Circulation

PowerDot Technology Combats Circulation Problems Causing Arthritis

Many suffer from poor circulation, specifically to the distal segments of their extremities, like poor circulation problems in the legs and feet. Circulation problems are due to the decrease in blood flow which results in inadequate oxygen supply to cellular tissues. This may result in numbness and tingling as well as impair or limit movement and function, making it imperative to find ways to increase blood flow circulation. Now, most do not associate circulation problems with arthritis, however, decreased blood flow circulation may be a primary mechanism inducing osteoarthritis (OA) (the wear and tear disease) [1]. Arthritis (painful inflammation and stiffness of a joint) is a major contributor to limited mobility and joint pain and may be mitigated and/or prevented by enhancing systemic circulation throughout the body.

Approximately 23% of the population already suffers from some form of arthritis and it is projected that this number is on the rise, to where soon, 78 million adults will suffer from arthritis (approximately 26%) [2]. Arthritis causes severe and debilitating joint pain which may lead to increased disability and loss of independence, limitations in activity participation, and increased risk of falls. The etiology, or potential cause, of OA may be due to circulation problems. The onset of this disease may start with poor blood flow circulation, though, it is the joint inflammation that ultimately leads to stiffness and functional mobility decrements. It is not uncommon for medical professionals to solely focus on addressing pain in those with arthritis, but there is something to be said about enhancing systemic circulation. Increasing blood flow circulation may not reverse arthritis, although it may help to alleviate the chronic state of inflammation within the joints by “flushing out” some of the inflammation. 

In those suffering from arthritis, in say… the knees, exercises and other treatment modalities may be used to enhance upper and lower extremity circulation. PowerDot has revolutionized the way in which we treat those that need to increase their blood flow circulation. It is understood that blood carries oxygen… our bodily cells need oxygen for life, and so essentially, our circulation carries life throughout our blood vessels and body. PowerDot has evolved two archaic therapy modalities, Transcutaneous Electrical Nerve Stimulation (TENS) and Neuromuscular Electrical Stimulation (NMES) devices, by incorporating them both into one small portable and wireless device. By providing custom scientifically designed protocols to enhance blood flow and circulation through the stimulation of muscle fibers, PowerDot impacts the physiology of the human body generating greater blood flow and removing inflammation that may be limiting functional mobility.

Blood Flow Circulatory System

As previously mentioned, blood carries oxygen throughout the systemic (bodily) circulation to the tissues of the body so each cell has the energy it needs to efficiently operate and live. Blood volume (ie. just normal blood in the circulation/body) consists of plasma volume (mainly water) and formed elements (mainly red blood cells). Red blood cells are produced from the bone marrow by the hormone erythropoietin (EPO), which is released from the kidneys. So, EPO from the kidneys stimulates red blood cell production, and it is the protein, hemoglobin, whose specific function is to carry oxygen for the red blood cell [3]. 

Now, the Circulatory System consists of both deoxygenated (oxygen not bound to hemoglobin) and oxygenated (oxygen bound to hemoglobin) blood. But, how does blood circulate through the body? Let’s first start on the right side of the heart (the pulmonary circulation as deoxygenated blood is going to the lungs to become oxygenated). Deoxygenated blood returns to the heart via the superior and inferior vena cava and enters the right atrium, the blood then goes through the tricuspid valve to the right ventricle and then travels through the pulmonary valve to the pulmonary arteries and is then oxygenated in the lungs.

From the lungs (this is the systemic circulation as the oxygenated blood will be pumped to the body), the newly oxygenated blood travels through the pulmonary veins to the left atrium. From the left atrium the blood travels through the mitral or bicuspid valve to the left ventricle. From the left ventricle the blood will be pumped through the aortic valve to the aorta and the blood will travel through the body via the arteries, then arterioles, then the capillaries (where gas exchange happens at the tissue). Then, after dropping off oxygen at the capillaries the blood is now deoxygenated and will return to the heart via the venules and then veins back to the right side of the heart.

Physiological Mechanisms Behind Increasing Circulation

The aim when increasing systemic circulation is to increase cardiac output. Cardiac output is the total volume of blood that is pumped from the heart to the body per minute. Cardiac output is dependent upon both heart rate and stroke volume. Heart rate is just the heart’s beats per minute and stroke volume is the amount of blood pumped from the heart per beat. When multiplied, heart rate times stroke volume, cardiac output is calculated (see Equation 1). So, if aiming to increase cardiac output, which would increase systemic blood flow and improve circulation problems, then an increase in heart and/or stroke volume is necessary.

Equation 1. Cardiac Output = Heart Rate x Stroke Volume

Just by looking at Equation 1, we can see physiologically as to how exercise increases blood flow. Increasing heart rate would increase cardiac output, thus, increasing blood flow systemically. However, it is possible to improve circulation problems by increasing stroke volume which may not require exercise. 

