Treating the New Normal: Electrical Stimulation. Timothy Devlin, OT

Transcription

1 Treating the New Normal: Electrical Stimulation Timothy Devlin, OT

2 Electrical Stimulation When normal communication between the brain and upper extremities is interrupted secondary to injury or disease, muscle weakness or paralysis may result. If a muscle and its nerve supply remain intact, electrical stimulation can be used to mimic the natural electrical signals from the brain, moving the affected limbs and potentially reeducating the muscles over time.

3 Potential Benefits of Electrical Increases hand function Increases or maintains hand range of motion Reduces muscle spasms Prevents muscle loss Reeducates muscles Increases blood circulation Stimulation Decreases neglect Reduces spasticity Reduces edema Reduces pain Improved hand posture

4 Contraindications Pacemaker Presence of a malignant tumor in stimulation area Fracture/dislocation that would be adversely affected by the motion from the stimulation Precautions Epilepsy Metal implants Implantable cardiac defibrillators Patients with alteration of normal arterial or venous flow Pregnancy

5 BIONESS H200 cleared by the U.S. Food and Drug Administration (FDA)

6 What is the H200? Two main parts that communicate wirelessly with each other: the functional stimulation support (orthosis) the control unit (microprocessor)

7 How the H200 works Electrodes held in place onto the orthosis delivers low-level electrical stimulation to activate the nerves that control the muscles in the hand and forearm. The orthosis supports the wrist in a functional position, improving functional use of the hand and fingers while grasping/releasing and pinching with the fingers.

8 How the H200 works The clinician is able to program the unit to provide the appropriate stimulation to the nerves and muscles of the forearm and hand, thus helping to reeducate electrical brain signals, stimulating weak or paralyzed muscles. The electrical stimulation applied in a precise sequence, which then elicits contraction of the muscles, helping them relearn to respond to signals for movement.

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10 Home Electrical Stimulation Units

11 Electrical Stimulation for Home Use Neuro Re-education: For patients that benefit from electrical stimulation during therapeutic sessions, home units can augment or replace clinical treatments. The clinician can program the device and train the patient to address deficits areas. Neuroprosthesis: Bioness can be used to open/close hand and sustain a grasp to complete functional tasks.

12 Use of Home Units Units can be utilized to elicit contractions of targeted muscle in isolation or two muscles can alternately or simultaneously contract. Operation is simple and easily taught to patients. Units are usually programmable and able to be locked to prevent accidental changes to the settings.

13 Encouraging Functional Use If patient displays the necessary AROM, both the Bioness and home units are encouraged to be used during the completion of functional tasks with the ultimate goal of improved overall independence. Examples: Opening/closing the hand or flexing the elbow during self feeding, sorting laundry, cleaning home

14 RT300 Arm Cycle

15 How the RT300 works Adhesive electrodes are placed at the arm, shoulder and trunk muscle groups that your clinician selected to be electrically stimulated. The hands are secured into the RT300s arm rests using velcro straps. Different models of arm rests are utilized depending on patient s size, shoulder stability, wrist and hand strength.

16 SAGE FES System Downloads your latest therapy settings from RTILink and the session begins. Controls the stimulation patterns being sent to your arms, shoulder and trunk, producing a smooth cycling motion. Dynamically controls the motor to maximize the work that the patient s muscles perform. The motor speed, resistance and torque (how hard the motor turns) are all automatically respond to the patient s performance and phase of therapy (warmup, active or cool-down phase) Once the session has completed, SAGE will save all results back to RTILink database where they can be reviewed.