Functional Electrical Stimulation (FES)

Functional Electrical Stimulation (FES) is a technique used to improve or restore function in individuals with paralysis, weakness, or poor coordination due to neurological disorders or injuries.

Definition and Purpose

FES involves the use of electrical currents to stimulate muscle contractions and evoke functional movements. The primary purpose of FES is to enhance motor function, improve mobility, and increase independence in individuals with impaired motor control.

Types of FES

• Surface FES: involves the placement of electrodes on the skin surface to stimulate muscle contractions.
• Implantable FES: involves the surgical implantation of electrodes and a pulse generator under the skin to stimulate muscle contractions.
• Percutaneous FES: involves the insertion of fine wires or electrodes through the skin to stimulate muscle contractions.

Applications of FES

• Spinal Cord Injury (SCI): FES can help restore bladder and bowel function, improve mobility, and enhance respiratory function in individuals with SCI.
• Stroke and Brain Injury: FES can aid in the recovery of motor function, particularly in the upper limb, and improve walking ability in individuals with stroke or brain injury.
• Muscular Dystrophy and Other Neuromuscular Disorders: FES can help maintain muscle strength and function, delaying the progression of muscle weakness and atrophy.
• Orthotics and Prosthetics: FES can be used to control orthotic or prosthetic devices, enhancing mobility and independence in individuals with amputations or musculoskeletal disorders.

Benefits and Risks of FES

The benefits of FES include improved motor function, enhanced mobility, increased independence, and reduced muscle atrophy. However, potential risks and complications associated with FES include:

• Skin irritation or infection at the electrode site
• Muscle fatigue or soreness
• Nerve damage or stimulation of unwanted muscles
• Equipment malfunction or failure

Contraindications and Precautions

FES is contraindicated in individuals with:

• Pacemakers or other implantable medical devices
• Severe osteoporosis or fragile bones
• Active cancer or metastatic disease
• Pregnancy or breastfeeding (in some cases)

Precautions should be taken when using FES in individuals with:

• Seizure disorders or epilepsy
• Cardiovascular disease or hypertension
• Respiratory disease or compromised lung function