Posts Tagged FES

[Abstract] Bi-cephalic transcranial direct current stimulation combined with functional electrical stimulation for upper-limb stroke rehabilitation: A double-blind randomized controlled trial


Bi-cephalic transcranial direct current stimulation (tDCS) plus functional electrical stimulation (FES) slightly improves reaching motor performance after stroke.

Bi-cephalic tDCS plus FES does not enhance reaching movement quality after stroke.

Bi-cephalic tDCS plus FES improves handgrip strength after stroke.



Stroke survivors often present poor upper-limb (UL) motor performance and reduced movement quality during reaching tasks. Transcranial direct current stimulation (tDCS) and functional electrical stimulation (FES) are widely used strategies for stroke rehabilitation. However, the effects of combining these two therapies to rehabilitate individuals with moderate and severe impairment after stroke are still unknown.


Our primary aim was to evaluate the effects of concurrent bi-cephalic tDCS and FES on UL kinematic motor performance and movement quality. Our secondary aim was to verify the effects of the combined therapies on handgrip force and UL motor impairment.


We randomized 30 individuals with moderate and severe chronic hemiparesis after stroke into tDCS plus FES (n = 15) and sham tDCS plus FES (n = 15) groups. Participants were treated 5 times a week for 2 weeks. Kinematic UL motor performance (movement cycle time, velocity profile) and movement quality (smoothness, trunk contribution, joint angles), handgrip force and motor impairment were assessed before and after the intervention.


For those participants allocated to the tDCS plus FES group, therapy was effective to improve movement cycle time (P = 0.039), mean reaching phase velocity (P = 0.022) and handgrip force (P = 0.034). Both groups showed improved mean returning phase velocity (P = 0.018), trunk contribution (P = 0.022), and movement smoothness (P = 0.001) as well as alleviated UL motor impairment (P = 0.002).


Concurrent bi-cephalic tDCS and FES slightly improved reaching motor performance and handgrip force of individuals with moderate and severe UL impairment after stroke.

via Bi-cephalic transcranial direct current stimulation combined with functional electrical stimulation for upper-limb stroke rehabilitation: A double-blind randomized controlled trial – ScienceDirect

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[Conference Paper] Modelling of a wearable jacket with sensors and actuators for upper limb rehabilitation


Introduction Spinal Cord Injury (SCI) affects a large number of young people and, if left  untreated, can deal irreversible damage to the human body. Several studies have demonstrated the positive impact of physical therapy to the rehabilitation process, promoting neuro-plasticity and thus at least partial restoration of functionality of the body and gait. These studies focus on the implementation of engineered solutions, such as robotic exoskeletons and virtual reality training regimens. The common denominator in most of them is the implementation of some form of Human-Machine Interface (HMI), for the control of these modalities by direct user feedback. These HMIs are based on a plethora of sensor arrays, ranging from direct motion-specific body data, such as Electroencephalography (EEG) and Electromyography (EMG) to more common sensor devices, such as accelerometers and gyroscopes. These sensors can provide direct measurements, tailored to the application at hand and provide the necessary data for the desired functionality. Materials and Methods The proposed device will function as a sensor array for the upper-body, providing live data for muscle activity, through the use of Electromyography (EMG) electrodes, as well as relative joint positioning and rotation, utilizing Inertial Measurement Units (IMUs), for the purpose of monitoring and Augmented Reality (AR) integration. Said motion data will be then used to enhance the users desired movement, through the use of Functional Electronic Stimulation (FES), by providing the necessary impulse to each muscle group, from the measured feedback. The relationship between sensor input and stimulation will allow for reinforcement of the users’ movements, promoting neuroplasticity and ease of movement in the process of neuro-rehabilitation. Furthermore, this modality will act as a platform for several other physiological measurements, such as heart rate and perspiration, essentially creating a functional Body-Area Network (BAN) of sensors. Integration with external motion actuators will be investigated, as a means to provide upper-body support, providing the necessary strength, as a means of easing the rehabilitation process and removing unnecessary stress from the user. Finally, interactions with implanted medical devices will be explored. Such devices could provide telemetry data from inside the body, to be used as a form of direct feedback for the designed Body Area Network (BAN), and the aforementioned stimulation and actuation.

via Modelling of a wearable jacket with sensors and actuators for upper limb rehabilitation

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[VIDEO] FES (Functional Electrical Stimulation) System by FES Center India – YouTube

Functional Electrical Stimulation (FES): Best and latest treatment for Neurological rehabilitation/ Physiotherapy

FES is a technique that utilizes patterned electrical stimulation of neural tissue with the purpose of restoring or enhancing a lost or diminished function. It produces contractions in paralysed muscles by the application of small pulses of electrical stimulation to nerves that supply the paralysed muscle. The stimulation is controlled in such a way that the movement produced provides useful function.

FES is used as a tool to assist walking and also as a means of practicing various functional movements for therapeutic benefit. FES may be used to replace the natural electrical signals from the brain, helping the weak or paralyzed limbs move again. With continued stimulation over time, the brain may even be able to recapture and relearn this movement without the stimulation.

