treatment is indicated for the treatment of all muscle related injuries.
- Relaxation of muscle spasms,
- Prevention and retardation of disuse atrophy,
- Increase of local blood circulation,
- Muscle re-education,
- Maintaining and increasing range of motion.
Post-surgical Rehabilitation
ARP protocols can also be specifically used with the ARP to accelerate
muscle rehabilitation of the following:
- Shoulder
- Elbow
- Wrist
- Hip
- Knee
- Ankle
- Foot
- Cervical and Lumbar spine
Pre-training and Recovery:
For patients involved in recreational and competitive
athletics, as well as elite strength and speed training, the
ARP is used to relax muscle spasm and promote muscle elongation
while also increasing blood flow.
When used prior to competition or training, this
effect will reduce the risk of muscular injury and optimize muscle
function.
When used post competition or training, the effect aids recovery by reducing
muscle shortening from repetitive concentric contraction and also decreases
delayed onset muscle soreness.
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ARP:
Treatment with the ARP is contraindicated in those
patients with:
- Cancer
- Epilepsy
- Implanted electrical devices (ex. pacemakers)
- Pregnancy
- Autoimmune disorders (e.g. lupus)
- History of fainting spells
- Current menstruation
- Recent (within 4 weeks of) corticosteroid injection
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The Science behind ARP:
The conservative treatment of many soft tissue and joint inflammatory conditions
have been a source of frustration for health care practitioners. Despite
the most modern techniques and equipment in rehabilitation, the course and
length of time for healing can be both long and arduous. The frustration
lies in the fact that the underlying pathology is usually not severe enough
to warrant surgical intervention, yet conservative treatment regimens can
fall short of restoring full, painless, active function in a timely fashion.
The ARP program was conceived out of this frustration. It’s growth process
has been filled with passion and serendipity and continues to expand.
Electrotherapy is a complex field comprised of many different types
of devices with a multitude of currents, waveforms, frequencies, amplitudes,
durations, phases and pulse charges. The reason for such a myriad of
devices may be inferred from a general rule in medicine that the number
of alternatives or devices available for treatment of a condition are
usually inversely proportional to their effectiveness. Because present
models insufficiently addressed the current treatment problems, a new
approach was needed.
The new approach was based on the observation that most of the basic science
research documenting the positive effects of electricity with tissue and bone
healing was done with direct current. Direct current was shown to produce increased
motility of reparative cells and to promote bone production in fractures. These
landmark findings were made in the 1960’s, 70’s, and 80’s.
The basic science was quite clear – direct current promotes dramatic
effects in both tissue and bone for healing. Clinically, however, it was difficult
to apply direct current for treatment without a high degree of discomfort.
During the mid 1980’s, the leading manufacturers of electrical stimulation
devices began using alternating current which could be applied with much greater
ease. The scientific data on cellular response to alternating current, however,
was lacking. The clinical results with devices using alternating current have
been only adequate (and refer back to the references in "Scientific Basis").
The technology for the ARP was designed to apply the dramatic cellular
effects of direct current to clinical use and strength training. To accomplish
this, a high frequency, double exponential background wave was linked
to the direct current. The net effect was a reduction in skin and fatty
tissue impedance, allowing deeper penetration of the direct current,
and decreasing pain and irritation at the electrode sites. Direct current
could now be applied in ways previously not possible.
At the same time that the technology for what would later be called
the ARP was being developed by Gary Thomas, Denis Thompson, an American
exercise physiologist, was passionately researching ways to relieve muscle
spasm. Denis had done extensive research on Yakov Kots, an exercise physiologist
for the Soviet Olympic program. In his work with Kots’ theories,
Denis became well versed in Soviet training methods using high voltage
electrical stimulation. He witnessed extraordinary gains in muscular
size and strength by Russian Olympic athletes using Kots’ Stimul
1 electrical stimulator. Like all devices of that time, the Stimul 1
often caused severe skin burns and was quite painful. Also, during treatment,
the muscles could not be elongated. In order for movement to occur at
the joint, the unit had to be turned off.
After extensive experience with Kots’ training methods including
the use of Stimul 1, Denis was convinced that an electrical stimulation
device could be developed that would allow a muscle to elongate and relieve
muscle spasm. Through the Tesla Society, Denis was introduced to Gary
Thomas, the creator of the technology for the ARP. Testing was performed
for 2 years before methods were perfected to relieve muscle spasm after
injury.
