Unfortunately, despite centuries of research on electrical stimulation, we still have yet to see the practical use of electrical stimulation reach its full potential.
A quick Google search for electrical stimulation will lead you to discover a lot of names, abbreviations, and acronyms, including:. All of these names refer to the same basic thing — applying electricity to the body to increase or decrease activity in the nervous system.
The different names come from applying the current in different ways, to different parts of the body, or for different reasons. Some FES devices have a sensor that is worn in the heel area, to help with the timing, but in modern devices that is optional.
This means that the FES device can be worn with bare feet or sandals. If you have difficulty with walking due to foot drop, you may benefit from FES.
However, as FES stimulates the existing nerves in the legs, it is important that your nerve fibres between the spinal cord and the muscles are not damaged. To be suitable for the treatment, you need to be able to walk, even if only for a few metres with a stick or crutch. Typically you will have an initial assessment that lasts for about an hour to see if you are suitable for treatment and if you respond to the FES stimulation. If you do respond then you can start the treatment process.
A health professional will set up the device with you and teach you how to use it. At first you may find it difficult and time consuming to put the device on and position the pads correctly, but this becomes easier with practice. Follow up sessions might be necessary to adjust the electrode position and the strength of the electrical stimulation.
This can change as your muscles strengthen and your nerves get used to the level of stimulation. Research and experience has shown that treatment with FES produces a more normal walking pattern, enabling people to walk faster, further and with less effort. It can also help build confidence in walking and increase independence as well as reducing the risk of trips and falls.
As well as being a treatment for foot drop FES can also be used in rehabilitation, complementing physiotherapy techniques, often to assist with movements in muscles that have become weak. This allows you to build up strength and range of movement. This may also help with reducing spasticity and sometimes in reducing swelling, depending on the cause.
FES can really open up a person's world. We can quite literally have someone walk in to our clinic with a stick and walk out without needing it, so we know it can have huge benefits for some people with MS. The electrical stimulation causes a tingling 'pins and needles' or buzzing sensation on the skin, much like a TENS machine.
Ensuring that wires and pads are in the correct positions can help minimise some of these sensations. For most people this is not a problem, but you might find the effect uncomfortable and may not want to continue using the FES. FES may take a little bit of getting used to. Your physiotherapist may need to help you relearn a comfortable gait, as old habits that helped you manage your foot drop are no longer needed.
FES can be incorporated into many different activities. Below are some examples that you might see in therapy at INI:. There are many FES exercises that a person can do at home, either independently or with the assistance of a friend or caregiver. Throughout your bout of therapy, your therapists are considering the exercises and equipment that are suitable for use at home.
Our therapists work with Dr. Becker and your insurance company to help obtain FES equipment to use as part of a custom home-based rehabilitation program. Our patients are encouraged to regularly follow-up at INI for continued therapy and updates to an FES program to maximize the benefit.
Request an Appointment Research shows that FES can: Increase blood flow Increase muscle bulk Increase the recruitment of muscle fibers utilized for a movement Promote nervous system recovery within the spinal cord Increase bone density when paired with weight-bearing activities Reduce spasticity At INI, your therapist will complete a detailed assessment of your strength and function during your initial evaluation and determine if you would benefit from the use of FES.
People have varying tolerance for electrical stimulation, but there are three important points to note: There are many different settings that can be trialed to maximize your comfort Most people become accustomed to the sensation of the stimulation and can gradually tolerate more intensity over time. An EMS machine works in more or less the same way. It also consists of an electrical impulse generator connected to electrodes that are placed on your skin around the muscle to be treated.
It also works by sending small electrical impulses, which this time are delivered directly to the muscle, causing it to contract. The muscle contracts and relaxes repeatedly, which helps to improve blood circulation, which in turn serves to:.
TENS machines are used to relieve nerve, muscle or joint pain, which is often chronic and takes various forms, including inflammatory arthritis, back pain, foot pain, contractions during childbirth, or post-operative pain. Migraine pain can be relieved by specialised TENS machines. EMS machines , on the other hand, are used to relax or strengthen the muscles, for example in cases of muscular spasm, poor blood circulation particularly in the back and nape of the neck , muscle atrophy after an illness or as part of rehabilitation from an injury.
They are therefore more often recommended for the relief of muscle pain. Athletes also sometimes use EMS in order to recover from an injury more quickly, as electrical muscle stimulation will enable them to re build muscle without too much strain and to exercise muscles that they may not use very much.
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