by lisa rosenberg · combination of manual and electrical stimulation patient imagines feeling the...

By Lisa Rosenberg

Electrical Current

Stimulates muscles and nerves

Produces movement

Helps Individuals with Disabilities

Lack of muscle control (Stroke, bladder control,

neurological disorders)

Passive Therapy

Mechanical movement – therapist assisted

Active Therapy

Functional Electrical Stimulation (FES) and

mechanical movement

Spinal Cord Injury

Stroke

Cerebral Palsy

Paraplegia

Quadriplegia

Urinary Incontinence

Sexual Dysfunction

Multiple Sclerosis

Upper and Lower limb control

Combination of manual and electrical

stimulation

Patient imagines feeling the movement

Sensory signals generated

Stimulates peroneal nerves

Retrains the central nervous system

Unlike neuromuscular electrical stimulation

(NMES)

Creates action potential

Several different devices available

Designed for different areas of the body

Affects individuals who have suffered

through a stroke

Uses Compex Motion Electric Stimulator

Surface stimulation nodes

Nodes are placed on areas to be stimulated

Anterior and posterior deltoid

Biceps and triceps brachialis

Flexor and Extensor carpi radialis

Flexor and Extensor carpi ulnaris

Symmetrical biphasic current pulses

Pulse duration of 250 microseconds

40 Hz frequency

Hand switch trigger used by therapist to

time arm movements

Twice a day for 1 hour sessions over 12

weeks

Different movements emulated

Touch nose, swing forward, left side up

Over time, therapist assisted movement is

reduced to a minimum

After a stroke, individuals often can not draw

circles due to the shoulder and elbow

coordination requirement

After 12 weeks of FES patients can draw

small and large circles, pick up thin objects,

and touch their own nose due to the

retraining of their muscles and nerves.

Gait abnormality due to MS, muscular

dystrophy or ALS

Peroneal nerve is stimulated

Hip flexors and extensors are activated

Walkaide device – lifts foot while walking

Improves walking endurance, speed, and

lower limb muscle strength

Walking speed increased 15% over 3 months

32% after 6 months

47% after 1 year

Muscles get tired rapidly due to the

frequency of electrical stimulation

Therapists will increase level of stimulation to

battle fatigue which increases fatigue rate

Important to optimize stimulation

strategy

Pain and skin irritation at node placement

site

Depression due to lack of results

Helps individuals across a large span of

disabilities

Costs $5,000 for device

Device and therapy sessions covered by

insurance

Implantable devices

Avoid pain and skin irritation

Invasive surgery

Advancement in technology

More efficient and effective

1] "Effect of Intensive Functional Electrical Stimulation Therapy on Upper-Limb Motor Recovery after Stroke." Pysiotherapy Canada. 2013. 65: 20-28.

[2] "Functional electrical stimulation in neurological disorders." European Journal of Neurology. 2008. 15:437-444.

[3] "Functional electrical stimulation for spinal cord injury." Mayo Clinic. Web. <http://www.mayoclinic.org/functional-electrical-stimulation/>.

[4] "Neuroprosthesis Control Group." Automatic Control Laboratory. Web. <http://control.ee.ethz.ch/~ncg/previous_projects/elecstim.php>

[5] "Functional electrical stimulation." Wikipedia. Web. <http://en.wikipedia.org/wiki/Functional_electrical_stimulation>

[6] "Functional Electrical Stimulation." American Stroke Association. Web. <http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/PhysicalChallenges/Functional-Electrical-Stimulation_UCM_310628_Article.jsp>

[7] "National Clinical FES Centre." University of Bournemouth School of Design, Engineering and Computing. Web. <http://www.salisburyfes.com/>

[8] "The New WalkAide Bi-Flex Cuff." The WalkAide System. Web. <http://www.walkaide.com/en-US/Pages/biflexlanding.aspx>

[9] "Foot Drop." Wikipedia. Web <http://en.wikipedia.org/wiki/Foot_drop>

[10] "Walk Aide." Eagle Orthopaedics. Web. <http://www.eagleorthopaedics.com/walkaide.html>