Spotlight on Electrical Stimulation

Overview

There are several different types of electrical stimulation that can be used as part of physiotherapy treatment, and these are described below. Generally, the devices used at home are either wired or wireless, and electrodes are usually in the form of sticky pads, which are placed on the skin in specific places. Electrical impulses pass between the electrodes, to give various therapeutic benefits.

TENS (transcutaneous electrical nerve stimulation)

This is a small device that fits into a pocket or on a belt loop that produces a mild electric current over the skin via sticky pad electrodes to give electrical impulses. It feels like a tingling sensation and is used for pain relief.

NMES (neuro-muscular electrical stimulation)

This is also a small device that delivers a mild electric current via sticky pad electrodes, giving high intensity electrical impulses to the nerves. It feels like a stronger sensation, more like pins and needles, and causes the muscles to contract.  NMES is used to increase strength and range of movement, and can be used to retrain or re-educate muscles. This may lead to a carryover effect beyond the treatment time. It may also be used to improve motor control, and for shoulder subluxation (a ‘dropped shoulder’). It is not used during specific tasks.

SES (sensory electrical stimulation)

This can be delivered through electrodes or electro-mesh garments such as a specially designed glove or sock attached to a device with specific settings for sensory stimulation. The electro-mesh garments enable the stimulation to cover a large area and are more comfortable. The low intensity currents, below, at, or only just above the threshold for sensation provides sensory input but not any muscle contraction.

This input can aid motor recovery, e.g. for people who have little or no movement. It may also reduce spasticity, improve sensation, and be used as a ‘priming’ activity before attempting to walk, for example.

FES (functional electrical stimulation)

This is a form of NMES, the key difference being that it is used to provide a direct benefit at the time of wearing when doing an activity or task. Examples of use include grasping and releasing a cup, and lifting the foot to clear the ground when walking.

How neuro physio can help

Following training, a neuro physio will be able to assess your suitability to try one of these devices and advise on the key things to consider. