The Edition 5 S2x - Russian Stimulation Protocol

The new Edition 5 S2x electrotherapy device hosts a number of excellent stimulation protocols but we find that knowledge about their application is not that well understood. In a series of articles we will take a look at some of these protocols and how they might be used. The first protocol we explore is sometimes known as “Russian Stimulation” but it also goes by other names - for example Kotz stimulation or Burst Mode Alternating Current which does tend to lead to some confusion.

Certainly the origins of this approach have been attributed to a Kotz based in Russia (although good luck trying to find the original literature not this). It seems that the approach was developed with professional athletes in mind as it develops significant muscle strength and has few contraindications. Although developed with athletes in mind this waveform class is relevant to situations when strength development of innervated muscle is required.

This protocol is classed as a Medium Frequency Current Waveform and uses a 2.5kHz sinusoidal pattern modulated at 50 Hz. The modulation at 50 Hz produces a strong muscle contraction.

Why 2.5 KHz? It seems that 2.5kHz was found to be the most effective frequency after exploring a range of frequencies. This frequency was found to allow a nice balance between comfort and intensity. The stimulation is applied in 10 second bursts followed by a 10 second pause to give the muscle chance to recover. A typical session using this protocol would apply 10 contractions in a session and repeat three times daily and three times per week at the maximum tolerable intensity.

The biphasic nature (positive and negative going) of the waveform means that it will be a generally comfortable form of stimulation and safe to use when metal implants are present.

In common with the other protocols with this product we use non-adhesive electrodes. The wet sponge and carbon rubber electrodes should cover as much of the muscle bulk as possible and the intensity is increased until a clear muscle contraction is achieved.

Before commencing treatment, the sponge must be well-moistened with tap water and then squeezed out a little. The carbon rubber plate electrode is then placed into the sponge pocket so that it completely disappears in the sponge pocket. The intermediate layer between the user and the electrode should be approx. 1 cm larger than the electrode on all sides.

The multilayer thick side of the sponge pockets must face the surface of the user's skin. A pocket that must be placed entirely on the skin is fixated with elastic Velcro straps as shown in the image. This ensures even contact pressure with the skin. The skin should be “degreased” - no skin creams prior to application of the electrodes.

Related articles

Selkowitz, D. M. (1989). "High frequency electrical stimulation in muscle strengthening: a review and discussion... the quadriceps femoris." American Journal of Sports Medicine 17(1): 103-111.

Ward, A. R. and N. Shkuratova (2002). "Russian electrical stimulation: the early experiments." Physical Therapy 82(10): 1019-1030.

Ward, A. R. (2009). "Electrical stimulation using kilohertz-frequency alternating current." Phys Ther 89(2): 181-190.