Despite the technological advances of the ARP, patients would still
involuntarily contract surrounding musculature during treatment, therefore
limiting the amount of direct current that could be applied. Denis then
found that if specific movements were performed after a patient reached
what he perceived as the maximum voltage tolerable, a relaxation response
occurred and the voltage could be increased further. As this technique
was perfected, a proportional relationship was noted between the rate
of healing of the injured tissue and the voltage output delivered to
it. The combined technique of delivering high voltage direct current
to injured tissue being actively moved through a full range of motion
yielded dramatic, accelerated healing and strength.
Shortly thereafter, Denis became intrigued with the training methods
of Jay Schroeder who gained national notoriety after the success of one
of his athletes’s, Adam Archuleta. Archuleta was selected in the
first round of the 2002 NFL draft by the St. Louis Rams, after beginning
his career as a walk on safety at Arizona State University. What gained
national attention were the techniques used by Jay to develop Archuleta
over a 4 year time. Archuleta was able to accomplish extraordinary feats
of strength and speed for an athlete born with average ability. Adam
was essentially a product of an elaborate system of training designed
to elicit specific traits necessary for athletic mastery.
Jay partnered with Denis to apply these training techniques in rehabilitation.
The training techniques elicited traits in the neuromuscular system that
were augmented by the simultaneous application of direct current through
the ARP. The ARP program thus consisted of application of the ARP with
specific movement protocols to relieve pain from injury followed by strength
and speed training methods performed in conjunction with the ARP to prevent
recurrence. Once pre injury status was achieved, the strength and speed
training methods were further intensified to achieve athletic mastery.
The program was seamless, from the most elementary level of training
post injury and post surgery to elite level training for maximum performance.
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ARP Results:
Outcomes for ARP treatment have been based, thus
far, on retrospective clinical observations. Randomized, double
blinded, prospective studies have been initiated for the treatment
of ankle sprains, hamstring injuries, and distal radius fractures.
The hypotheses for these prospective studies is that ARP treatment
will yield recovery rates 60% to 80% faster than for traditional
conservative treatment.
The basis for these hypotheses is the large retrospective
clinical data on ARP treatment over the past 5 years. In general,
recovery rates for acute soft tissue injury have been 60% to
80% shorter than the predicted clinical outcome. Specific examples
include grade II lateral ankle sprains, and grade II acute hamstring
injury.
Athletes sustaining grade II lateral ankle sprains (partial ligament
tear with moderate swelling and ecchymosis and limited weight bearing
ability) treated with 6 to 10 ARP sessions, and no other conservative
treatment except supportive bracing, had an average recovery rate and
return to play at 3 to 5 days post injury. Athletes sustaining grade
II hamstring injuries (1-2cm soft tissue defect with associated ecchymosis
and inability to walk without limp) treated also with 6 to 10 ARP sessions,
without other modalities, had an average recovery rate and return to
play at 8 to 12 days post injury.
These accelerated recovery rates also extrapolated to the more severe
grade III injuries, as well as chronic soft tissue tendinopathies. In
many cases of chronic tendinopathy, all other conservative measures were
exhausted, without relief of symptoms, before ARP treatment was initiated.
The ARP experience has produced a sense of astonishment among both the
practitioner and the patient. Undoubtedly, prospective data will be required
to corroborate these retrospective findings, but it is certainly clear
that the rate of acceleration in healing has been dramatic. |
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ARP:
The cellular processes of tissue and bone healing
are complex and multifactorial. The scientific basis for ARP
treatment is the positive cellular effects of direct current
electrical fields on these processes. Direct current has been
shown to affect cellular migration and orientation, endothelialization,
protein synthesis, and calcium regulation, as well as stimulation
of new bone formation and fracture healing.(4,6,7,10,18,19,21,22,24,25)
The initial response after injury is coagulation
modulated by plasma platelet cells that form fibrin clots to
stop bleeding. The clots attract polymorphonuclear neutrophils
(PMNs) and fibroblasts that, in turn, adhere to the clots forming
a fibrin gel. The PMNs consume bacteria and wound debris by secreting
proteases.
