– By Sabrina Shah (Neuro Physiotherapist)
Functional Electrical Stimulation to help with your muscle function!
Firstly, what is it?
Functional Electrical Stimulation (FES) is a technique used in rehabilitation that uses electrical impulses to stimulate muscles or nerves in order to restore or improve function.
The electrode pads send electrical impulses to the muscles, which send signals to the spinal cord to be able to activate the muscle. Normally for a muscle to activate a muscle, a signal is sent from your brain to the spinal cord, then to the muscle. Hence FES bypasses the message having to be sent down from the brain. It works by delivering controlled electrical signals to specific muscles, mimicking the natural signals that would normally be sent by the brain.
Can it only be used to treat stroke patients? Who can benefit from functional electrical stimulation or FES for short?
Most neurological conditions benefit from the use of FES. FES is commonly used for rehabilitation in people who have experienced spinal cord injuries, strokes, multiple sclerosis, Parkinson’s disease or other neurological conditions that affect motor function. It can help improve mobility, prevent muscle atrophy, reduce spasticity, and enhance overall quality of life.
How does FES help people?
Restoring motor function: For individuals with paralysis or weakness, it can help them regain the ability to perform tasks like walking, standing, or grasping objects.
Muscle strengthening and prevention of atrophy: Regular stimulation can help maintain muscle tone and strength, which is important for individuals who are unable to use their muscles naturally.
Improve sensation to the skin and help with neglect: Regular stimulation can help the sensation to the skin come back and with neglect it can give awareness to the side the client is neglecting.
Improving circulation and reducing swelling: FES can help improve blood flow and reduce fluid retention in muscles.
Pain relief: It may be used to alleviate chronic pain conditions by stimulating nerves that interfere with pain signals.
Myths of FES
“It’s scary and it hurts”
You should not be afraid of it, with a good physiotherapist they will always talk you through the process and reassure you that they will ease into it.
It is a difficult sensation to explain, but it is not like being electrocuted with a taser – we’ll leave that for the movies. Recently, a client described it as a bubbly sensation on the muscle, other people describe it as a firm tickling sensation. There is a control volume on the machines that we use at ph.therapy, so we start off on a low level and check in with you as we go up, and we only go up to a point which you can tolerate.
“I have to use it for the rest of my life”
Sometimes with FES rehabilitation you can help to create new neuroplasticity (regrow the signal from the brain to the spinal cord), this means that the muscle can start getting stronger organically so you therefore do not have to use FES.
See the video below of one of our stroke clients who could not lift her ankle up when we first started working with her. We used FES 3 times a week for a few months and then she was able to start safely walking outside. Before this she had to wear a splint to keep her foot up when walking, so she did not trip over it.
Things to note
The first time is always the worst. You’ve without realising it built up this worry in your head as it’s something new, so your body’s pain receptors will react to that fear. Best thing we can say is ‘don’t worry about it, it does not hurt, it’s just an unusual sensation’.
Once your body gets used to the sensation that is the first hurdle.
It is not something that will work overnight, you have to keep on using it daily in the initial stages. Hence why we recommend, with neurological rehabilitation, particularly stroke rehab, to have sessions a few times a week so that we can get the maximum benefit from functional electrical stimulation.