Week 9: Electrotherapy for Muscle Weakness - FES & EMS

Question 1

Parameters of FES/EMS

Characterized by changes in parameters from NMES to (increase/reduce) likelihood of fatigue
(Higher/Lower) frequency
(Higher/lower) amplitude – tetany for movement
Can use shorter pulse durations for (smaller/larger) muscles

Frequency - (above/under) 50pps
Amplitude - (Twitch/Tetany) for movement
Pulse Duration - - usec (high for larger muscles)
Treatment time - - hrs, 1:5 ratio and progress to 1:1 on/off

Answer 1

reduce; lower; lower; smaller; under; Tetany; 200-600; 4-7;

Question 2

Uses of FES/EMS

(FES/EMS)

Orthotic substitution
Eliminate need for a brace/orthosis/sling
Muscle control of movement and/or posture

(FES/EMS)

Low Frequency Electrical Exercise – more accurate term?
Stimulating muscle contraction in denervated muscle: to preserve muscle function after temporary injury (e.g. Bell’s palsy)
to improve muscle function after incomplete SCI
to preserve musculoskeletal system and improve metabolic conditions after complete SCI

Answer 2

FES; EMS

Question 3

FES

Shoulder Orthotic Substitution

Frequency - - pps
Amplitude: Just enough to achieve (twitch/tetanic) contraction, (twitch/tetany) sufficient to achieve desired motion
Pulse Duration- - usec (tends to be lower - )
Treatment time - 4-7 hrs per session, 3-7 times per week for 4-8 weeks
On/Off time; ramp time - Start with : ratio and progress to : on/off
Current- (AC/PC)

Answer 3

10-36; tetanic; tetany; 200-600; 200-300; 1:5; 1:1

Question 4

FES

Orthotic substitution for wrist ext or ankle df

Frequency - - pps
Amplitude: Just enough to achieve (twitch/tetanic) contraction, (twitch/tetany) sufficient to achieve desired motion
Pulse Duration- - usec (tends to be lower - )
Treatment time - Depends on goal of tx – for ther ex or for orthotic wear (e.g. with an external device)
On/Off time; ramp time - - sec/- sec
Current- (AC/PC)

Answer 4

20-50; tetanic; tetany; 200-600; 200-300; 5-10; 5-25; PC

Question 5

FES

Correction for scapular winging due to MT/LT weakness

Frequency - - pps
Amplitude: Just enough to achieve (twitch/tetanic) contraction, (twitch/tetany) sufficient to achieve desired motion
Pulse Duration- - usec (tends to be lower - )
Treatment time - Sufficient to complete desired exercise
On/Off time; ramp time - Depends on desired movement, exercise; using hand trigger if available
Current- (AC/PC)

Answer 5

10-75; tetanic; tetany; 200-600; 200-300; PC