Posts Tagged FES

[WEB SITE] Integration of FES Into G-EO System Gait Trainer Receives FDA Nod

Reha Technology USA Inc announces it now offers FDA-approved integrated Functional Electronic Stimulation (FES) for its G-EO System Evolution robotic gait trainer.

“The FES in conjunction with the G-EO System will allow clinicians to generate contractions in paralyzed or weakened muscles in lower extremities at the appropriate time in the walking cycle to maximize patient outcomes,” says Matthew Brooks, clinical director of Reha Technology USA Inc, in a media release.

The G-EO System robotic gait trainer provides passive and active, assistive and resistive training and the simulation of stairs walking up and down.

“We look forward to add this integrated FES feature to all of our current and future customers and we are confident that this extended offering will create added value for their therapy environment,” adds executive VP Paul Abrams, in the release.

[Source(s): Reha Technology USA Inc, PR Newswire]

Source: Integration of FES Into G-EO System Gait Trainer Receives FDA Nod – Rehab Managment

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[BLOG POST] Foot Drop Implants Market Analysis and Forecasts 2025

Foot drop can be defined as an abnormality in the gait where the forefoot drops due to factors such as weakness of the ankle and toe dorsiflexion. The abnormality is also caused by paralysis of the muscles in the anterior portion of the lower leg or damage to the fibular nerve. Foot drop can be associated with various conditions, including peripheral nerve injuries, neuropathies, drug toxicities, dorsiflexor injuries, and diabetes. Anatomic, muscular, and neurologic are the three categories of foot drop.

Functional electrical stimulation technology is employed in the foot drop implant to improve the gait of patients and avoid foot drop or tripping while walking. Functional electric stimulators (FES) can either be implanted within the patient’s body or employed externally. External FES is tested on the patient prior to its implantation. Implant FES involves a surgery in which the electrodes are directly placed on the nerves of the patient, which are controlled by the implant placed under the skin. The FES device activates the implant through a wireless antenna that is worn outside the body. Sensors are also associated with FES which trigger events in the walking pattern such as lifting of the heel, thereby stimulating the nerves.

The advantages of implant FES include reduction in sensation that is associated with external stimulation. In addition, it eliminates the need to adjust the electrodes on the skin on a daily basis. Rise in number of foot drop disorders due to nerve injuries, growth in knee and hip replacement therapies that lead to foot drop disorders, and increase in the number of sports related injuries contribute to the growth of the foot drop implants market. Foot drop disorders are commonly observed in diabetic retinopathy patients and this prevalence is growing due to increase in incidence of diabetes, which is propelling the growth of the market. Furthermore, the market players are focus on research and development to increase the number of foot drop implant products available in the market, driving the market growth. However, lack of reimbursement, high cost of the implants, and low awareness among the people are likely to hinder the growth of the foot drop implants market in the near future.

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The global foot drop implants market can be segmented on the basis of product, end-user, and region. On the basis of product, the market is categorized into functional electrical stimulators and internal fixation devices. The internal fixation devices segment is anticipated to record a significant growth during the forecast period owing to increasing demand for the devices and advantages offered by these devices such as elimination of the need to stimulate the electrodes daily. Based on end-user, the market can be segmented into hospitals, orthopedic centers, and palliative care centers, among others. The orthopedic centers segment is anticipated to record a high growth during the forecast period due to the increasing number of foot drop cases due to injuries.

Geographically, the foot drop implants market is distributed over North America, Latin America, Europe, Asia Pacific, and Middle East & Africa. North America dominated the market in 2016 and is anticipated to continue its dominance during the forecast period. The significant growth of the market in the region can be attributed to the strong focus on research and development, increase in health care spending, and growth in awareness about the abnormality. The sluggish economy might have a negative impact on the market growth of Europe. Asia Pacific is anticipated to record a high CAGR during the forecast period, primarily driven by India and China. The rising disposable income is anticipated to contribute to the growth of the Asia Pacific market. In addition, a factor contributing to the market growth is rise in prevalence of diabetes that leads to diabetic retinopathy, which is one of the primary causes of foot drop.

View Report @ http://www.transparencymarketresearch.com/foot-drop-implants-market.html

Key players operating in the foot drop implants market include Finetech Medical, Arthrex, Inc., Zimmer Biomet, Bioness Inc., Stryker Corporation, Wright Medical Group N.V., Ottobock, Narang Medical Limited, PONTiS Orthopaedics, LLC, and Shanghai MicroPort Orthopedics.

