FUNCTIONAL ELECTRICAL STIMULATION (FES)
Functional electrical stimulation (FES) is a technique that uses low energy electrical pulses to artificially generate body movements in individuals who have been paralyzed due to injury to the central nervous system. More specifically, FES can be used to generate muscle contraction in otherwise paralyzed limbs to produce functions such as grasping, walking, bladder voiding and standing.
This technology was originally used to develop neuroprostheses that were implemented to permanently substitute impaired functions in individuals with spinal cord injury (SCI), head injury, stroke and other neurological disorders. In other words, a consumer would use the device each time he/she wanted to generate a desired function. FES is sometimes also referred to as neuromuscular electrical stimulation (NMES).
In recent years FES technology has been used to deliver therapies to retrain voluntary motor functions such as grasping, reaching and walking.
- Spinal Cord injury: Injuries to the spinal cord interfere with electrical signals between the brain and the muscles, resulting in paralysis below the level of injury. Restoration of limb function as well as regulation of organ function is the main application of FES. Some examples of FES applications involve the use of Neuroprostheses that allow the people with paraplegia to walk, stand, and restore hand grasp function in people with quadriplegia, or restore bowel and bladder function.
- Stroke and upper limb recovery: In the acute stage of stroke recovery, the use of cyclic electrical stimulation has been seen to increase the isometric strength of wrist extensors. In order to increase strength of wrist extensors, there must be a degree of motor function at the wrist spared following the stroke and have significant hemiplegia. Patients who will elicit benefits of cyclic electrical stimulation of the wrist extensors must be highly motivated to follow through with treatment, After 8 weeks of electrical stimulation, an increase in grip strength can be apparent. Many scales, which assess the level of disability of the upper extremities following a stroke, use grip strength as a common item. Therefore, increasing strength of wrist extensors will decrease the level of upper extremity disability.
- Patients with Hemiplegia following a stroke commonly experience shoulder pain and subluxation; both of which will interfere with the rehabilitation process. Functional electrical stimulation has been found to be effective for the management of pain and reduction of shoulder subluxation, as well as accelerating the degree and rate of motor recovery. Furthermore, the benefits of FES are maintained over time; research has demonstrated that the benefits are maintained for at least 24 months.
- Drop foot is a common symptom in hemiplegia. It has been shown that FES can be used to effectively compensate for the drop foot during the swing phase of the gait. Drop foot stimulators have been used successfully with various patient populations, such as stroke, spinal cord injury and multiple sclerosis. The term “orthotic effect” can be used to describe the immediate improvement in function observed when the individual switches on their FES device compared to unassisted walking.
- Stroke: Hemiparetic stroke patients, who are impacted by the denervation, muscular atrophy, and spasticity, typically experience an abnormal gait pattern due to muscular weakness and the incapacity to voluntary contract certain ankle and hip muscles at the appropriate walking phase.
- Multiple sclerosis: FES has also been found to be useful for treating foot drop in people with multiple sclerosis. Researches with NMES have proven that this form of treatment has shown measurable gains in ambulatory function and found a significant improvement in orthotic effect for walking speed.
- Cerebral palsy: FES has been found to be useful for treating the symptoms of cerebral palsy and found significant orthotic and training effects for children with unilateral spastic cerebral palsy. Improvements were found in gastrocnemius spasticity, community mobility and balance skills. Research has given evidence that treatment has the potential to improve a number of different areas including muscle mass and strength, spasticity, passive range of motion, upper extremity function, walking speed, positioning of the foot and ankle kinematics. The research has also proved that the technology is safe and well tolerated by this population.
Treatment Sessions are offered in clinics across Northamptonshire and Milton Keynes or at Home Environment.
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Rehab Basics offers Treatment Sessions in Clinics across Northamptonshire and Milton Keynes OR at Home Environment.