Spasticity interventions include FES - Functional Electrical Stimulation, This is usually applied to the antagonist muscle, the one opposite the spastic one. In fingers the flexors are usually spastic causing clenched fingers, the FES is applied to the opposite muscle, the extensors.
Why? If the problem is the flexors why aren't we working on sending electrical signals to them telling them to relax? There has to be some kind of electrical signal telling them to relax. I don't have a good enough background to even see if this has been thought of and discarded or never thought of.
Doing FES is usually thought of as reducing spasticity when it actually does nothing of the sort. It fires the antagonist muscle to overpower the agonist muscle.
When a muscle contracts the spinal cord sends a message to the antagonist to relax. If one muscle didn't relax when another fired muscles would never be able to produce joint movement.
ReplyDeleteV well put - as u explained in your post. I had my appointment to day at the hospital & asked them if they would trial me with the FES - after checking me out as suitable candidate, i'm now on the waiting list! (8-12 wks). The physio pretty well explained it as u did. If all goes well with the FES trial (see how i get on with it for a couple of weeks), i then have the option to buy it - costs around £400. Apart from that, they couldnt offer much help with the spasticity apart from drugs or botox; (drugs are out cos i come up with side effects whatever i'm given; have more luck with herbal medicine for my general health needs)...they said keep doing what i'm doing - exercise & more exercise...! They didn't seem to know much about TENS either. I guess us folks are ahead of the curve,pioneering types - "keep going & never give up!" echoes in my head! *:)
ReplyDeleteAs far as arm/hand goes re. FES, they hadn't got that far yet. Treating dropfoot is still new/novel for them. Shall talk more about my hand & arm when i next see them. I'm hoping that someone will give me advice with the TENS machine - i keep calling it TENS, I've got 2 different machines/things that do TENS, both with different modes, also does electrical stimulation.
If anyone's interested, my 2 "TENS machines" are - "Sanitas Digital EMS/TENS unit" - i used that loads in the early days/wks/months following my stroke which really speeded on my recovery (i had a pretty severe stroke affecting my right side, with speech difficulties & luckily only eye strain; no perceptual difficulties.) My other one is an "Electro reflexoxologist plus" made by Sasaki, which i'v been using on my feet & hands most evenings for 2/3 hrs the past 3 weeks or so. - so far notice my foot doesn't drag so much, but v slow progress/early days yet to tell any difference.
ReplyDeleteI have been researching Stroke rehab for my father when I came across this site. Was wondering if FES/TNS/EM, etc are safe for people who had hemorrhagic strokes, particularly in the right frontal region.
ReplyDeleteNAR: Cant seem to see my post so reposting , Is the FES/EMS/TENS safe for severe hemorrhagic strokes, particularly in the right frontal region?
ReplyDeletethe eStim has nothing to do with the type of stroke. Not sure what you mean by the frontal region, executive control? These units are meant to fire electrical signals through your nerves to make muscles contract.
ReplyDeleteHmmm, interesting. My husband had an FES sleeve made for his left arm by Phil Muccio of Axiobionics. We thought this was "the answer" since he has only had minimal movement in his upper arm so far. He has worn it all day, every day (well, almost every day) and it is exercising his arm for him, but thus far, we have only seen ONE little finger wiggle that he has not since duplicated. The next step was Botox injections into the spastic muscles. He hasn't seen much progress since those injections about 2 months ago. We were hoping that relaxing those muscles would be the next "answer." Stroke rehab is definitely different for each person. . . .
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