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Source: Foot Drop Implants Market Analysis and Forecasts 2025 | Medgadget

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[BOOK] Chapter 7: After Stroke Movement Impairments: A Review of Current Technologies for Rehabilitation – Full Text

 

 “Physical Disabilities – Therapeutic Implications”, book edited by Uner Tan, ISBN 978-953-51-3248-6, Print ISBN 978-953-51-3247-9, Published: June 14, 2017 under CC BY 3.0 license. © The Author(s)

Chapter 7: After Stroke Movement Impairments: A Review of Current Technologies for Rehabilitation

Abstract

This chapter presents a review of the rehabilitation technologies for people who have suffered a stroke, comparing and analyzing the impact that these technologies have on their recovery in the short and long term. The problematic is presented, and motor impairments for upper and lower limbs are characterized. The goal of this chapter is to show novel trends and research for the assistance and treatment of motor impairment caused by strokes.

1. Introduction

Stroke is the most common acquired neurological disease in the adult population worldwide (15 million every year [1]). Based on recently published studies, incidence of stroke in Europe at the beginning of the twenty-first century ranged from 95 to 290/100,000 per year [37]. Between 2000 and 2010, the relative rate of stroke deaths dropped by 35.8% in the United States and other countries. However, each year stroke affects nearly 800,000 individuals, becoming the first cause of chronic disability and the third cause of death. It is a global public health problem worldwide that generates a significant burden of illness for healthy life years lost due to disability and premature death.

One-third of stroke survivors achieve only a poor functional outcome 5 years after the onset of stroke. Although there is great progress in the management of acute stroke, most of the care to reduce dependence on post-stroke patients depends on rehabilitation. Optimal functional recovery is the ultimate goal of neurorehabilitation after acute brain injury, mainly by optimizing sensorimotor performance in functional actions. New brain imaging techniques are making it clear that the neurological system is continually remodeling throughout life and after damage through experience and learning in response to activity and behavior.

Rehabilitation in stroke patients seeks to minimize the neurological deficit and its complications, encourage family, and facilitate social reintegration of the individual to ultimately improve their quality of life. Stroke rehabilitation is divided into three phases. The acute phase usually extends for the 1st weeks, where patients get treated and stabilized in a hospital and get stabilized. Subacute phase (1–6 months) is the phase where the rehabilitation process is more effective for recovering functions. In chronic phase (after 6 months), rehabilitation is meant to treat and decrease motor sequels.

The potential ability of the brain to readapt after injury is known as neuroplasticity, which is the basic mechanism underlying improvement in functional outcome after stroke. Therefore, one important goal of rehabilitation of stroke patients is the effective use of neuroplasticity for functional recovery [38].

As mentioned before, neural plasticity is the ability of nervous system to reorganize its structure, function, and connections in response to training. The type and extent of neural plasticity is task—specific, highly time-sensitive and strongly influenced by environmental factors as well as motivation and attention.

Current understanding of mechanisms underlying neural plasticity changes after stroke stems from experimental models as well as clinical studies and provides the foundation for evidence-based neurorehabilitation. Evidence accumulated during the past 2 decades together with recent advances in the field of stroke recovery clearly shows that the effects of neurorehabilitation can be enhanced by behavioral manipulations in combination with adjuvant therapies that stimulate the endogenous neural plasticity.

Nowadays, a large toolbox of training-oriented rehabilitation techniques has been developed, which allows the increase of independence and quality of life of the patients and their families [39]. The recovery of function has been shown to depend on the intensity of therapy, repetition of specified-skilled movements directed toward the motor deficits and rewarded with performance-dependent feedback.

The use of technological devices not only helps to increase these aspects but also facilitates the work of therapists in order to enhance the abilities of patients and a higher level of functional recovery. They create environments with a greater amount of sensorimotor stimuli that enhance the neuroplasticity of patients, translating into a successful functional recovery. The use of technological devices can transfer the effects of rehabilitation to the different environments where patients spend their daily life allowing a favorable social reintegration. In this chapter, a review of technologies for rehabilitation of mobility in upper and lower extremity is presented.[…]

Continue —>  After Stroke Movement Impairments: A Review of Current Technologies for Rehabilitation | InTechOpen

Figure 1. Mechanical treatment devices. (a) Armeo Spring and (b) Saebo ReJoyce.

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[VIDEO] Ottobock ActiGait Explained Functional Electrical Stimulation FES – YouTube

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[VIDEO] The Ottobock MyGait for patients with dorsiflexor weakness – YouTube

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[WEB SITE] Restorative Therapies, Inc. Offers Expanded Options for RT300 at Home Functional Electrical Stimulation Cycling

Restorative Therapies, Inc. advances its new era in physical and occupational therapy systems for neurological injury and paralysis, announcing new options for home-based use of the groundbreaking RT300 functional electrical stimulation (FES) cycling system.