Platelets also release growth factors that attract
monocytes to the site of injury. Monocytes mature into macrophages
that become the controlling cells in tissue healing. Macrophages
continue the process of bacteria phagocytosis and cleaning of
wound debris and also secrete growth factors that attract and
activate fibroblasts.
Fibroblasts proliferate and migrate, and produce
a collagen matrix. Concomitantly, endothelial cells migrate to
the collagen matrix to produce new blood vessels in this matrix.
Granulation tissue is formed composed of fibroblasts, endothelial
cells, PMNs, and a collagen matrix.
Direct current electrical fields can modulate a
number of factors involved in the healing response. A major process
that is affected by direct current is cellular migration and
orientation. Cooper and Keller, working with amphibian neural
crest cells exposed to a direct current field, demonstrated a
migration of cells towards the cathode with a resultant perpendicular
cellular orientation.(7) In further studies, Cooper and Schliwa
concluded that cell locomotion could be controlled with manipulation
of the direct current field.(8) This process, called galvanotaxis,
has been demonstrated also in neutrophils, macrophages, and fibroblasts.(10,18,21,22,23)
Direct current can also produce changes in endothelialization.
Nannmark et al reported an increased permeability to macromolecules,
and changes in capillary permeability to white blood cells with
exposure to low levels of direct current.(19) Direct current
can affect the migration of endothelial cells in vitro.(24)
Intracellular processes are also affected by exposure
to direct current. Cheng et al established that relatively low
levels of direct current can raise the adenosine triphosphate
(ATP) level almost 500 % and increase protein synthesis and membrane
transport.(6) Bourguignon et al demonstrated an uncapping of
insulin receptors on the cell membrane and enhancement of protein
and DNA synthesis within the first minute after direct current
stimulation.(4)
New bone formation and fracture healing are positively
affected by the application of a direct current electrical field.(11,12,14,17)
The net effect of direct current on bone is an increase in osteoblastic
activity and new bone formation around the cathode. These effects
are optimally demonstrated with a current level of 5 to 20 micro
amps. Studies have shown increased spinal fusion rates, and increased
healing of fracture nonunions.(5,9,13)
The scientific basis for the use of direct current
stimulation in tissue healing has long been established. The
clinical problem has been in the application of the direct current
without severe discomfort and skin damage. With precise application
of an ingenious, patented background waveform, ARP technology
allows clinically appropriate levels of direct current to be
delivered to tissues safely.
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References:
ARP is the culmination of an immense body of research comprising the
science behind the technology:
1. Bassett CAL, Hermann I. The effect of electrostatic fields on macromolecular
synthesis by fibroblasts in vitro. J Cell Biol, 329: 9, 1968.
2. Borgens RB, Vanable JW, Jaffe LF. Bioelectricity and regeneration. Large
currents leave the stumps of regenerating newt limbs. Proc Natl Acad Sci USA,
74: 4528-4532, 1977.
3. Borgens RB, Chapter 5: Integumentary potentials and Wound Healing in Electric
Fields in Vertebrate Repair: Natural and Applied Voltages in Vertebrate Regeneration
and Healing. Borgens RB, Robinson KR, Vanable JW, McGinis ME, McCaig CD (eds).
New York, NY, Alan R. Liss, pp 171-224, 1989.
4. Bourguignon GJ, Wenche JY, and Bourguignon L. Electrical stimulation of
human fibroblasts cause an increase in calcium influx and the exposure of additional
insulin receptors. J Cellular Physiology, 140: 379-385,1989.
5. Brighton CT. Current concepts review: The treatment of nonunions with electricity.
J Bone Joint Surg, 62A: 847-851, 1981.
6. Cheng N, et al. The effect of electrocurrents on ATP generation protein
synthesis, and membrane transport in rat skin. Clinical Orthopedics, 171: 264-272,
1982.
7. Cooper MS, Keller RE. Perpendicular orientation and directional migration
of amphibian neural crest cells in DC electric fields. Proc Natl Acad Sci USA,
81: 160-164, 1985.
8. Cooper MS, Schliwa M. Electrical and ionic controls of tissue cell locomotion
in DC electric fields. J. Neurosci Res, 13: 223-244, 1985.
9. Dwyer AF, Wickham GG. Direct current stimulation in spinal fusion. Med J
Aust, 1: 73-75, 1974.
