FES courses from Salisbury District Hospital The purpose of the course is to give an introduction to practical clinical FES as practised in the clinical service at Salisbury District Hospital. The techniques taught are applicable to a range of neurological conditions including: Stroke Multiple Sclerosis Spinal Cord Injury Cerebral Palsy Familial Spastic Paraparesis Traumatic Head Injury The courses will review basic theory and teach the practical methods of using the stimulators and skin surface electrodes. The courses will have a large practical component with participants first using the devices on them selves or each other and then with patients volunteers. The courses will be taught by physiotherapists and clinical engineers who have both clinical and research experience. The courses are aimed at anyone who wants to know more about the clinical application of FES either from a clinical or biomedical engineering background. Completion of the courses will lead to accreditation, enabling future purchase and use of stimulators. Course groups will be limited to 12-16 participants. Course participants should be prepared to try the applications on them selves before trying them on patients! For lower limb applications please bring a pair of shorts. For the upper limb course ware a loose top or tea shirt. (Please note that some medical conditions contraindicate the use of FES: poorly controlled epilepsy, cardiac pace maker uses, pregnancy. Please contact us for more information) Stimulators can be borrowed following the course at no additional charge for a period of 2 months. 1
Courses 1. Introductory FES and the Odstock Dropped Foot Stimulator Length: 2 days Cost: 240 This course introduces basic FES theory and clinical practices and teaches the practical application of the Odstock Dropped Foot Stimulator and the Microstim 2V2 exercise stimulator 2. Introduction to the Odstock Two Channel Stimulator Length: 1.5 days Cost: 225 This course explores the application of a 2 channel device for gait assistance in stroke, MS and incomplete SCI. Applications include: bilateral dropped foot, dropped foot and hamstrings, dropped foot and quadriceps, dropped foot and gluteal muscles, dropped foot and calf etc.. Course participants should have attended course 1 before attending this course. 3. Introduction to the use of electrical stimulation in the upper limb following stroke. Length: 1 day Cost: 160 This courses describes the techniques currently used in the Salisbury FES clinic to improve hand, arm and shoulder function in hemiplegics. Other courses are available from time to time, for example, FES in paediatrics or different combinations of the above. Please contact us for details. All course enquiries to course secretary Claire Hall, Department of Medical Physics and Biomedical Engineering, Salisbury District Hospital, Salisbury, Wiltshire, SP2 8BJ, UK. Tel ++44 (0)1722 429 066, Fax ++44(0)1722 425 263 E-mail claire@salisburyfes.com 2
Introductory FES and Odstock Dropped Foot Stimulator 9.00 Registration 9.15 Introduction About the course Day1 9.15 Neurophysiology and Functional Electrical Stimulation (FES) theory What is FES? Upper and lower motor neurone lesions Stimulation parameters Patient selection and contra indications Stroke, MS, SCI, CP, TBI, spastic hereditary paraparesis Reciprocal inhibition, stretch reflex, withdrawal reflex and spastically Effects of exercise 10.00 Setting up the Odstock Dropped Foot Stimulator (ODFS) How the ODFS works How to find electrode positions Practical use in the clinic Practice on each other How to set ramps, times and extensions Heel rise or heel strike? Fixed or adaptive timing? 11.00 Break 11.15 Set up continued Practice on normals continues Techniques in physiotherapy 12.15 Patient demonstration 12.45 Lunch 1.30 ODFS set up practice with normals 2.15 ODFS set up Practice with patients Course participants work in groups of two with a patient volunteer 3.30 Case presentation and discussion Course participants briefly discuss with the group what they have achieved with their volunteer. 3.45 Break 4.00 Research and development An overview of past and future research at Salisbury 4.30 Close Continued next page 3