(PRWEB) June 05, 2017

FES is a physical and occupational therapy modality used to evoke functional movements and exercise not otherwise possible for individuals with a neurological impairment such as a spinal cord injury, stroke, multiple sclerosis, cerebral palsy, brain injury or transverse myelitis.

Restorative Therapies is the developer of FES medical devices for clinic and at home activity-based therapies. RT300 FES cycle is the result of Restorative Therapies’ ongoing commitment to the research and development of FES powered physical and occupational therapy systems. RT300 is the FES cycle chosen by all leading neurological rehabilitation clinics. RT300 has been used by over 65,000 individuals with neurological impairments.

RT300 is available for home use with an entry level system starting at $10,995. This 6 channel leg and trunk FES system includes multiple therapy options including standard, isokinetic and interval therapies and access to our FES therapy database RTILink.com which tracks outcomes motivating patients. RT300 is also unique in being easily expanded to include arms, additional channels of FES and ability to target any impaired leg, arm, shoulder or trunk muscle group.

Many people can also benefit from the use of FES separate from cycling, as a therapy for functional activities such as standing, transfers, feeding, brushing hair etc. Restorative Therapies’ new Xcite system evokes coordinated muscle contractions to assist with a wide range of task specific, strengthening and gross motor activities. RT300 home systems are expanding to include Xcite at home so patients can benefit not only from cycling but also these other activities.

Restorative Therapies’ commitment to RT300 home use is supported by our acclaimed insurance reimbursement process and dedicated clinical and technical support teams.

“Very impressed with the ownership Restorative Therapies took of the insurance appeal process. Meredith our installer was wonderful during the install process and I appreciate her knowledge and patience,” said Maryann Murphy, RT300 at home rider. “The quality of RT300 is excellent and the user manuals and website are very helpful. I had an excellent experience with Restorative Therapies and I appreciate the resources and customer support that I have access to as a customer.”

“RT300 is the most practical FES cycle because its flexibility and expandability allow it to cater to the varied needs of people with a neurological injury or paralysis. Reaching over 65,000 individuals is the result of a huge team effort between Restorative Therapies and our clinic partners,” says Andrew Barriskill, CEO of Restorative Therapies. “Together we have worked to make RT300 easy to use at home. Our new entry level systems with important therapy options including Xcite will help us assist more people with neurological impairments at home.”

“The continued growth of home FES cycling is enormously motivating to me and my team,” said Wendy Warfield MSHA, OTR/L, Clinical Manager of Restorative Therapies. “This level of at-home FES use completes the continuum of care for people with weak or paralyzed muscles due to a variety of conditions, diseases, and events,” concludes Warfield.

About Restorative Therapies
Restorative Therapies’ mission is to help people with a neurological impairment or in critical care achieve their full recovery potential. Restorative Therapies combines activity-based physical therapy and Functional Electrical Stimulation as a rehabilitation therapy for those with impaired mobility associated with conditions including but not limited to stroke, multiple sclerosis, cerebral palsy, brain injury, transverse myelitis, and spinal cord injury or for patients in critical care.

Restorative Therapies is a privately held company headquartered in Baltimore. To learn more about Restorative Therapies please visit us at http://www.restorative-therapies.com 

For the original version on PRWeb visit: http://www.prweb.com/releases/2017/06/prweb14388936.htm

Source: Restorative Therapies, Inc. Offers Expanded Options for RT300 at Home Functional Electrical Stimulation Cycling | Benzinga

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[ARTICLE] Functional Electrical Stimulation with Augmented Feedback Training Improves Gait and Functional Performance in Individuals with Chronic Stroke: A Randomized Controlled Trial – Full Text PDF

Abstract

Purpose: The purpose of this study was to compare the effects of the FES-gait with augmented feedback training to the FES alone on the gait and functional performance in individuals with chronic stroke.

Methods: This study used a pretest and posttest randomized control design. The subjects who signed the agreement were randomly divided into 12 experimental groups and 12 control groups. The experimental groups performed two types of augmented feedback training (knowledge of performance and knowledge of results) together with FES, and the control group performed FES on the TA and GM without augmented feedback and then walked for 30 minutes for 40 meters. Both the experimental groups and the control groups received training five times a week for four weeks.

Results: The groups that received the FES with augmented feedback training significantly showed a greater improvement in single limb support (SLS) and gait velocity than the groups that received FES alone. In addition, timed up and go (TUG) test and six minute walk test (6MWT) showed a significant improvement in the groups that received FES with augmented feedback compared to the groups that received FES alone.