To increase stroke volume, venous blood return must increase, meaning, the focus needs to be on increasing the amount of blood pumped back to the heart. By increasing the amount of blood pumped back to the heart, the end diastolic volume becomes greater. This means the left ventricle stretches and fills with more oxygenated blood. The increased stretch of the myocardial cells leads to a more forceful contraction of the heart, noted as the Frank-Starling Mechanism [4], and this increases the amount of blood being pumped in the circulation to the body.

PowerDot Increases Systemic Blood Flow Circulation via Muscle Pump and Increasing Heart Rate

How is it possible to increase the amount of blood pumped back to the heart? How can the human body increase venous return? The answer is muscle pump. As muscles contract, more blood is pumped back to the heart. This happens because veins consist of one way valves. Meaning, blood only goes one direction, which is back to the heart as the muscles contract. So, muscular contraction helps pump blood back to the heart. 

NMES stimulates both Type I and Type II muscle fibers to contract utilizing a “nonselective approach”. Meaning there is no orderly recruitment of muscle fibers resulting in both Type I and Type II fibers being activated while using PowerDot Smart NMES. By causing all muscle fibers to contract, electric muscle stimulation has demonstrated to increase blood flow by up to approximately 301% [5].

Electric Stimulation activates a large muscle mass stimulating the muscle venous pump, facilitating venous return, increasing end diastolic volume and ultimately stroke volume through the Frank-Starling Mechanism, thus increasing cardiac output [6]. Previous findings revealed NMES applied to the calf muscles promotes venous return by activating the skeletal muscle pump promoting a positive hemodynamic (blood flow) response in both healthy subjects and patients suffering from chronic venous disease [7,8]. Though, NMES also elicits an aerobic response by increasing heart rate [9]. PowerDot electric muscle stimulation elicits a positive physiological response, increasing cardiac output, and thus improving circulation problems. 

Circulation Problems Cause Joint Degradation and Arthritis

The joints of the human body consist of two bones that are “joined” or articulate with one another. Synovial joints are freely moving joints. Synovial joints get their name because they are composed of a synovial membrane which is a thick flexible membrane. This membrane creates a sac-like structure that contains fluid lubricating the joint and allowing for pain free and smooth movement. As the joints move, not only does the synovial fluid within the synovium allow for smooth movement, but so does the articular cartilage that covers the end of each bone. 

For instance, the knee joint consists of the femur (thigh bone) sitting on top of the tibia (shin bone). The end of the femur has articular cartilage and on top of the tibia there is articular cartilage (which works with the meniscus) to provide smooth movement and prevent bone on bone contact. These structures are designed to allow proper and pain free movement. However, in the case of arthritis, the structural integrity of the whole joint is compromised as these structures are attacked by inflammatory cells. This may be due to circulation problems early in the onset of the progression of this disease.

Circulation and blood flow to bones is not a well covered topic, though, it is important to note that osteocytes (bone cells) also need to receive oxygen and nutrients as well as to get rid of any metabolic waste [10]. Circulation problems impairing blood flow negatively impacts bone health by stimulating osteocyte (bone cell) death and altered bone remodeling [10]. Bone is a highly vascularized structure, specifically in the subchondral regions (this is the area below the articular cartilage), which is important as this region may supply nutrition to the avascular articular cartilage [11]. For instance, the meniscus, which is cartilage that sits on top of your tibia (shin bone) would receive nutrients from this area of vascularized bone. And if circulation problems arise, that cartilage may not receive the nutrients that it needs compromising the integrity of the cartilage [11], as seen in arthritis.

These findings and conclusions support enhancing circulation as an essential measure in the prevention and treatment of arthritis. As previously mentioned, NMES enhances systemic blood flow circulation by increasing cardiac output through muscular contractions. Previous findings suggest, bone remodeling rates are increased with higher rates of bone blood flow [12]. NMES also stimulates osteoblast proliferation (osteoblasts are bone building cells) [13]. Meaning, if bone is not remodelling and osteoblasts are not activated, it’s like a house staying in a state of a construction and never being finished. Also, arthritis negatively impacts muscle quality of the surrounding skeletal muscle structures [1]. NMES training in those with arthritis not only improved muscular strength and caused the muscle to increase in size, but reduced pain, stiffness, and functional limitations in patients with arthritis [14]. Lastly, by increasing oxygenated blood flow to the inflamed arthritic joint, inflammatory cells may be removed from the area [15]. So, whether aiming to prevent arthritis or improve quality of life with arthritis, the PowerDot FDA technology provides a scientifically designed solution. 

