Chapter 14: NMES and FES in Patients with Neurological Diagnoses

INTRODUCTION

Patients with neurological conditions have impairments and functional limitations that may be addressed through the use of electrical stimulation. For example, a person who has sustained a stroke may have multiple impairments, such as decreased strength, motor control, and passive range of motion (ROM); compromised balance; and spasticity. These impairments contribute to functional limitations and disability. Mobility is compromised, so an important component of rehabilitation is to improve mobility to allow for greater independence. Neuromuscular electrical stimulation (NMES) and functional electrical stimulation (FES) may be used clinically to address some of these areas. For patients with neurological impairments, NMES is defined as the use of electrical stimulation (ES) to activate muscles through stimulation of intact peripheral motor nerves, and FES is the use of NMES to promote functional activities.¹

EXAMINATION NEEDS

A thorough examination must be performed to determine the patient's appropriateness for receiving ES (Box 14-1). Table 14-1 identifies items that should be considered when determining if a patient with a neurological condition is suitable for ES. This table is not all-inclusive. Other pertinent examination items specific to the patient should be included.