Use of “FES (Functional Electrical Stimulation) System India” for treatment of Foot Drop due to Hemiplegia. FES is a novel device for treatment/ rehabilitation of Neurological diseases. FES System India has many applications like

  1. Sit to stand training
  2. Pre Gait Training
  3. Correction of Foot Drop,
  4. Correction of Circumductory Gait

  5. for Paraplegia (Incomplete SCI) using FES unit on both sides

  6. Shoulder subluxation and shoulder rehabilitation

  7. Hand Function (Grasp and release)

This novel treatment is useful for all type of UMN disorders like hemiplegia (Cerebro Vascular Accident, Head Injury, Traumatic Brain injury, Brain tumor ), multiple scerosis, cerebral palsy, incomplete paraplegia etc.

contact “FES Center India” to buy FES System.


For more details visit:

via FES (Functional Electrical Stimulation) System by FES Center India – YouTube

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[VIDEO] Functional Electrical Stimulation for Stroke Rehab – YouTube

Combo video including patients participating in contralaterally controlled FES therapy followed by a patient performing a grasp-release test before CCFES therapy and the same patient performing the same test after 12 weeks of CCFES therapy. All patients were participating in research studies at MetroHealth Medical Center in Cleveland.

via  Functional Electrical Stimulation for Stroke Rehab – YouTube

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[VIDEO] Foot Drop and Functional Electrical Stimulation (FES) – YouTube

PhysioFunction are recognised as international experts in the use of Functional Electrical Stimulation (FES). We ensure our clients receive the most clinically correct rehabilitation technology suited to their needs. Jon Graham, Clinical Director at PhysioFunction talks about Foot Drop and Functional Electrical Stimulation.

via Foot Drop and Functional Electrical Stimulation (FES) – YouTube

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[VIDEO] Using Functional Electrical Stimulation For Patients With Neurological Deficits – YouTube

Functional electrical stimulation is a biophysical technology that have seen increased use in the management of neurological disorders. This talk will discuss principles of use with specific therapeutic cases and would be of primary interest to occupational and physical therapists. The participant will develop skills necessary to choose appropriately and apply electrotherapy in the rehabilitation setting. Various new technologies using electrotherapy will also be demonstrated.

via Using Functional Electrical Stimulation For Patients With Neurological Deficits – YouTube

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[VIDEO] Functional Electrostimulation – YouTube

Functional Electrostimulation Using a sliding mode controller, contralateral movements

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[VIDEO] Testing Functional Electrical Stimulation (FES) – YouTube

via (2) Testing Functional Electrical Stimulation (FES) – YouTube

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[Abstract + References] Synergy-Based FES for Post-Stroke Rehabilitation of Upper-Limb Motor Functions


Functional electrical stimulation (FES) is capable of activating muscles that are under-recruited in neurological diseases, such as stroke. Therefore, FES provides a promising technology for assisting upper-limb motor functions in rehabilitation following stroke. However, the full benefits of FES may be limited due to lack of a systematic approach to formulate the pattern of stimulation. Our preliminary work demonstrated that it is feasible to use muscle synergy to guide the generation of FES patterns.In this paper, we present a methodology of formulating FES patterns based on muscle synergies of a normal subject using a programmable multi-channel FES device. The effectiveness of the synergy-based FES was tested in two sets of experiments. In experiment one, the instantaneous effects of FES to improve movement kinematics were tested in three patients post ischemic stroke. Patients performed frontal reaching and lateral reaching tasks, which involved coordinated movements in the elbow and shoulder joints. The FES pattern was adjusted in amplitude and time profile for each subject in each task. In experiment two, a 5-day session of intervention using synergy-based FES was delivered to another three patients, in which patients performed task-oriented training in the same reaching movements in one-hour-per-day dose. The outcome of the short-term intervention was measured by changes in Fugl–Meyer scores and movement kinematics. Results on instantaneous effects showed that FES assistance was effective to increase the peak hand velocity in both or one of the tasks. In short-term intervention, evaluations prior to and post intervention showed improvements in both Fugl–Meyer scores and movement kinematics. The muscle synergy of patients also tended to evolve towards that of the normal subject. These results provide promising evidence of benefits using synergy-based FES for upper-limb rehabilitation following stroke. This is the first step towards a clinical protocol of applying FES as therapeutic intervention in stroke rehabilitation.

I. Introduction

Muscle activation during movement is commonly disrupted due to neural injuries from stroke. A major challenge for stroke rehabilitation is to re-establish the normal ways of muscle activation through a general restoration of motor control, otherwise impairments may be compensated by the motor system through a substitution strategy of task control [1]. In post-stroke intervention, new technologies such as neuromuscular electrical stimulation (NMES) or functional electrical stimulation (FES) offer advantages for non-invasively targeting specific groups of muscles [2]–[4] to restore the pattern of muscle activation. Nevertheless, their effectiveness is limited by lack of a systematic methodology to optimize the stimulation pattern, to implement the optimal strategy in clinical settings, and to design a protocol of training towards the goal of restoring motor functions. This pioneer study addresses these issues in clinical application with a non-invasive FES technology.

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via Synergy-Based FES for Post-Stroke Rehabilitation of Upper-Limb Motor Functions – IEEE Journals & Magazine

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[VIDEO] Post Stroke Foot Dorsiflexion: Using Electrical Stimulation to Reduce Tone & Promote Plasticity – YouTube

Further reading on electrophysiology and muscle contractions:…

via  Post Stroke Foot Dorsiflexion: Using Electrical Stimulation to Reduce Tone & Promote Plasticity – YouTube

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