what is the purpose of neuromuscular electrical stimulation
increases strength in the innervated muscles
xteristics of nems
freq..30-50
pulse duration..1-400 s
amplitude.. contraction must be achieved
features of type 1 or slow twitch muscle fiber
aerobic muscular endurance moderate weight 12-20 reps 30-50 percent of 1rep maximum
features of type 2 or fast twitch muscle fibers
anaerobic muscular strength heavy weight 3-5 reps 80 perc of 1 rep maximum
in type 1 what hz are the following respectively
vibration,tetanization,maximal tetanic contraction
0-10
10-33
33
in type 11 what are the hz of the following vibration tetenization and maximal tetanic contraction
0-33
33-66
66
what are the responses to the muscle fibers when nems is applied
acuumulation of lactic acid reduces
fatigue is delayed
glucose consumption increases
blood flow and oxygen consumption increases
there is a ch1ange is aerobic and anaerobic capacities
trpomyosis varies from rapid to slow
what fibers are stimulated at a higher rate in nmes application
type 2
why is the type 1 fiber activated earlier than the type 2 in involuntary contraction
Because involuntary stimulation progresses from the smallest diameter motor neuron to the largest diameter)
xteristics of the typr 1 fiber formed by the nmes
high resistance
endurance
low mx contraction rate
nmes reduces pain with an incease in wat
microcirculation
advantages of the monopolar application
incr ROM
inhibits atrophy
increases muscle mass. reeducation and facilitation
what techniques are used in the superempoze techni in nmes application
fast interpolation tech
superficial electrical stimulation tech
roles of nmes in spacity
increase muscle strength
incr excitability
incr in blood circulation
recovery of functionality and recovery control
what type of contraction should be preferd in nmes
stimulation of motor nerves
patient participation
what types of application of contarction are suitable fpr agonist and antagonist muscle respectively
tetanic contr
surge application
what type of contractio should be applied for edema , analgesia and muscel spasm
tetanic
intermittent
surge
main contraindication
peripheral vascular disease
cognitive impairement
sensory impairement
unstable hyper or hypotension
what electrophysiscal agent is applied to paralyzed muscles
FES OR functional electrical stimulation
main purpose of FES
contraction and helps the reflex motor activities to normalize
replacement of motor functions
eliminating gait and standing disturbance
afferent and efferent fes
efferent is a direct stimulation of the motor nerves
afferent is indirect late weaker response occur as a result of stimulation of the sensory nerves and activation of the spinal reflex mechanism
what do we do for motor learning
TEACH NORMAL MOVEMENT • PROVIDE MUSCLE ACTIVATION • MAKING FOCUS ON MOVEMENT • LOTS OF REPETITION • GIVING TRAINING TO ACTIVITY-BASED MOVEMENT
types of electrodes
superficial…superficial
percutaneous….about 3 months
implants … 3 months plus
parameters for fes
freq...20-200 upper extremity..12-15 lower extremity...18-25 intensity..15-120 volts pulse duration..200-400 us duration..0,1-1
clinical aims for fes
Rehabilitation of motor functions • Restoring reflex mechanisms • Support for spontaneous recovery • Accelerate neuromotor development • Prevent / correct disorders that develop especially in locomotormusculoskeletal system after disorders
features of unilateral single chanel stimulation
it can peform ipsilateral and contralateral control
the odstock dropped foot stimulator is divided into
bionic walk aid
stimulation time during walking
emg trigger point stimulation has a
closed biofeedback
what is a parastep
its an FES with a superficial electrode
its designed for standing in short distances in patients with thoracic level complete paraplegia and stroke
what is a neuroprotesis
developed for walking in patients with incomplete
paraplegia and stroke. Suitable for patients with drop foot and no
muscle control on one leg.
what nerve is stimulated in the neuroprotesis application
peroneal nerve
what rom movement does the stimulation of the peroneal nerve cause
flexion reflex
hip knee and ankle
fes containing system has been developed for
grip activity for upper extremity
what fes provides ambulation
hybrid orthosis
hybrid orthosis is a combination of
fes and mechanical orthotics
indications for fes
Stroke Spinal cord injury Cerebral palsy Central nervous system diseases (MS, ALS)
what is nmes
its the activation of muscle strengthening for
what is fes
activation of skeletal muscle for reeducation or movement training for functional use
