Electrical StimulationHow it works and it's uses in

Neurolgical Rehabilitation

Cody Small SPTHusson university

Objectives What is electrical stimulation

General uses of electrical stimulation in PT/OT

Specific uses in neurological rehabilitation

Different Placements

Components of the Empi Continuum

Instructional use of the Empi Continuum

What Is electrical Stimulation? Electrcial Stimulation is used in

physical therapy by placing lead wires and electrodes on the skin over target areas of the body. When the electrical stimualtion device is activited a signal is transmitted down the lead to the electrode where it causes depolarization of sensory nerves or motor units to help reduce pain or to increase musclar strength of atrophied muscles, along with many other uses.

Terms To know

Amplitude: Magntiude or the Intensity of the current.

Ramp up/Ramp down: Time it takes for the amplitude at the on/off time to to rise to peak amplitude and time from peak amplitude to back to zero

Pulse Frequency: The amount of energy being delivered to the body

Pulse amplitude: The amount of energy being released to the body

Uses In Physical Therapy

Pain management

Neuromuscular re-education

Hypertrophy of Muscle

Edema

Wound Care

Spasms

Iontophoresis

Biofeedback

Electrical Stimulation in Neuro Rehab Neuromuscular Re-education

Spasticity/tone

Edema control

Atrophy

Functional Electrical Stimulation

Shoulder Laxity

Wound care

Contraindications For It's Use Patients with implanted cardiac pacemakers, defibrillators, and brain

stimulators

Application on throracic region for patients with CHF, arrythmias, MI

Application over the carotid sinus

Application on cancerous tissue

Broken or irritated skin

Lack of sensation

Epilepsy

Application over protruding metal

Set up for shoulder subluxation

Wrist Extensors https://www.youtube.com/watch?v=OoCkog0NcCk

Spasticity: Biceps/Plantar Flexors https://www.youtube.com/watch?v=bsaQWcnJYHk

https://www.youtube.com/watch?v=3H4Gh5-sPQw

Quadriceps https://www.youtube.com/watch?v=i53vEyAZSeE

FES to Improve Ambulatory Function FES is a great option for patient who suffer from foot drop or plantar

flexor spasticity after a stroke

Placement is going to be on ther anterior tib --> refer to slide 9 to see placement

Placement on the quads is also an option for patients who stuggle to extend

the leg during swing phase of gait

FES should be used in conjunction with conventional stroke rehab

https://www.youtube.com/watch?v=PzUYDBWsmNE

Empi Continuum

Soft Keys Soft Keys

HomeKey

PowerKey

OkKey

Features Two independent channels

Allows for timed therapy sessions

Continous stimulation or Cycled Stimulation

Pre-programmed settings or customizable settings

Adjustable ramp up and ramp down times

Components

Electrical Stimulation Device

Lead wires Red: positive

Black: negative

Electrodes

Tips before use Clean the skin around the area the electrodes will be placed

Dry Skin before placing the electrodes on the area

If the patient has lots of hair, you may want to shave the site

Instruction for set up Attach the electrodes to the desired location

Attach the leads to the electrodes

Turn on the Estim Device

Select the desired treatment option

Set the time

Turn the channels up individually till you ge the results

Press start

Once the treatment is over turn the device off then remove the electrodes

References Linn, S. L., Granat, M. H., & Lees, K. R. (1999). Prevention of

shoulder subluxation after stroke with electrical stimulation. Stroke, 30(5), 963-968.

Sabut, S. K., Sikdar, C., Mondal, R., Kumar, R., & Mahadevappa, M. (2010). Restoration of gait and motor recovery by functional electrical stimulation therapy in persons with stroke. Disability and rehabilitation, 32(19), 1594-1603.

Sabut, S. K., Sikdar, C., Kumar, R., & Mahadevappa, M. (2010). Functional electrical stimulation of dorsiflexor muscle: effects on dorsiflexor strength, plantarflexor spasticity, and motor recovery in stroke patients. NeuroRehabilitation, 29(4), 393-400.