Physical therapy electrical stimulation, also known as neuromuscular electrical stimulation (NMES), is a technique used to promote healing and muscle function in patients with a variety of conditions. It involves the use of low-voltage electrical current to stimulate the muscles and nerves, which can help to reduce pain, improve muscle strength and coordination, and promote healing. In this article, we will discuss the indications, administration, benefits, and potential risks of physical therapy electrical stimulation.
Indications
Physical therapy electrical stimulation is used to treat a wide range of conditions, including muscle weakness and pain, arthritis, and nerve injuries. It is commonly used in patients who have had a stroke, spinal cord injury, or traumatic brain injury, as well as in patients with conditions such as multiple sclerosis, cerebral palsy, and Parkinson’s disease. It is also used to help patients recover from surgery, such as joint replacements, and to improve the function of muscles affected by conditions such as spinal stenosis.
Administration
Physical therapy electrical stimulation is typically administered by a physical therapist in a clinical setting. The therapist will place electrodes on the patient’s skin, near the area of muscle weakness or pain. The electrodes are connected to a machine that generates the electrical impulses. The intensity, frequency, and duration of the electrical impulses will be adjusted to suit the patient’s condition and needs.
The therapy is usually administered several times a week for a period of several weeks or months. The therapist will also provide the patient with exercises and techniques to practice between therapy sessions, to help reinforce the muscle strengthening and coordination work that is done during therapy.
Benefits
Physical therapy electrical stimulation has been found to be an effective treatment for a wide range of conditions. It can help to reduce pain, improve muscle strength and coordination, and promote healing. It can also help to improve the function of muscles affected by conditions such as spinal stenosis, and can help patients recover from surgery, such as joint replacements.
One of the most important benefits of physical therapy electrical stimulation is that it can help to improve the function of muscles that have been affected by nerve injuries. This can help to improve the patient’s mobility and reduce the risk of falls, which can be especially beneficial for patients with conditions such as stroke or spinal cord injury.
Risks
Physical therapy electrical stimulation is considered to be a safe and non-invasive treatment option, but it does carry certain risks. The most common side effect of the therapy is skin irritation at the site of the electrodes. However, this is usually mild and temporary. Other potential side effects include muscle cramping, pain, and burns, but these are also rare. It is not recommended for certain groups of people, such as pregnant women, people with a history of heart disease, or people who have a pacemaker. Electrical stimulation should not be applied over the eyes, on the head, or over cancerous tumors. It’s important to follow the manufacturer’s guidelines for use and consult with a healthcare professional before starting physical therapy electrical stimulation. It is also important to monitor the skin for any signs of irritation or burns, and to discontinue use if any adverse reactions occur.
An electrical stimulator is a relatively small piece of equipment but it’s making a huge difference in the lives of those suffering from osteoarthritis. This type of arthritis is caused by wear and tear on the joints and is often found in the knees, especially in women. One common treatment is to strengthen the muscles around the joint through exercise however for a number of patients the process of exercising the joint actually exacerbates the original problem.
Neuromuscular electrical stimulation (or NMES) is the process of sending small electrical impulses through the skin to the nerves and muscles below, causing an involuntary muscle contraction. These contractions actually strengthen the muscles being worked with and result in profound changes over time for the patient.
About a third of the patients with osteoarthritis get little or no exercise. This creates weakness in the muscles surrounding the joints and the arthritis becomes worse as pressure on the bones and connective tissue grows as the muscles around get less and less able to support weight. By using an electrical stimulator within an NMES protocol the muscles are able to experience the equivalent of exercise without creating stress on the joints.
A very useful aspect of NMES is that patients can actually learn to use the machine themselves to treat their osteoarthritis. A recent study (led by Dr. Laura Talbot from The Johns Hopkins University) involved giving patients a standard arthritis information as well as training in the NMES process and a machine they could use at home. They applied the NMES to themselves 3 time a week and after 12 weeks they were compared to patients that had received the same osteoarthritis training but no NMES information or machines. The results were staggering, with the NMES group showing improvement and the non-NMES group losing ground in both range of motion and chair rise time.
As such, several new studies are underway to determine the best ways to incorporate the small but mighty electrical stimulator in the treatment protocols for osteoarthritis patients. The fact that patients can treat themselves at home is a major part of the usefulness of NMES. With improvement in symptoms and abilities combined with no increased damage to the joints, NMES is a great new tool in the fight against arthritis.
Electrical Muscle Stimulation Treatments for Cerebral Palsy
Ninety percent of children with cerebral palsy have muscle spasticity as their dominant or exclusive impairment. EMS (electrical muscle stimulation) is the elicitation of muscle contracture through electronic stimulation and is sometimes used to treat children with spastic cerebral palsy. When combined with the right physical therapies, experts have demonstrated that EMS can improve overall motor function, increasing the child’s ability to perform physical tasks such as walking.
There are two ways of approaching EMS. The first is called NMES (neuromuscular electrical stimulation) or FES (functional electrical stimulation). The procedure, done only by a medical professional, involves giving specific muscles or muscle groups short bursts of electrical impulses designed to mimic the normal communication between the brain and the muscular system. Hopefully this can retrain the muscles to respond appropriately to the desires of the brain in a way they frequently don’t in someone suffering from spastic CP.
TES (threshold electrical stimulation) is very different. It involves much lower voltage and can be directed at a specific muscle or muscle group over a long period of time. It can be administered by the patient or a family member and can even take place overnight while the patient sleeps. It does not induce contraction, but instead is used to relieve patients of some of the discomfort and pain that comes with spasticity.
The way that NMES works is that electrodes are placed onto the skin in the vicinity of the muscles that are either in atrophy or have weakened due to spasticity. The electrodes are connected to a small generator. The current is low and rarely causes discomfort to the patient. The intent is to force the muscle to contract in a way that the brain is failing. The response is not dissimilar to having your reflexes induced by tapping on the knee. With TES, the procedure can be administered by a parent at home.
Unfortunately, with spastic cerebral palsy, any improvements brought about by EMS are temporary. The damage to the neuromuscular system is irreversible and the brain really can’t be trained to stimulate the muscles appropriately on its own. In most cases, full-time relief from the impairment of muscle spasticity requires approximately 2 hours of EMS every day of the week. Even then, any prolonged break from treatment will probably result in the abnormal spasticity returning to pre-treatment levels. For many, the benefits, however temporary, are worth a lifetime of daily treatment.
Because of the temporal nature of the benefits, many experts in the cerebral palsy world consider electrical muscle stimulation only as a supplement to standard treatments. Exercise and physical activity are still seen as having more enduring benefits to the ultimate health and well-being of children with cerebral palsy. But the debate is ongoing.
Other experts believe that with further advancements, EMS alone may be used to treat and improve, at least, the smaller muscle groups such as in the forearm or wrist. Whether or not EMS can one day stand alone as a treatment for EMS remains to be seen, but it is at least worth consideration as an element of your child’s physical therapy.
Conclusion
Physical therapy electrical stimulation, also known as neuromuscular electrical stimulation, is a technique used to promote healing and muscle function in patients with a variety of conditions. It involves the use of low-voltage electrical current to stimulate the muscles and nerves, which can help to reduce pain, improve muscle strength and coordination, and promote healing. It is a safe and non-invasive treatment option that can be administered by a physical therapist in a clinical setting. However, as with any medical treatment, it’s important to consult with a healthcare professional.