It is good to study for physiotherapy students

1. FUNCTIONAL ELECTRICAL
STIMULATION

3. INTRODUCTION
• Functional Electrical Stimulation is the technique in which electrical stimulation is
used in order to obtain a desired functional movement
• It has been in use since 1960. Lieberson was the first one who used it for the
treatment of foot drop. It had been used in the past for the patient suffering from
chronic stroke or the gait abnormalities.
• In Functional Electrical Stimulation, biphasic rectangular constant impulses are
used, with variation of pulse width from 150 ms-40 ms depending upon the severity
of condition, a single session of 60 min or twice a day with 30 min is usually enough
to achieve appropriate results.

4. • Functional Electrical Stimulation (FES) is a therapeutic technique used in
rehabilitation to restore or improve motor function in individuals with
neurological or musculoskeletal impairments.
• It involves the application of low-level electrical currents to specific muscles or
groups of muscles through electrodes placed on the skin.
• These currents stimulate the nerves that control the muscles, causing them to
contract in a controlled manner.

5.  DEFINITION: Functional Electrical Stimulation (FES) is the use of electrical currents
to activate paralyzed or weakened muscles, enabling functional tasks like
walking or grasping.
 MECHANISM: Stimulates motor neurons, bypassing damaged pathways to elicit
controlled muscle contractions.
 PURPOSE: Restores functional movement, prevents muscle atrophy, and improves
circulation.
 COMPARISON WITH OTHER MODALITIES: Unlike TENS, FES focuses on functional
outcomes rather than pain relief.

6. PHYSIOLOGICAL PRINCIPLES OF FES
• Electrical stimulation triggers action potentials in motor neurons.
• Frequency and intensity are adjusted to mimic voluntary contractions.
• Promotes neuroplasticity, enhancing motor learning and recovery.
• Gradually increase intensity to patient tolerance.

7. INDICATIONS
o Stroke rehabilitation (e.g., improving gait in foot drop).
o Spinal cord injury (e.g., activating paralyzed muscles).
o Multiple sclerosis and cerebral palsy (e.g., enhancing functional
independence).
TASKS SUPPORTED BY FES:
o Walking, hand grasp, posture control, and cycling.
CONTRAINDICATIONS
o Pacemakers, epilepsy, open wounds near electrode placement.

8. PURPOSE
• Restore voluntary movements.
• Improve muscle strength
• Prevent muscle atrophy in individuals with paralysis
• Enhance circulation and reduce spasticity.
MECHANISM
• Electrical impulses mimic the natural signals sent by the brain to the muscles.
These signals activate the motor neurons, causing the targeted muscles to contract.

9. APPLICATIONS
• Neurological Conditions: Used in patients with spinal cord injuries, stroke, cerebral
palsy, or multiple sclerosis to regain mobility.
• Orthopedic Rehabilitation: Aids recovery in patients after surgeries or injuries
affecting the musculoskeletal system.
• Gait Training: Helps individuals with foot drop or weak lower limb muscles to
improve walking patterns.
• Upper Limb Rehabilitation: Assists in regaining hand and arm functions, such as
grasping objects.

10. Typical Functional electrical stimulator consist of :
• Stimulator
• Leads and
• Electrodes which may be superficial or implanted.
The pulse duration should be 200-350 micro second, frequency should be 30-40
pps, ramp up time and down time both should be of 3 sec, time duration should be
30 min, 5-7 days/week. 4-6 weeks.

11. ADVANTAGES
• Enhances functional outcomes.
• Promotes neuroplasticity (brain and spinal cord adaptability).
• Improves independence in daily activities.
LIMITATIONS
• Effectiveness depends on the severity and type of injury or condition.
• May require long-term and consistent use for significant improvements.
• Not suitable for individuals with certain medical conditions like pacemakers or
skin sensitivities.
• FES is widely used in physiotherapy and rehabilitation settings, often integrated
into customized treatment plans for optimal results.

12. Thank you

13. 1. What does Functional Electrical Stimulation (FES) primarily aim to achieve?
o (a) Pain relief
o (b) Muscle relaxation
o (c) Functional movement restoration
o (d) Skin healing
(Correct answer: c)
2. Which type of patients would benefit most from FES?
o (a) Patients with neurological impairments
o (b) Patients with skin burns
o (c) Patients with acute infections
o (d) Patients with osteoporosis
(Correct answer: a)