PowerDot Technology In Summary: Circulation and Arthritis 

Arthritis is a debilitating disease resulting in a sedentary lifestyle as it becomes too painful to want to get up to even move. PowerDot technology provides a scientific stimulus, via NMES, to combat arthritis by increasing circulation. As noted, circulation problems may be the beginning of the later onset of arthritis [11]. Through scientific principles, the PowerDot Smart NMES technology promotes positive physiological responses to enhance circulation [5,6]. This increased blood flow and circulation promotes healthy bone remodelling and improves strength of the surrounding muscles, enhancing the integrity of the joint as a whole [13,14]. Utilizing one of the scientifically designed preset muscle stimulation settings with PowerDot promotes optimal circulation throughout the body. Grab the new PowerDot 2.0, risk free, and take advantage of the most powerful piece of health technology on the market today. 

References

1. Mora, J. C., Przkora, R., & Cruz-Almeida, Y. (2018). Knee osteoarthritis: pathophysiology and current treatment modalities. Journal of Pain Research, 11, 2189. [Link]
2. Hootman, J. M., Helmick, C. G., Barbour, K. E., Theis, K. A., & Boring, M. A. (2016). Updated projected prevalence of self‐reported doctor‐diagnosed arthritis and arthritis‐attributable activity limitation among US adults, 2015–2040. Arthritis & Rheumatology, 68(7), 1582-1587. [Link]
3. Bunn, H. F. (2013). Erythropoietin. Cold Spring Harbor Perspectives in Medicine, 3(3), a011619. [Link]
4. Warburton, D. E., Haykowsky, M. J., Quinney, H. A., Blackmore, D., Teo, K. K., & Humen, D. P. (2002). Myocardial response to incremental exercise in endurance‐trained athletes: influence of heart rate, contractility and the Frank‐Starling effect. Experimental Physiology, 87(5), 613-622. [Link]
5. Broderick, B. J., O’Briain, D. E., Breen, P. P., Kearns, S. R., & ÓLaighin, G. (2010). A pilot evaluation of a neuromuscular electrical stimulation (NMES) based methodology for the prevention of venous stasis during bed rest. Medical Engineering & Physics, 32(4), 349-355. [Link]
6. Carvalho, D. C. L., de Cassia Zanchetta, M., Sereni, J. M., & Cliquet, A. (2005). Metabolic and cardiorespiratory responses of tetraplegic subjects during treadmill walking using neuromuscular electrical stimulation and partial body weight support. Spinal Cord, 43(7), 400-405. [Link]
7. Moloney, M. C., Lyons, G. M., Breen, P., Burke, P. E., & Grace, P. A. (2006). Haemodynamic study examining the response of venous blood flow to electrical stimulation of the gastrocnemius muscle in patients with chronic venous disease. European Journal of Vascular and Endovascular Surgery, 31(3), 300-305. [Link]
8. Lyons, G. M., Leane, G. E., & Grace, P. A. (2002). The effect of electrical stimulation of the calf muscle and compression stocking on venous blood flow velocity. European Journal of Vascular and Endovascular Surgery, 23(6), 564-566. [Link]
9. Crognale, D., De Vito, G., Grosset, J. F., Crowe, L., Minogue, C., & Caulfield, B. (2013). Neuromuscular electrical stimulation can elicit aerobic exercise response without undue discomfort in healthy physically active adults. The Journal of Strength & Conditioning Research, 27(1), 208-215. [Link]
10. Findlay, D. M. (2007). Vascular Pathology and Osteoarthritis. [Link]
11. Imhof, H., Breitenseher, M., Kainberger, F., & Trattnig, S. J. S. R. (1997). Degenerative joint disease: cartilage or vascular disease?. Skeletal Radiology, 26(7), 398-403. [Link]
12. Reeve, J., Arlot, M., Wootton, R., Edouard, C., Tellez, M., Hesp, R., ... & Meunier, P. J. (1988). Skeletal blood flow, iliac histomorphometry, and strontium kinetics in osteoporosis: a relationship between blood flow and corrected apposition rate. The Journal of Clinical Endocrinology & Metabolism, 66(6), 1124-1131. [Link]
13. Meng, S., Rouabhia, M., & Zhang, Z. (2013). Electrical stimulation modulates osteoblast proliferation and bone protein production through heparin‐bioactivated conductive scaffolds. Bioelectromagnetics, 34(3), 189-199. [Link]
14. Vaz, M. A., Baroni, B. M., Geremia, J. M., Lanferdini, F. J., Mayer, A., Arampatzis, A., & Herzog, W. (2013). Neuromuscular electrical stimulation (NMES) reduces structural and functional losses of quadriceps muscle and improves health status in patients with knee osteoarthritis. Journal of Orthopaedic Research, 31(4), 511-516. [Link]
15. Vanderthommen, M., Soltani, K., Maquet, D., Crielaard, J. M., & Croisier, J. L. (2007). Does neuromuscular electrical stimulation influence muscle recovery after maximal isokinetic exercise?. Isokinetics and Exercise Science, 15(2), 143-149. [Link]