By Lisa Rosenberg · Combination of manual and electrical stimulation Patient imagines feeling the...
Transcript of 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>