Posts Tagged Functional electrical stimulation
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
- Sit to stand training
- Pre Gait Training
- Correction of Foot Drop,
Correction of Circumductory Gait
for Paraplegia (Incomplete SCI) using FES unit on both sides
Shoulder subluxation and shoulder rehabilitation
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: http://www.fescenterindia.com
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.
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.
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.
[Abstract] The comparative efficacy of theta burst stimulation or functional electrical stimulation when combined with physical therapy after stroke: a randomized controlled trial
Objective: To study the long-term effectiveness of Theta Burst Stimulation (TBS) or Functional Electrical Stimulation (FES) combined with Physical therapy (PT) as compared to PT alone for improving arm functions in patients with acute stroke.
Interventions: 60 patients were randomized into three groups of 20 each: TBS+PT; FES+PT; and PT alone. TBS group received intermittent TBS of ipsilesional hemisphere and continuous TBS of contralesional hemisphere while FES group received FES of paretic limb, both for four weeks. All groups received supervised physical therapy for four weeks followed by home physiotherapy for one year.
Outcome measures: Fugl Meyer Assessment upper limb score (FMA-UL) was primary outcome measure. Patients were evaluated at baseline and subsequently at one, three and six months and one year.
Results: Compared to PT group, mean FMA-UL scores were higher in TBS and FES groups at all follow-ups (P < 0.001). From baseline to one year, mean (SD) FMA-UL scores increased from 14.9(2.1) to 55.55(2.46) in TBS group, 15.5(1.99) to 55.85(2.46) in FES group, and 14.3(2.2) to 43.3(4.22) in PT group indicating an increase of 273%, 260%, and 203% respectively. There was no difference between FES and TBS groups.
via The comparative efficacy of theta burst stimulation or functional electrical stimulation when combined with physical therapy after stroke: a randomized controlled trial – Fayaz Khan, Chaturbhuj Rathore, Mahesh Kate, Josy Joy, George Zachariah, P C Vincent, Ravi Prasad Varma, Kurupath Radhakrishnan, 2019
[VIDEO] Split-Crank Functional Electrical Stimulation Cycling: An Adapting Admitting Rehabilitation Robot – YouTube
[ARTICLE] Speed-adaptive control of functional electrical stimulation for dropfoot correction – Full Text
Functional electrical stimulation is an important therapy technique for dropfoot correction. In order to achieve natural control, the parameter setting of FES should be associated with the activation of the tibialis anterior.
This study recruited nine healthy subjects and investigated the relations of walking speed with the onset timing and duration of tibialis anterior activation. Linear models were built for the walking speed with respect to these two parameters. Based on these models, the speed-adaptive onset timing and duration were applied in FES-assisted walking for nine healthy subjects and ten subjects with dropfoot. The kinematic performance of FES-assisted walking triggered by speed-adaptive stimulation were compared with those triggered by the heel-off event, and no-stimulation walking at different walking speeds.
Higher ankle dorsiflexion angle was observed in heel-off stimulation and speed-adaptive stimulation conditions than that in no-stimulation walking condition at all the speeds. For subjects with stroke, the ankle plantarflexion angle in speed-adaptive stimulation condition was similar to that in no-stimulation walking condition, and it was significant larger than that in heel-off stimulation condition at all speeds.
The improvement in ankle dorsiflexion without worsening ankle plantarflexion in speed-adaptive stimulation condition could be attributed to the appropriate stimulation timing and duration. These results provide evidence that the proposed stimulation system with speed-related parameters is more physiologically appropriate in dropfoot correction, and it may have great potential value in future clinical applications.
About three quarters of stroke survivors experience different levels of brain dysfunction and movement disorder , which result in lower living quality and limited ability in social activities . Of these subjects, 20% suffer from impaired motor function in the lower extremities. One of such impairments is dropfoot, which is characterized by poor ankle dorsiflexion during the swing phase and an inability to achieve heel strike at the initial contact [3, 4]. Abnormal gaits such as circumduction gait and abnormal foot clearance on the affected side are often found as a method of compensating for excessive hip abduction and pelvis elevation on the unaffected side . This results in gait asymmetry and slow walking speed .
