Electrical stimulation uses small electrical currents to stimulate nerves and muscles. It can be used to reduce pain, prevent muscle atrophy, and improve strength. In neurological rehabilitation, it is used for spasticity reduction, edema control, and functional electrical stimulation to improve gait. The Empi Continuum device has two channels and customizable settings to provide timed electrical stimulation sessions to targeted areas like the shoulder, wrist, quadriceps, and plantar flexors. Electrical stimulation must be applied carefully based on a person's needs and medical conditions.

1. Electrical Stimulation
How it works and it's uses in
Neurolgical Rehabilitation
Cody Small SPT
Husson university

2. Objectives
 What is electrical stimulation
 General uses of electrical stimulation in PT/OT
 Specific uses in neurological rehabilitation
 Different Placements
 Components of the Empi Continuum
 Instructional use of the Empi Continuum

3. What Is electrical Stimulation?
 Electrcial Stimulation is used in
physical therapy by placing lead
wires and electrodes on the skin
over target areas of the body.
When the electrical stimualtion
device is activited a signal is
transmitted down the lead to the
electrode where it causes
depolarization of sensory nerves
or motor units to help reduce pain
or to increase musclar strength of
atrophied muscles, along with
many other uses.

4. Terms To know
 Amplitude: Magntiude or the Intensity of the current.
 Ramp up/Ramp down: Time it takes for the amplitude at the on/off
time to to rise to peak amplitude and time from peak amplitude to
back to zero
 Pulse Frequency: The amount of energy being delivered to the body
 Pulse amplitude: The amount of energy being released to the body

5. Uses In
Physical Therapy
 Pain management
 Neuromuscular re-education
 Hypertrophy of Muscle
 Edema
 Wound Care
 Spasms
 Iontophoresis
 Biofeedback

6. Electrical Stimulation in Neuro Rehab
 Neuromuscular Re-education
 Spasticity/tone
 Edema control
 Atrophy
 Functional Electrical Stimulation
 Shoulder Laxity
 Wound care

7. Contraindications For It's Use
 Patients with implanted cardiac pacemakers, defibrillators, and brain
stimulators
 Application on throracic region for patients with CHF, arrythmias, MI
 Application over the carotid sinus
 Application on cancerous tissue
 Broken or irritated skin
 Lack of sensation
 Epilepsy
 Application over protruding metal

8. Set up for shoulder subluxation

9. Wrist Extensors
 https://www.youtube.com/watch?v=OoCkog0NcCk

10. Spasticity: Biceps/Plantar Flexors
 https://www.youtube.com/watch?v=bsaQWcnJYHk
 https://www.youtube.com/watch?v=3H4Gh5-sPQw

11. Quadriceps
 https://www.youtube.com/watch?v=i53vEyAZSeE

12. FES to Improve Ambulatory Function
 FES is a great option for patient who suffer from foot drop or plantar
flexor spasticity after a stroke
 Placement is going to be on ther anterior tib --> refer to slide 9 to
see placement
Placement on the quads is also an option for patients who stuggle to extend
the leg during swing phase of gait
 FES should be used in conjunction with conventional stroke rehab
 https://www.youtube.com/watch?v=PzUYDBWsmNE

13. Empi Continuum
Soft Keys Soft Keys
Home
Key
Power
Key
Ok
Key

14. Features
 Two independent channels
 Allows for timed therapy sessions
 Continous stimulation or Cycled Stimulation
 Pre-programmed settings or customizable settings
 Adjustable ramp up and ramp down times

15. Components
 Electrical Stimulation Device
 Lead wires
Red: positive
Black: negative
 Electrodes

16. Tips before use
 Clean the skin around the area the electrodes will be placed
 Dry Skin before placing the electrodes on the area
 If the patient has lots of hair, you may want to shave the site

17. Instruction for set up
 Attach the electrodes to the desired location
 Attach the leads to the electrodes
 Turn on the Estim Device
 Select the desired treatment option
 Set the time
 Turn the channels up individually till you ge the results
 Press start
 Once the treatment is over turn the device off then remove the
electrodes

30. References
 Linn, S. L., Granat, M. H., & Lees, K. R. (1999). Prevention of
shoulder subluxation after stroke with electrical stimulation.
Stroke, 30(5), 963-968.
 Sabut, S. K., Sikdar, C., Mondal, R., Kumar, R., & Mahadevappa, M.
(2010). Restoration of gait and motor recovery by functional
electrical stimulation therapy in persons with stroke. Disability
and rehabilitation, 32(19), 1594-1603.
 Sabut, S. K., Sikdar, C., Kumar, R., & Mahadevappa, M. (2010).
Functional electrical stimulation of dorsiflexor muscle: effects on
dorsiflexor strength, plantarflexor spasticity, and motor recovery
in stroke patients. NeuroRehabilitation, 29(4), 393-400.