High frequency muscle stimulation

The high frequency muscle stimulation , also high tone called, is a method of treatment in the field of electrotherapy .

In contrast to classic electrotherapy, high-frequency muscle stimulation uses alternating electrical fields in the frequency range of around 4 to 30 kilohertz. In addition, the current strength and the frequency are modulated at the same time . The main indications of the method are back pain , degenerative joint diseases (here in particular: knee osteoarthritis ), diabetic polyneuropathy , migraines and headaches , wound healing and treatment of edema . The effectiveness of the procedure has not yet been proven.

The high-frequency muscle stimulation was patented by the German neurologist and psychiatrist Hans-Ulrich May . It has been used experimentally to treat diabetic polyneuropathy. In a pilot study by the German Diabetes Center Düsseldorf on a total of 41 test persons with type 1 and 2 diabetes , a positive effect of high-frequency muscle stimulation in the symptomatic treatment of the disease was assumed. 16 of 20 test persons reported a clear subjective improvement in symptoms after high-frequency muscle stimulation. In the control group, which was treated with transcutaneous electrical nerve stimulation (TENS), 7 of 21 test persons stated that the symptoms had significantly decreased, which is not statistically significant. However, with both treatments, the symptoms reappeared after a few days, so that permanent treatment appears necessary. In another clinical study carried out at Heidelberg University Hospital , 13 out of 20 patients reported a subjective improvement in symptoms. However, no control group was examined in this study, which means that this study is of little informative value.

According to the proponents of the method, the therapy should be applied three times a week for 30 minutes in order to permanently alleviate the symptoms. Otherwise the complaints would return. In spite of its effectiveness, which has not been shown, around 400 doctors nationwide, as well as five specialist diabetology clinics, offer the treatment. The health insurance companies do not cover the costs of high-frequency muscle stimulation .

The IGeL monitor of the MDS ( Medical Service of the Central Association of Health Insurance Funds ) rates the high-tone therapy as "unclear". There is no evidence of possible harm, but also no evidence of benefit. Only two studies met certain formal quality criteria, one on circulatory disorders and one on a concomitant disease of diabetes, diabetic polyneuropathy. However, both studies have the character of pilot studies and are therefore not suitable for making reliable statements. This is the result of the Main Association of Austrian Social Insurance Institutions in 2014. The frequently cited study by Reichstein, which compared transcutaneous electrical nerve stimulation (TENS) with high-tone therapy, is not very meaningful, according to the evaluation of the IGeL-Monitor scientists. In the study, significantly more subjects reported relief from their symptoms when treated with high-tone therapy. However, the effect no longer seemed to exist after a few days. The results did not allow any statements about medium or long-term effects. Since the study on circulatory disorders (peripheral arterial occlusive disease, PAOD for short) also shows methodological weaknesses, promised treatment successes could not be based on scientific evidence.

Individual evidence

1. ↑ German Diabetes Center: Electrical muscle stimulation as an alternative treatment. ( Memento of the original from September 29, 2007 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved February 6, 2010 
2. ↑ PM Humpert et al .: High-frequency muscle stimulation for the treatment of painful neuropathy in type 2 diabetics improves the microvascular endothelial cell function. In: Diabetology and Metabolism 1, 2006. doi : 10.1055 / s-2006-943853
3. ^ R. Klakow-Franck: Schedule of fees for doctors: Muscle games - In the field of orthopedics. In: Dtsch Arztebl 99, 2002 (PDF)
4. ↑ IGeL-Monitor: Hochtontherapie , accessed on February 14, 2019. More on the justification for the assessment in the results report , accessed on February 14, 2019.
5. ↑ Doctors newspaper: Kassen wading further IGeL , April 17, 2013.
6. ↑ Main Association of Austrian Social Insurance Institutions, Evidence-Based Economic Health Care, HTA Report 2014. High- tone therapy for polyneuropathy
7. ↑ Reichstein L. et al., Effective treatment of symptomatic diabetic polyneuropathy by high frequency external muscle stimulation. Diabetologia. 2005; 48, 824-828
8. ↑ Szymańska J et al. The effect of high tone power therapy on gait range in patients with chronic lower limb ischaemia. Ortop Traumatol Rehabil. 2011 MayJun; 13 (3): 279-92.

Web links

• L. Reichstein: Effective treatment of symptomatic diabetic polyneuropathy through high-frequency external muscle stimulation. Dissertation, University of Düsseldorf, 2006
• H.-U. May The scientific basis of high-tone therapy. Summary description of high-tone therapy, 2010

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