10. Erickson CA, Nuccitelli RL. Embryonic cell motility can be guided by physiological
electric fields. J Cell Biol, 98: 296-307, 1984.
11. Friedenberg ZB, Kohanim M. The effect of direct current on bone. Surg Gynecol
Obstet, 131: 894-899, 1970.
12. Friedenberg ZB, Andrews ET, Smolenski BI et al. Bone reaction to varying
amounts of direct current, Surg Gynecol Obstet, 131: 894-899, 1970.
13. Friedenberg ZB, Harlow MC, Brighton CT. Healing of nonunion of medial malleolus
by means of direct current: a case report. J Trauma, 11: 883-885, 1971.
14. Friedenberg ZB, Roberts PG, Didizian NH, Brighton CT. Stimulation of fracture
healing by direct current in the rabbit fibula. J Bone Joint Surg, 53A: 1400-1408,
1971.
15. Goh JCH, Bose K, Kang YK, Nugroho B. Effects of electrical stimulation
on biomechanical properties of fracture healing in rabbits. Clin Orthop, 233:
268-273, 1988.
16. Illingworth CM, Baker AT. Measurement of electrical currents emerging during
the regeneration of amputated finger tips in children. Clin Phys Physiol Meas,
1: 87, 1980.
17. Lavine LS, Lustrin I, Shamos M, Moss ML. The influence of electric current
on bone regeneration in vivo. Acta Orthop Scand, 42: 305-314, 1971.
18. Luther PW, Peng HB, Lin JC. Changes in cell shape and action distribution
induced by constant electrical fields. Nature, 303: 61-64, 1985.
19.Nannmark U, Buch F, Albrektsson T. Vascular reactions during electrical
stimulation. Vital microscopy of the hamster cheek pouch and the rabbit tibia.
Acta Orthop Scand, 56: 52-56, 1985.
20. Nessler JP, Mass DP. Direct current electrical stimulation of tendon healing
in vitro. Clinical Orthpedics, 217: 303 -308, 1985.
21. Orida N, Feldman JHD. Directional protrusive psudopodial activity and motility
in macrophages induced by extracellular electric fields. Cell Motility, 2:
243-255, 1982.
22. Nucatelli R, Erickson Ca. Embryonic cell motility can be guided by physiologic
electric fields. Exp Cell Res, 147: 195-201, 1983.
23. Pethig R, Kell DB. The passive electrical properties of biologic systems:
their significance in physiology, biophysics, and biotechnology. Phys Med Biol,
32 (8): 933-970, 1987.
24. Sawyer PN, Suckling EE, Wesolowski SA. Effect of small electric currents
on intravascular thrombosis in the visualized rat mesentery. Am J Physiol,
198: 1006-1010, 1960.
25.Schwan HP. Mechanisms responsible for electrical properties of tissues and
cell suspension. Med Prog Technol, 19 (4): 163-165, 1993-94
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The ARP (Accelerated Recovery Performance) is a remarkable, proprietary
device designed and licensed exclusively for use with ARP Protocols.
It is licensed exclusively for use with its companion Protocols. Think
of the ARP as great hardware, and ARP Protocols as highly specialized
software continually updated and optimized to enhance the performance
of the hardware.
The ARP is FDA authorized for the following uses:
- Muscle Reeducation: Eliminating compensation patterns
- Relaxation of muscle spasms: Reducing pain in the affected muscles
- Increased local blood circulation: Shown to speed up healing
- Prevention and retardation of disuse atrophy: Quickly builds muscle
strength
- Maintaining and increasing range of motion: Designed to increase
your muscles ability to absorb force and prevent muscle related injury
For over 25 years, we've helped some of the best known names in all
of sports reach and stay at the top of their game, as well as individuals
with chronic muscle pain.
The ARP license gives you access to:
- Unfettered access to the ARP Expert Team as your personal prehab
and rehab consultants for a period of 5 years.
- Specialized protocols designed exclusively for specific athletic
activities — pre-game, training and practice — to minimize
and possibly eliminate the incidence of muscle-related injury.
- Unique post-game protocols designed exclusively to fully "recover" you
after every game.
- Carefully calibrated protocols designed to fully "recover" you
after each training and practice session.
- 24/7 Online and eMail support on all protocols.
At ARP, we are relentless about keeping you fresh in-season, off-season
and every step in between.
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