Functional electrical stimulation was a representative intervention to correct dropfoot and Liberson et al. first introduced functional electrical stimulation (FES) to correct dropfoot for chronic hemiplegic subjects in the 1960s . An electrical charge is delivered via a pair of electrodes to activate the tibialis anterior (TA), which results in ankle dorsiflexion. Yan et al. applied two dual-channel stimulators to the quadriceps, hamstring, gastrocnemius, and TA to recover motor function of the lower extremities in an early stage after stroke . The stimulation was followed by a predetermined sequence of muscle activations that mimic a healthy gait cycle . The duration of stimulation was five seconds in Yan et al.’s study. However, subjects with different severities of impairment might have different walking speeds , which means that a fixed stimulation duration might not be able to account for different walking patterns.
Liberson et al. used the heel-off event detected by a footswitch to trigger the stimulation . However, the reliability of the footswitch controller was significantly reduced when subjects who dragged their feet during walking encountered a slope or an obstacle . Bhadra et al. proposed a manual switch to trigger stimulation as a walking aid for subjects with spinal cord injury (SCI) . However, manual control may distract subjects from maintaining balance and lead to an increased risk of falls [13, 14]. Furthermore, the cable between the control sensor and stimulator was inconvenient for walking .
Instead of a footswitch, Mansfield et al.  and Monaghan et al.  detected the heel event of the gait cycle in FES-assisted walking using an accelerometer and a uniaxial gyroscope, respectively. The commercially available product WalkAide also uses an accelerometer for this purpose . Electromyography (EMG) signal is also applied as a control source in FES-assisted walking for the detection of volitional intent of muscle . Yeom et al. amplified the EMG signal of the TA and modulated the stimulation intensity in proportion to the integrated EMG envelope. The electrical pulses are then sent to the common peroneal nerve for dropfoot correction .
In these studies, FES applied to the TA was mainly triggered by the heel-off event. However, this event occurs during the push-off phase and before TA activation . An earlier start of TA stimulation results in reduced ankle plantarflexion . Spaich et al. suggested implementing a constant time interval before the onset timing of TA stimulation to extend the push-off phase before the ankle dorsiflexion . Some studies have found that walking speed can affect the activation of TA [22, 23]. Shiavi et al. found that the duration of EMG activity decreased as speed increased . In Winter et al.’s study, the shape of the EMG patterns generally remained similar at the different walking speeds and the duration of EMG activity was closely related to the normalized stride time . Although the duration of TA activation changes with the walking speeds has been reported , the selection of speed-adaptive FES parameters for TA has not been investigated.
The objective of this study is to find a more physiologically appropriate FES design for dropfoot correction. Firstly, speed-related changes in onset timing and the duration of TA activation were examined. Next, linear models were built for the walking speed and time interval from the heel-off event to the onset timing of TA activation, as well as for the walking speed and the duration of the TA activation. The speed-adaptive stimulation (SAS) timing and duration were then calculated based on the two models and applied for FES-assisted walking. Finally, the performance of stimulation triggered by SAS, heel-off event (HOS) and no stimulation (NS) were compared during FES-assisted walking on both subjects with stroke and healthy subjects at different walking speeds.[…]
Community Regional Medical Center is currently part of the first study on the west coast working with a device that helps stimulate muscles when a patient is not able to do it themselves.
Smart Functional Electrical Stimulation System.
Treatment for foot drop patient.
It can be used when an upper motor neuron injury has caused a foot injury.
- – Multiple sclerosis (MS)
- – Stroke (CVA)
- – Incomplete spinal cord injury (SCI)
- – Cerebral palsy (CP)
- – Traumatic brain injury (TBI)
What is Functional Electrical Stimulation? This video posted by Active Linx demonstrates the benefits of FES.