Functional electrical stimulation takes place at the functional, activity or action level.
Why functional electrical stimulation?
Electrical stimulation is described as functional if the contractions triggered by the stimulation are coordinated in such a way that they support a limited or absent function.
FES is electrical stimulation during the execution of a voluntary movement. This means that every time a person wants to perform a movement, they receive electrical support.
Application
Motor learning, recovery or improvement of functions
e.g. standing training with simultaneous stimulation of the naturally active muscle groups. [1]
When using FES in patients with spinal cord injury, a distinction must be made between two groups: those with a lesion of the upper motor neuron (UMNL) and those with a lesion of the lower motor neuron (LMNL). The stimulation parameters differ for both types of lesions. Damage to the upper motor neuron (UMNL) is stimulated via the nerve with pulse widths in the μs range, while damage to the lower motor neuron (LMNL) is stimulated directly via the muscle with pulse widths in the ms range.
Damage to the 1st motor neuron, upper motor neuron
UMNL = Upper Motor Neuron Lesion, lesion of the upper motor neuron.
Damage to the 2nd motor neuron, lower motor neuron
In electrostimulation of denervated muscles in LMNL = lower motor neuron lesion, lesion of the lower motor neuron, FES is established to support reinnervation even in the case of partial denervation. Stimulation is performed directly on the denervated muscle, as stimulation via upstream nerves is (currently) no longer possible[1].
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