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Old 09-22-2015, 09:05 PM
Suebee Suebee is offline
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Default 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
.
http://www.everydayhealth.com/news/p...ted-foot-drop/
I guess I want access to this technology and i don't know how.
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  #2  
Old 09-22-2015, 09:12 PM
Suebee Suebee is offline
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Default Dr wahls FES protocol

Excerpt from: http://neurochangers.com/2013/10/04/...e-sclerosis-2/

"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."
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Old 09-23-2015, 10:16 AM
Suebee Suebee is offline
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Default 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."
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Old 09-23-2015, 10:35 AM
Suebee Suebee is offline
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Default 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?
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  #5  
Old 09-23-2015, 10:35 AM
Suebee Suebee is offline
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Article *
http://ezinearticles.com/?Mitochondr...-MS&id=1728861
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  #6  
Old 09-23-2015, 11:23 AM
teena marie teena marie is offline
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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
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  #7  
Old 04-05-2017, 05:15 PM
Lmh Lmh is offline
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Default FES for muscle stimulation

Hi everyone!
I've been keeping up with the various postings on FES use in MS. I would love to have one of the cycles ( who wouldn't!) for home use, but the insurance company doesn't agree.

The facility that I frequent for PT has a cycle and I was able to give it a whirl. Unfortunately, this is not a place that I could visit and log the number of hours needed for benefit.

So, my PT said a TENS unit could be a good alternative!! I have a dual unit and was taught where to place my electrode patches, the correct mode and intensity. I have various home exercises with the unit, gym exercises, and the best part of all.... a way to reduce my spasticity and pain! Several good nights of sleep resulted from this gizmo

I do believe one of the postings had an article showing electrode placement to help aid constipation. Lots of uses, and worth asking your PT for information.
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  #8  
Old 04-09-2017, 08:15 PM
Suebee Suebee is offline
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LMH,
Oh my gosh LMH, that is awesome! I begged three different PTs to help me to use a FES unit and no dice. I think liability reasons prevents and because there are little empirical evidence.
Dr. Wahls got a PT to help her and she adivises patients to get direction for PTs. So I guess it is hit or miss.

My core weakness is being particularly problematic rt now. I have gone back to work and I'm getting back and ab spasms (where ab six pack should be but isn't. I've tried tilting desk chair back. That is good to rest core, but one can't do much in reclined position, other than look like you are taking a break.

So, I was thinking about buying the ab belt that was the article I linked long ago and was evaluated by non involved drs and found to strengthen abs. the price for an experiment, though has stopped me from the purchase so far. I'll keep you posted....
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  #9  
Old 05-11-2017, 01:41 PM
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ActiveMSers ActiveMSers is online now
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Here's a study on FES that just got published. - D

Effects of Functional Electrical Stimulation Cycling on the Physiological Functions, Walking Performance, and Body Composition of Persons with Severe Multiple Sclerosis
Irisa Myint, Illinois Mathematics and Science Academy
Session Number
Session 3C: 3rd Presentation
Advisor(s)
Lara Pilutti, University of Illinois at Urbana-Champaign
Abstract

Advanced MS patients experience severe ambulatory impairments and require specialized exercise equipment. One option is functional electrical stimulation (FES) cycling, which electrically stimulates leg muscles to elicit movement on the leg-ergometer.

Methods/Design: The randomized controlled trial recruited 11 people with severe MS (EDSS 6.0-6.5). Participants were randomized into either the FES cycling condition or the passive cycling condition in which electrical stimulation was not delivered, but the leg ergometer were controlled by a motor. The intervention was delivered 3 times/week for 12 weeks. Participantsí walking speed, endurance, and agility were assessed through mobility tests, and body composition was measured using dual-energy X-ray absorptiometry (DXA).

Results: Body composition remained stable over the 3-month period. The passive cycling group had a moderate increase in time taken to walk 25 feet and a moderate decrease in distance travelled during a 2-minute walk test. The passive cycling group had a moderate to large decrease in oxygen used during exercise (VO2), time to exhaustion, and work rate. The only significant difference for the FES group was a large increase in peak flexor strength. Small changes between baseline and final testing may be attributed to the small sample size (n=11) and short training period.
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