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Suebee 09-22-2015 09:05 PM

FES to improve muscle strength
Hi, I've been doing PT at a local hospital and I was inspired by Dr. Terry Wahls to try functional electric stimulation to improve my muscle strength and reduce spasticity but PT said it wasn't appropriate for my situation. As I understood it, FES has been well documented to help stroke issues and spinal cord injuries but less so with MS. Dr Wahls, who has MS, says she used FES with diet changes to get out of a wheelchair but there doesn't seem to be a lot of support and insurance reimbursement for this type of therapy if the MSer is still "mobile" and doesn't have obvious atrophy of muscles. Just for fun I did measure my weak leg against the strong one and there is a slight difference. One I didn't have before MS ( I always used to
like my leg shape). I was wondering if anyone has tried FEs. My internet searches seem to suggest there may be a few places in the country that offer this type of rehab but I didn't see any near me. Here is a link that discusses recent studies using FES in MS patients
I guess I want access to this technology and i don't know how.

Suebee 09-22-2015 09:12 PM

Dr wahls FES protocol
Excerpt from:

"Dr.Wahls also mentions the use of neuromuscular electrical stimulation to help improve muscle strength. As part of her recovery she used an FES (functional electrical stimulation) bike similar to the one provided at Aim2Walk. This type of stimulation is an electrical impulse sent to the nerve that stimulates the muscles in the leg needed to propel the bike. In the studies she read about FES, it was noted to decrease muscle spasticity and improve endurance."

Suebee 09-23-2015 10:16 AM

Ex of PT rehab center using FES
I found this description of FES specifically for people of all levels of disability and mentioning as treatment for MS. It also mentions that it is covered under Medicare for spinal cord only. The facility is in NY, the Helen Hayes center :
"State-of-the-art Functional Electric Stimulation (FES) equipment is currently helping many patients at HHH regain their strength and cardiovascular fitness. While FES technology has been around for more than thirty years, recent advances have made the equipment much more user-friendly. Physical therapists, who have received specialized training in the use of the equipment, including how to monitor the settings to ensure maximum benefit to the user, use the FES bicycle with inpatients and outpatients.

FES technology can help people with many levels of disability, including those with multiple sclerosis, spinal cord injury, brain injury, Transverse Myelitis, Parkinsonís Disease, stroke and other conditions. It is also being used to help children with cerebral palsy improve their motor skills.

This high-tech bicycle provides patterned electrical stimulation to the surface of muscles, which stimulates nerves and evokes muscle contractions and activity. Surface electrodes are placed on one or both sides of the patientís upper or lower body. The electrodes are then connected to the computerized brain of the machinery that controls speed and resistance. It also measures the amount of effort the cyclist is exerting and automatically measures each patientís progress.

FES enables the individual who may have lost voluntary control over their muscles due to spinal cord injury to cycle or walk. Patients can even use the FES equipment without transferring from their wheelchairs. The exercise relaxes spasms, improves circulation, maintains or increases range of motion, and prevents muscle atrophy that often accompanies lack of use.

Once patients leave the hospital to return home, they can access FES as an outpatient, or even obtain the equipment for home use. Medicare covers FES therapy for patients with spinal cord injury."

Suebee 09-23-2015 10:35 AM

Dr Wahls protocol for FES
Here is article by dr wahls explaining how she started using FES and worked with pT and 2 different devices. She says her body was slowly getting weaker from spms and in 7 mos she was dramatically improved in strength and endurance. She seems like a reputable source. Does anyone think her improvement was exaggerated? The devices are pricey and PT isn't going to advise me in my area. On one hand the science makes sense, and it's benefited stroke suffers, but on the other hand it sounds too good, and main line medicine hasn't embraced it. I'm not sure if lack of insurance reimbursement means anything other than that. I wasn't able to find a FES device to rent. Anyone have ideas, observations, experiences with this?

Suebee 09-23-2015 10:35 AM

Article *

teena marie 09-23-2015 11:23 AM

Hi Suebee,

This will be quick-in a rush. I believe FES refers to all equipment such as the bike, bioness and walkaide. Terry Wahl,s used a neuromuscular electrical stimulator for muscle strengthening. Which is electrodes you apply to a muscle group that provides a contraction thereby getting the muscle to work. It's best if you are also trying to make the muscle contract yourself connecting brain messages to the muscle. I've used this in the past with modest benefits and will start again soon. I purchased it online and had my PT show me where to place the electrodes and did it at home. The device was under $200.00. I'm in Canada so not sure about insurance, etc.

Hope this is helpful. I'm happy to share my experiences anytime so fire away the questions. It has been my experience that PT's don't see it as beneficial for MS. I ignored that and kept pursuing it.

Good luck and keep us posted.

Teena Marie

Suebee 09-24-2015 10:04 AM

TM, thanks for reply! I worry sometimes about grabbing onto cures without substance, so I was reassured to hear about your experience. There are quite a few on mArket, but I have such little understanding I did not want to invest yet. Dr wahls points out that ones with 2 pads don't let you zap enough muscle groups, which made her switch to a 8 pad FES. Some Informational material talked about passive vs isometric zapping, the first helps tone and the latter strengthens. Also I read the size of pad and frequency can impact the type of twitch muscles and depth of tissue stimulation. Some commercial sites talked about the need to time the zap with the muscle contraction while exercising . But dr wahls sounds like she did both exercising and just squeezing muscles. Peer reviewed published med journal articles explain protocol but use just one muscle group and I can't get illustration of placement of pads on internet. I have not deteriorated as much as Dr wahls did before she started her protcol, but I feel my core and endurance slipping. I'm doing PT but so frustrating that walking 2 min fast, a few leg lifts, and stretches leave me taking a long rest for rest of day. I will not accept this state and I'm determined to fight this. So any more information you can give is appreciated. I also think I'm going to need to stock up on kale 😋 , per dr wahls. She says getting key nutrients is part of the equation.

Suebee 10-02-2015 08:05 PM

Journal article on dr wahls improvement with FES and diet
Hi, I've been continuing standard Pt and investigating dr wahls protocol to determine if I could duplicate her result. Besides the outlay of cost for FES, one needs to understand placement and type if contraction needed for therapeutic result. Dr wahls had benefit of PT and her own medical background. The article link also says she worked up to over 5 hrs day of FES. Wow that us amazing and I admire that she did that but I'm not sure if that can be a realiStic goal for me. I have begun to implement the some if the diet changes, mainly more greens and fruit. I need to investigate the supplements she used some more.
The link lists Amt and type of veggies , fruits, duration and muscle groups, and supplements. I wasn't able to get her books at library or local book store , so waiting for online delivery. If anyone hAs used FES , even for non ms muscle improvement, I d be interested in your thoughts on FES.
Link to journal article

teena marie 10-06-2015 11:04 AM

Hi Suebee,

I followed the Wahl's protocol in 2009 for many months also using some estim. It was a challenge getting that much veg into me. I'm not sure what it actually did but it was healthy eating during a stressful time of my life. Now I follow an extremely low saturated fat diet that I feel makes more sense to me. Also, good for many other potential health conditions.

Keep up all your amazing work,

Teena Marie

Suebee 08-08-2016 12:05 PM

Recent Electric ab muscle stim for MS
There was a small but promising study on using electric muscle stimulation outside the body on abs of female MS patients and it was found to improve bowel issues. I'm so glad they explored this but continue to be intrigued that overall the medical community accepts electric muscle stimulation for muscle strengthing in paraplegics, stoke victims, and elite athletes, but not MS patients. :confused:
Link to article

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