Conclusion: Compared with the existing FES gait training, augmented feedback showed improvements in gait parameters, walking ability, and dynamic balance. The augmented feedback will be an important method that can provide motivation for motor learning to stroke patients.

Full Text PDF

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[ARTICLE] The Use of Functional Electrical Stimulation on the Upper Limb and Interscapular Muscles of Patients with Stroke for the Improvement of Reaching Movements: A Feasibility Study

Introduction: Reaching movements in stroke patients are characterized by decreased amplitudes at the shoulder and elbow joints and greater displacements of the trunk, compared to healthy subjects. The importance of an appropriate and specific contraction of the interscapular and upper limb (UL) muscles is crucial to achieving proper reaching movements. Functional electrical stimulation (FES) is used to activate the paretic muscles using short-duration electrical pulses.

Objective: To evaluate whether the application of FES in the UL and interscapular muscles of stroke patients with motor impairments of the UL modifies patients’ reaching patterns, measured using instrumental movement analysis systems.

Design: A cross-sectional study was carried out.

Setting: The VICON Motion System® was used to conduct motion analysis.

Participants: Twenty-one patients with chronic stroke.

Intervention: The Compex® electric stimulator was used to provide muscle stimulation during two conditions: a placebo condition and a FES condition.

Main outcome measures: We analyzed the joint kinematics (trunk, shoulder, and elbow) from the starting position until the affected hand reached the glass.

Results: Participants receiving FES carried out the movement with less trunk flexion, while shoulder flexion elbow extension was increased, compared to placebo conditions.

Conclusion: The application of FES to the UL and interscapular muscles of stroke patients with motor impairment of the UL has improved reaching movements.

Introduction

Reaching movements in stroke patients are characterized by decreased amplitudes at the shoulder and elbow joints compared to healthy subjects (16). The movement pattern of patients with stroke is highly related to their level of motor function impairment, which becomes modified due to the lack of inter-articular coordination (1). There is a decrease in the range of motion at the elbow joint with a tendency toward flexion, which avoids correct extension of the upper limb (UL), hampering the ability to perform appropriate reaching movements. Excessive shoulder abduction is also observed as a compensatory movement when there is a lack of appropriate shoulder flexion (7).

In the case of the trunk, greater trunk displacements have been observed in patients with stroke, forward displacements, and torsion movements, which are related to deficits in elbow extension, and shoulder flexion and adduction, as compensatory mechanisms that occur during reaching movements or other activity. Patients are able to develop new motor strategies to achieve their goal despite UL deficits (17). There is a greater involvement of the trunk and scapula during the execution of reaching movements due to the creation of new movement strategies to compensate for the deficiencies (8).

The scientific literature has shown that stroke patients need to create new movement strategies. This involves the development of pathological synergies to carry out the desired movements. An example of this is the excessive movements of the trunk and scapula to compensate the deficiencies resulting from the pathology (7). Proper activation of the interscapular muscles depends on the position of the trunk. Stroke patients, due to the deficits affecting their trunk and scapular movement patterns, are under unfavorable conditions for being able to perform appropriate and selective activation of these muscles, which has a negative impact on the movement of the UL (911).

Regarding the UL muscles involved in reaching movements, a deficit in muscle control and activation has been observed (51213). The synergistic contraction of the shoulder flexor and extensor muscles during reach becomes deteriorated due to muscle weakness and; therefore, the resulting movement is deficient (14). Furthermore, spastic muscle patterns may also prevent the correct performance of UL movements (1518).

Functional electrical stimulation (FES) is a form of treatment that seeks to activate the paretic muscles using short-duration electrical pulses applied via surface electrodes through the skin (19). The use of FES and neuroprostheses has spanned almost four decades (2021). The use of FES as a neuroprosthesis consists of self-treatment at home by means of a neuroprosthetic neuromuscular stimulation system. The objective of this modality is to assist the performance of an activity of daily living (ADL) (22). Recently, functional and clinical improvements have been reported with the therapeutic application of FES, in which stimulation was used to increase voluntary movement after stroke (2223). Therapeutic FES modalities have been used to recruit UL muscles, improving weakness, the dyscoordination of single and multiple joints movements, and spasticity (24).

