Name of the Procedure:

Functional Neuromuscular Stimulation, Transcutaneous Stimulation of Sequential Muscle Groups of Ambulation with Computer Control (E0764)

Summary

Functional neuromuscular stimulation uses electrical impulses to stimulate muscle groups, mimicking natural muscle contractions. It is a computer-controlled system designed to help individuals with spinal cord injuries achieve functional walking.

Purpose

This procedure is specifically designed for individuals with spinal cord injuries that impair their ability to walk. The goal is to enhance mobility, improve walking patterns, and increase the overall quality of life by restoring functional ambulation capabilities.

Indications

• Spinal cord injuries affecting motor function
• Severe muscle weakness or paralysis in the lower extremities
• Patients who have completed an extensive training program to use the system effectively

Preparation

• Comprehensive physical examination
• Assessment of muscle response to electrical stimulation
• Training sessions to familiarize the patient with the system
• Possible adjustments to medications as per physician recommendations

Procedure Description

1. The patient undergoes a series of training sessions to learn how to use the system.
2. Electrodes are placed on the skin over specific muscle groups.
3. The system is programmed to deliver controlled electrical pulses to stimulate muscle contractions.
4. A computer regulates the sequence and intensity of the stimulation based on the patient's walking pattern.
5. The patient practices walking with the device under supervision until proficient.

Duration

The initial training can take several weeks, with individual sessions lasting about 1 to 2 hours. Once trained, daily usage can vary based on the patient’s rehabilitation plan.

Setting

The procedure and training are generally conducted in outpatient rehabilitation clinics or specialized medical centers.

Personnel

• Rehabilitation specialists
• Physical therapists
• Biomedical engineers
• Healthcare providers trained in functional neuromuscular stimulation

Risks and Complications

• Skin irritation or burns at the electrode sites
• Muscle fatigue or soreness
• Malfunction of the electronic device
• In rare cases, muscle or nerve damage

Benefits

• Improved ability to walk
• Enhanced muscle strength and coordination
• Increased independence and mobility
• Better quality of life and psychological well-being

Recovery

• Regular follow-up appointments for device adjustments and monitoring
• Daily practice with the system
• Gradual improvements in walking ability over weeks to months
• Adherence to a prescribed rehabilitation plan

Alternatives

• Traditional physical therapy
• Wheelchair use for mobility
• Assistive devices such as walkers or canes
• Advanced mobility aids like robotic exoskeletons Comparison: While traditional physical therapy and mobility aids provide support, functional neuromuscular stimulation offers the potential for a more natural walking pattern and improved muscle function.

Patient Experience

• Initially, patients may experience mild discomfort from the electrical stimulation.
• As they become accustomed to the device, walking may feel more natural.
• Proper pain management and comfort measures are provided to ensure patient well-being during the transition period.