The Importance of Functional Electrical Stimulation (FES)

The European Journal Translational Myology (2012) published an article studying the reversal of muscle atrophy due to spinal-cord injuries for individuals who had complete absence of peripheral nerves, “Severe muscle atrophy due to SCI can be reversed in complete absence of peripheral nerves.”

This research holds tremendous value to the paralysis/SCI community as it shines light on a promising process to help develop more independence, strength and confidence in their activities for daily living. The use of Functional Electrical Stimulation (FES) is the key to stimulate muscle contraction, since the machine is able to emit electrical impulses activating the muscles in the upper and lower extremities. FES was developed with the aim of reversing long-lasting muscle atrophy for the muscles in the lower extremities of SCI patients affected by complete lesion of the conus cauda, i.e. patients that have no peripheral nerves. FES stimulation has been proven to be an effective method used to prevent muscle atrophy and improve recovery following paralysis. The results reveal a striking structural recovery of muscle fiber ultrastructure (the architecture of cells) in all FES treated patients: “the 90% (or more) of the studied fibers recovered from a very profound atrophy under the influence of the electrical Stimulation” (Boncompagni, et. al., 2012, pg. 161). Another significant benefit of FES facilitated exercises, “allows patients to sit longer in the wheelchair because of the increased perfusion (passage of fluid through the circulatory system), better trophism (condition of the skin) and the bigger muscle mass, which, reduces the risk of pressure sores, permits activities of daily living and thus a better social reintegration” (Boncompagni, et. al., 2012, pg. 194).

In addition to presenting the process and benefits of using FES to stimulate atrophied muscles, the article also addresses the consequences associated with opting out of a therapy of this nature. “Lack of muscle treatment generates a long series of alterations to tissues other than muscle, such as bones (osteoporosis), skin (pressure sores, decubital ulcers), etc., that are a direct consequence of inactivity and poor blood supply to the denervated areas” (Boncompagni, et. al., 2012, pg. 161). Ultimately, the result of not exercising the atrophied muscles results in a lose-lose situation, as the atrophied muscles continue to lose strength and blood-flow, but the bones start to degrade and can lead into osteoporosis which can present a cascade of eventual issues and complications.

If you or anyone you know has been struggling with the transition into a chair following paralysis, we highly encourage you to check with your primary care physician to see if some form of Functional Electrical Stimulation in conjunction with adaptive exercise can help increase function for daily living activities, self-confidence, esteem and social reintegration.

At NeuAbility, we have a fully functional adaptive exercise facility equipped with several FES units ranging in intensities and functions, in addition to state-of-the-art equipment to help with both short term and long term sustainability and progression.

Publication Citation: Boncompagni, S. (2012). Severe muscle atrophy due to spinal cord injury can be reversed in complete absence of peripheral nerves. European Journal of Translational Myology, 22(4), 161-200.

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