Most studies employing therapeutic FES for paretic UL rehabilitation are based on stimulation of the shoulder, elbow, and wrist muscles without recruitment of the interscapular muscles (2528). The importance of an appropriate and specific contraction of the interscapular musculature during UL movement is necessary to adapt the position of the scapulothoracic joint to the degree of movement of the glenohumeral joint. This musculature has a stabilizing function upon the entire glenohumeral complex, which is necessary for a correct reaching movement (2931). In healthy subjects, the posture of the trunk has been shown to influence changes in scapular movement and interscapular muscle activity during UL elevation (2932). The motor control of shoulder movement influences the correct and proper activation and synchronization of these muscles (33).

In this study, we tested the ability of a FES system to assist the UL movement of stroke patients based on the stimulation of interscapular, shoulder, elbow, wrist, and finger muscles. To our knowledge, no empirical study to date directly addresses this question. The authors hypothesized that participants receiving FES to the UL and interscapular muscles would be able to perform the movement with less trunk anteroposterior tilt and major shoulder flexion and elbow extension. The aim of this feasibility study was to evaluate whether the application of FES to the UL and interscapular muscles of stroke patients with UL motor impairment would be able to modify their reaching patterns, measured using instrumental movement analysis systems.[…]

Continue —> Frontiers | The Use of Functional Electrical Stimulation on the Upper Limb and Interscapular Muscles of Patients with Stroke for the Improvement of Reaching Movements: A Feasibility Study | Neurology

Figure 1. Patient with the functional electrical stimulation device.

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[VIDEO] Difference Between EMS Electrical Muscle Stimulation and TENS – YouTube

TENS vs EMS: the main difference between the two: TENS stimulates the nerves – the rationale being that the simulation keeps pain signals from reaching the brain. EMS causes the muscles to contract – by mimicking the action potential that comes from the central nervous system.Muscle Stimulation EMS stands for electronic muscle stimulation. These units are designed to provide relief by stimulating the muscles …Transcutaneous Electrical Nerve Stimulators (TENS) use electrotherapy to stimulate the nerves and active therapeutic healing. Electronic Muscle Stimulators (EMS), on the other hand, sends electric impulses that cause muscle contraction.EMS, or Electrical Muscle Stimulation, is the use of electrical pulses to generate a muscle contraction. EMS is typically used to enhance muscle …Neuromuscular Electrical Stimulation for Skeletal Muscle Function … nerve stimulation (TENS), and functional electrical stimulation (FES). ….. withdrawal of ES are present across different types of applications, such as …EMS (Electrical Muscle Stimulation) vs TENS. EMS or Electrical Muscle Stimulation, which is also referred to as neuromuscular electrical …The biggest difference between TENS and EMS is that TENS is designed to stimulate … The electrical muscle stimulation of an EMS device induces muscle …A TENS unit stimulates the nerve endings while the EMS unit stimulates the muscles. Amazingly enough, electrical stimulation of the nerves dates back to ancient Rome … pain reduction begins to last longer and the time between sessions lengthens. … The EMS units are specifically used to prevent atrophied muscles or for …Whether looking for a tool to boost your fitness and strength or recover from an injury quickly, electric muscle stimulation (EMS or NMES) can …

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[WEB SITE] Stroke rehabilitation device lets the patient do the shocking

 

When a person’s arm has become paralyzed due to a stroke, therapists often try to get it moving again using what’s known as functional electrical stimulation – this involves delivering electric shocks to the arm, causing its muscles to move. Studies have shown, however, that it works better when the patient is in charge of delivering those shocks themselves. A new device lets them do so, and it has met with promising results.

The system was developed by Intento, a company affiliated with Switzerland’s EPFL research institute. It consists of three parts: electrodes that the patient places on their arm, a controller that is operated by their “good” hand, and a tablet running custom software.

The therapist starts by selecting a desired arm movement on the tablet, and then loading it into the controller. A display on the tablet’s screen then shows the patient where the electrodes should be placed. Once those are attached, the patient sets about using the controller to deliver shocks to their arm muscles, resulting in the targeted movement – this could be something like pressing a button or picking up an object.

Ideally, once the action has been repeated enough times, the muscles will be “trained” and it will be possible for the patient to perform the movement without any external stimulation.

In a clinical trial performed at Lausanne University Hospital, 11 severely stroke-paralyzed patients – for whom other therapies hadn’t worked – used for the device for 1.5-hour daily sessions, over a course of 10 days. A claimed 70 percent of them subsequently “showed a significant improvement in their motor functions,” as opposed to just 30 percent who were undergoing conventional occupational therapy.

A larger clinical study is now being planned, after which the device will hopefully be commercialized. The research is described in a paper that was recently published in the journal Archives of Physical Medicine and Rehabilitation.

Source: EPFL

Source: Stroke rehabilitation device lets the patient do the shocking

 

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