NMES + FES in Patients With Neuro Diagnoses

Lecture 5 - Ch. 14 in Book

FES, NMES

______ is for innervated or denervated muscles but _____ is only for innervated muscles

NMES

The goal of _______ is strength and re-education

FES

The goal of _____ is to facilitate functional movement like gait, grasping, or standing

denervated, nerve

EMS works with _____ muscles to preserve the muscle while the ____ regenerates

True

T/F: EMS depolarizes the muscle itself

hand function

NMES for CVA patients focuses on _____ and really only helps short term

NMES

For patients with CP, _____ has been proven to help with strength, ROM, spasticity, and function

hypertrophy

For SCI patients, NMES is effective for muscle _____ and lean mass but the parameters are very widespread

urinary incontinence

MS patients have shown improvement with NMES in reducing spasticity and decreasing ______

False; no MS is typical

T/F: Every MS patient is “typical”

all of the above

To decrease SPASTICITY, you should do the following

NMES to decrease spasticity

• waveform: biphasic Asym/Sym or russian

• pulse duration: 250-500 microsec

• frequency: 20-100 pps

• amplitude: 3-/5 for Antagonist/Agonist theory, no motor response for Sensory Input

• ramp: 0-3”

• duty cycle: larger ratio

• tx duration: 10-60’ / day

FES

the goal of ______ for shoulder subluxation is protection so the patient can be functional

80%

______ of CVA patients have subluxations within the first couple of weeks post stroke

True

T/F: Subluxations improved by an average of 1.9 mm, when FES was used BEFORE subluxation occured

existing

FES is not effective in reducing ______ subluxations

posterior delt, supraspinatus

Proper electrode placement for shoulder subluxations is ______ and ______

capsule stretch

In early stages, use FES to prevent _______ after a CVA to avoid shoulder subluxation

pain

FES is not effective for _____ in subluxed shoulders

FES for shoulder subluxation

• waveform: biphasic asym or russian

• pulse duration: 200-350 micro sec (for endurance)

• frequency: 30-60 pps (more fatiguing)

• amplitude: enough to get sensation of humerus in capsule with no capsule stretch

• ramp time: 3”

• duty cycle: start at 1:1 then get to 15:1

• duration: 20’ - 6 hrs, 5-7x/week, 4-8 weeks

BioNess H200

the _______ is an FES device to help increase UE function where repetition is KEY

True

T/F: lots of research for FES is about DF assistance and ambulation

gait

The goal of FES for ambulation is to increase _____ speed, and decrease the physiological cost of walking

FES for DF Assist + Ambulation

• waveform: biphasic

• pulse duration: 200-350 micro sec

• frequency: 30-40 pps

• amplitude: enough for foot to clear the ground (3/5)

• ramp time: 0-1”

• duty cycle: N/A (timed with heel strike)

incomplete

for _______ SCI, FES can help with swing, walking speed, and strength

restoration

for complete thoracic SCI, there are surface electrodes or implanted electrodes that help with ________ of gait via FES

bone density, spasticity

FES with cycling improves _______ in joints, muscle fiber size, ________ and quality of life for complete/incomplete SCI and CVA pts

Osteopenia

for pts with ________, FES can help to partially reverse bone mineral density decreases via Wolff’s Law