Name of the Procedure:

Common name(s): Functional Electrical Stimulation (FES) Technical/Medical term: Transcutaneous Stimulation of Nerve and/or Muscle Groups

Summary

Functional Electrical Stimulation (FES) is a non-invasive procedure that uses electrical impulses to activate nerves and muscles. It involves placing electrodes on the skin to deliver electrical currents that stimulate muscle contractions, helping to improve or maintain muscle function.

Purpose

FES is primarily used to address conditions that result in muscle weakness, paralysis, or limited movement. The goal is to enhance muscle strength, improve mobility, and promote better functional outcomes in patients with neurological conditions such as spinal cord injuries, stroke, or multiple sclerosis.

Indications

• Muscle atrophy or weakness due to neurological disorders
• Paralysis resulting from spinal cord injuries
• Motor impairment following a stroke
• Other conditions leading to limited movement or muscle function

Patient criteria include:

• Adequate skin condition to tolerate electrode placement
• Absence of contraindications such as pacemakers
• Willingness and ability to follow post-procedure instructions

Preparation

• No specific fasting or medication adjustments required.
• Assessment of the patient's skin condition.
• Possible diagnostic tests to evaluate muscle and nerve function.

Procedure Description

1. The patient is positioned comfortably, and the skin area where electrodes will be placed is cleaned.
2. Electrodes are strategically placed on the skin over targeted nerve or muscle groups.
3. An FES device is then connected to the electrodes, and electrical impulses are administered.
4. The clinician adjusts the intensity and frequency of the stimulation based on the patient's tolerance and therapeutic goals.
5. The procedure is monitored to ensure effectiveness and patient comfort.

No anesthesia or sedation is generally required.

Duration

The procedure typically takes about 30-60 minutes per session.

Setting

FES is usually performed in outpatient clinics, rehabilitation centers, or sometimes in a hospital setting.

Personnel

• Trained physical therapists or clinicians specializing in neurorehabilitation
• Medical technicians
• Occasionally, physicians overseeing the treatment plan

Risks and Complications

• Skin irritation or burns at electrode sites
• Muscle soreness or fatigue
• Rarely, allergic reactions to electrode adhesives
• Potential interactions with implanted devices like pacemakers

Management of complications includes adjusting stimulation parameters or temporarily discontinuing the procedure.

Benefits

• Improved muscle strength and function
• Enhanced mobility and coordination
• Potential for better quality of life Patients may begin to notice benefits after several sessions, with continued improvements over time.

Recovery

• Minimal to no downtime is required post-procedure.
• Patients are usually advised to hydrate and may need to perform gentle stretching to reduce muscle stiffness.
• Follow-up appointments may be scheduled to monitor progress and adjust therapy as needed.

Alternatives

• Physical therapy without electrical stimulation
• Pharmaceutical treatments for muscle spasticity or weakness
• Surgical interventions in more severe cases

Pros and cons of alternatives vary based on individual patient conditions and treatment goals.

Patient Experience

During the procedure, patients may feel a tingling sensation at the electrode sites and muscle contractions, which might feel unusual but should not be painful. Post-procedure, patients may experience mild muscle soreness, similar to what they might feel after exercising. Comfort measures like applying a warm compress post-treatment can help alleviate any discomfort.