Electric therapy, also known as electrical muscle stimulation (EMS) or neuromuscular electrical stimulation (NMES), is a form of physical therapy that uses electrical impulses to stimulate muscle contractions. This therapy can be used to improve muscle strength, increase range of motion, and reduce pain and muscle spasms.
The electrical impulses are delivered to the muscles through electrodes placed on the skin. The impulses mimic the signals sent by the brain to the muscles, causing them to contract and relax. The intensity and frequency of the impulses can be adjusted to target specific muscle groups and achieve different therapeutic effects.
EMS is commonly used to treat a variety of conditions, including muscle weakness, muscle atrophy, and paralysis resulting from spinal cord injuries or neurological disorders. It can also be used to improve muscle strength and endurance in athletes, as well as to reduce pain and muscle spasms in individuals with chronic pain conditions such as fibromyalgia and back pain.
EMS can be used in combination with other forms of physical therapy, such as exercise, to enhance its effectiveness. For example, it can be used to help individuals with spinal cord injuries regain muscle function by allowing them to contract their muscles in a specific pattern, which can then be reinforced through exercise.
Additionally, EMS has been used to help with recovery from injuries and surgeries, such as a broken bone or a knee surgery. It can stimulate blood flow, which can speed up the healing process and reduce inflammation. This can also lead to an improvement in range of motion and strength.
EMS is considered safe when used under the supervision of a healthcare professional. Some of the most common side effects include mild skin irritation or redness at the site of the electrodes, and muscle soreness or fatigue.
Functional Electrical Stimulation?
FES is a fairly simple technology. It can be done with a small device that delivers an electrical impulse to a muscle. It is a low-energy current that acts like a tiny shock to activate nerves, which in turn causes the muscle to move.
This can be used for a paralyzed muscle that the person cannot normally move. Because the electrical energy delivered is low, the procedure is safe and not expected to be painful. The person receiving the impulse may feel a minor tingling or, at worst, a slight burning sensation.
Traditionally, FES technology has been developed and used for people who suffer paralysis from accidents. The stimulation can assist a person with small-scale muscle movements like voiding the bladder and swallowing, as well as with larger movements like walking, grasping objects, or standing up.
FES has also been used in people recovering from a stroke who have lost some muscle function and those with neurological disorders or brain damage.
This therapy is described as functional because it restores function but also because it is not designed to be a lifelong mobility aid. It is only intended to be used as a short-term therapeutic modality to retrain muscles and restore some degree of voluntary muscle function.
The technology is being developed further, though, with some paralyzed patients benefiting from implanted electrical stimulation devices that allow them to regain some muscle movement.
Improving Gait in Spastic Cerebral Palsy
Spastic cerebral palsy is the most common form of this condition, describing between 70 and 80 percent of all children with CP. It causes the muscles to be stiff and painful and the reflexes to be exaggerated. Most children with this form of CP will struggle to walk to some degree. They may also experience involuntary limb movement, continuous muscle spasms, joint contractures, and limited flexibility.
Studies show that FES can be used to help children with spastic cerebral palsy walk better and more easily. In one such study, the children received eight weeks of daily functional electrical stimulation to the muscles. The study involved 32 children with an average age of 10 years. There was a control group along with the group that received the FES treatment.
All of the children were evaluated at the beginning of the study, again at the end of the eight weeks of treatment, and six weeks after that. They were assessed for their walking ability and their own perceptions of how they were walking.
Those who received the treatment showed significant improvements in how they perceived their ability to walk. These children felt that they could walk better and with less pain.
In another study involving children with hemiplegic spastic cerebral palsy, FES treatment was shown to improve gait abnormalities. Hemiplegic CP occurs when the disability is only on one side of the body, left or right. This can cause the child to toe-walk and have other asymmetrical gait issues that disturb the child’s balance.
Over time, these often cause more challenges with flexibility, coordination, pain, and movement.
The children in this study could walk, but many used braces. They received FES instead of braces or splints. The children were evaluated before and after the treatment, and there were significant improvements in toe-walking and other asymmetries. All of the children were able to move more symmetrically due to the treatment.
These studies are more examples of research demonstrating similar improvements for children with spastic cerebral palsy treated with FES.
Correcting Foot Drop
Some children with cerebral palsy develop a type of movement called foot drop. They have difficulty picking up their feet to take steps, and the toe tends to drag while they move through each step. To avoid this, they lift the knee higher or swing it outward to help elevate the foot off the ground while walking.
It is an awkward movement to keep the foot from dragging, and it can cause pain and other issues later on. Foot drop is most often corrected with braces or orthotics, but these can limit a child’s movement.
Benefits of EMS Treatment
There are many potential benefits of EMS treatment, including:
• Reduced pain: One of the most common reasons people seek EMS treatment is for pain relief. Studies have shown that EMS can effectively reduce pain in a variety of conditions, including low back pain, neck pain, and migraines.
• Improved function: In addition to reducing pain, EMS can also improve function. Studies have shown that EMS can improve range of motion, strength, and coordination in people of various ages and health conditions.
• Faster healing: EMS has also been shown to promote healing. One study showed that EMS significantly reduced the time it took for people with Achilles tendon injuries to return to their previous level of activity.
• This therapy can be used to improve muscle strength, increase range of motion, and reduce pain and muscle spasms. However, it is important to note that there are some complications and solutions that may arise during the use of this therapy.
• One of the most common complications of electric therapy is skin irritation or redness at the site of the electrodes. This can occur if the electrodes are not placed correctly or if the skin is not properly cleaned before the therapy is administered. To avoid this complication, the therapist should ensure that the electrodes are placed correctly and that the skin is cleaned before the therapy is administered. Additionally, using an electrode gel or cream can help to reduce skin irritation.
• Another complication of electric therapy is muscle soreness or fatigue. This can occur if the therapy is administered for too long or if the intensity of the impulses is too high. To avoid this complication, the therapist should monitor the patient’s response to the therapy and adjust the intensity and duration of the impulses accordingly. Additionally, it is important for the patient to rest and properly stretch after the therapy.
• Another issue that may arise during electric therapy is muscle cramping, it can occur if the therapy is applied for too long or if the intensity of the impulses is too high. To avoid this, the therapist should monitor the patient’s response to the therapy and adjust the intensity and duration of the impulses accordingly. Additionally, it is important for the patient to properly hydrate before and after the therapy.
• In some cases, electric therapy may not be suitable for certain individuals such as pregnant women, people with pacemaker, or people with certain medical conditions such as cancer, deep vein thrombosis or varicose veins. In these cases, alternative forms of therapy may be recommended.
• Additionally, electric therapy should not be used on open wounds or broken skin. It is also important to avoid placing electrodes directly over bony areas, as this can cause discomfort or pain.
• It’s important to note that electric therapy should always be administered by a trained healthcare professional. It is also important for the therapist to have a thorough understanding of the patient’s medical history and any conditions that may contraindicate the use of electric therapy.
• In conclusion, electric therapy or electrical muscle stimulation is a form of physical therapy that uses electrical impulses to stimulate muscle contractions. However, it is important to be aware of the potential complications that may arise during the use of this therapy such as skin irritation, muscle soreness, fatigue, cramping and some medical conditions that may contraindicate its use. To avoid these complications, the therapist should ensure that the electrodes are placed correctly, the skin is cleaned before the therapy is administered, monitor the patient’s response to the therapy and adjust the intensity and duration of the impulses accordingly, and ensure that the patient is properly hydrated before and after the therapy. It is also important for the therapist to have a thorough understanding of the patient’s medical history and any conditions that may contraindicate the use of electric therapy.