Functional Electrical Stimulation (FES) is the application of an electrical current to excitable tissue to improve or restore functions lost in neurologically compromised subjects” (Peng et al., 2010).

It is a subgroup of electrical stimulation focussed around the activation of paralysed or paretic muscles and is commonly applied on the surface of the skin using adhesive or carbon electrodes

Various types of waveform can be applied using different devices which can influence the specificity, effect, ease of application and comfort. For optimal effects the peripheral nervous system is required to be intact, so the neurological compromise is central nervous system (brain and spinal cord) in origin.

This is not to say effects cannot be gained with damage to the peripheral nervous system, but they are likely to require much higher levels of current and will generate smaller, less powerful contractions.

The benefits of FES

Using FES will create patterned movement in the arms, legs and trunk. This will enable the muscles to work and perform activities even though they may be weak or paralysed through neurological disease or injury. This activity will:

  • Improve blood sugar homeostasis
  • Enhance cardiovascular function
  • Enhance endothelial function
  • Decrease chronic inflammation
  • Regulate hormone levels
  • Preserve/build musculoskeletal & neuromuscular integrity
  • Decrease depression, increase cognition

How does it fit into rehabilitation therapy?

During passive therapy, muscles don’t actually do any of the work. Arms legs are moved mechanically by a non-FES cycle. Active therapy allows muscles to do the work they are meant to do. This is achieved either by an individual moving their muscles on their own, or when muscles are activated by FES.

This means that active therapy ensures muscles are working and performing the activity.

Where can it be used in the continuum of care?

FES systems can be applied across the continuum of care from the acute phase to chronic intervention. For some FES is a short-term intervention. Whilst, for others, where recovery is longer or less function is regained, patients may benefit from using FES long term at a facility in the home.

This article was taken from our forthcoming White paper – The integration of Functional Electrical Stimulation (FES) technology and neurorehabilitation.

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