Introductory FES and Odstock Dropped Foot Stimulator Day 2 9.00 Evidence The randomised controlled trial Evidence from clinical audit Evidence from questionnaire surveys and interviews Assessment techniques 9.30 Applications of the ODFS in physiotherapy Techniques using the ODFS as a tool for gait re-education Practical session with normals 10.45 Break 11.00 Introduction to FES in the upper limb Theoretical background Practice with normals 12.45 Lunch 1.30 Practice with patient volunteers II Once the ODFS has been successfully set up and demonstrated, other techniques may be tried 2.45 Case presentation and discussion Course participants briefly discuss with the group what they have achieved with their volunteer. 3.00 Break 3.15 Clinical Service issues and discussion 3.30 End 4
Introduction to the Odstock Two Channel Stimulator 1.45 Registration 2.00 Introduction About the course Day 1 2.15 The O2CHSII device Similarities with the ODFS New functions Delays Frequency No time out Interaction of channels Clinical considerations Patient selection, precautions and contraindications Stroke, MS, SCI, CP, spastic hereditary paraparesis Clinical service model 2.45 Applications I The following applications will be described and participants will set the stimulator up on them selves to test the applications. Course participants should wear shorts for these practical sessions. Bilateral dropped foot Dropped foot and triceps (for arm swing) 3.30 Break 3.45 Applications II Gluteal stimulation with dropped foot Bilateral gluteal stimulation Hamstrings stimulation with dropped foot 5.00 End 5
Introduction to the Odstock Two Channel Stimulator Day2 9.00 Clinical experience and evidence Clinical studies and video demonstration 9.30 Applications II Calf stimulation for push off with Dropped foot Bilateral calf Quadriceps stimulation with dropped foot Bilateral quadriceps 10.30 Break 10.45 Practice with patient volunteers I 12.30 Case presentation and discussion Course participants briefly discuss with the group what they have achieved with their volunteer. 12.45 Break 1.30 Practice with patient volunteers II 3.00 Case presentation and discussion Course participants briefly discuss with the group what they have achieved with their volunteer. 3.15 Break 3.30 Discussion 4.00 End 6
Introduction to the use of electrical stimulation in the upper limb following stroke. 9.15 Introduction About the course 9.30 Neurophysiology, theory and clinical practice Physiological effects Spasticity, stretch reflex and reciprocal inhibition Neuroplactisity and motor relearning Muscle training effects Sensory and propriceptive effects Adjuncts to treatment Physiotherapy Splinting Botulinum toxin Exercise stimulators and stimulation parameters Patient selection, precautions and contraindications 10.30 Break 10.45 Applications The following applications will be described and participants will set the stimulator up on each other to test the applications. Course participants should wear a loose fitting top to allow application of electrodes. Shoulder Arm Hand Reaching 13.00 Lunch 14.00 Measurement of outcome 14.30 Practice with patient volunteers I 15.30 Break 15.45 Practice with patient volunteers II 16.30 Evidence base 17.00 End 7
FES COURSE APPLICATION FORM NAME: ADDRESS: (home or work) Tel: E-mail: Professional Body Registration No: (if applicable) COURSE LOCATION: COURSE DATE: COURSE TYPE: Single 2-Channel Upper Limb COURSE FEES Single Channel 240 2-Channel 225 Upper Limb 160 METHOD OF PAYMENT I enclose a cheque made payable to Salisbury Healthcare NHS Trust Please send an invoice to my workplace Please arrange for a budget transfer request PLACES ARE ALLOCATED ON A FIRST COME FIRST SERVE BASIS. RECEIPT OF PAYMENT WILL SECURE A BOOKING. CHEQUES WILL NOT BE CASHED UNTIL AFTER THE COURSE. TELEPHONE BOOKINGS ARE TREATED AS PROVISIONAL BOOKINGS AND MUST BE FOLLOWED UP WITH A FORM AND PAYMENT. Please return completed application form to: Claire Hall, Course Secretary, Department of Medical Physics & Biomedical Engineering, Salisbury District Hospital, Salisbury, Wiltshire SP2 8BJ, UK. 8