electrical stimulation inservice pdf
TRANSCRIPT
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Electrical StimulationHow it works and it's uses in
Neurolgical Rehabilitation
Cody Small SPTHusson university
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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
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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.
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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
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Uses In Physical Therapy
Pain management
Neuromuscular re-education
Hypertrophy of Muscle
Edema
Wound Care
Spasms
Iontophoresis
Biofeedback
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Electrical Stimulation in Neuro Rehab Neuromuscular Re-education
Spasticity/tone
Edema control
Atrophy
Functional Electrical Stimulation
Shoulder Laxity
Wound care
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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
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Set up for shoulder subluxation
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Wrist Extensors https://www.youtube.com/watch?v=OoCkog0NcCk
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Spasticity: Biceps/Plantar Flexors https://www.youtube.com/watch?v=bsaQWcnJYHk
https://www.youtube.com/watch?v=3H4Gh5-sPQw
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Quadriceps https://www.youtube.com/watch?v=i53vEyAZSeE
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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
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Empi Continuum
Soft Keys Soft Keys
HomeKey
PowerKey
OkKey
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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
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Components
Electrical Stimulation Device
Lead wires Red: positive
Black: negative
Electrodes
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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
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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
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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.