Functional Electrical Stimulation (FES)
Key Points
- Therapeutic application of electrical current to activate muscles for functional movement
- Facilitates neuroplasticity and motor learning
- Enhances muscle strength and prevents atrophy
- Improves functional outcomes in pediatric neurological conditions
Core Principles
- Neuromuscular activation through controlled electrical impulses
- Task-specific training integration
- Motor pattern reinforcement
- Functional movement restoration
Technical Parameters
Stimulus Characteristics
- Waveform Properties
- Pulse width: 200-400 microseconds
- Frequency: 20-50 Hz for functional movement
- Amplitude: 0-120 mA (child-dependent)
- Ramp times: 0.5-2 seconds
- Current Modulation
- Constant current vs. constant voltage
- Biphasic balanced pulses
- Charge-balanced waveforms
Electrode Configurations
- Surface Electrodes
- Self-adhesive types
- Size selection criteria
- Placement optimization
- Implanted Systems
- Epimysial electrodes
- Cuff electrodes
- Intramuscular electrodes
Clinical Applications
Neurological Conditions
- Cerebral Palsy
- Gait improvement
- Hand function enhancement
- Spasticity management
- Spinal Cord Injury
- Standing systems
- Walking assistance
- Upper extremity function
- Acquired Brain Injury
- Motor recovery
- Functional retraining
- Spasticity control
Specific Applications
- Drop Foot Management
- Peroneal nerve stimulation
- Gait cycle triggering
- Ankle control
- Upper Extremity Function
- Reach and grasp training
- Fine motor control
- Bilateral coordination
Treatment Protocols
Assessment Procedures
- Initial Evaluation
- Motor function testing
- Muscle response assessment
- Sensory evaluation
- Functional goal setting
- Parameter Setting
- Threshold determination
- Comfort level assessment
- Movement pattern optimization
Treatment Implementation
- Progressive Loading
- Initial familiarization phase
- Gradual intensity increase
- Duration progression
- Integration with Activities
- Task-specific training
- Functional movement patterns
- Daily activity incorporation
Monitoring and Progression
- Outcome Measures
- Range of motion assessment
- Strength testing
- Functional assessments
- Quality of movement analysis
- Protocol Adjustments
- Parameter modification
- Progression criteria
- Goal updates
Clinical Considerations
Safety Guidelines
- Contraindications
- Active seizure disorders
- Cardiac pacemakers
- Active inflammation/infection
- Compromised skin integrity
- Precautions
- Growth plate considerations
- Pain monitoring
- Skin assessment
- Fatigue management
Age-Specific Considerations
- Developmental Stage
- Motor milestone integration
- Cognitive understanding
- Compliance capability
- Growth Considerations
- Electrode placement adjustments
- Parameter modifications
- Equipment adaptation
Further Reading
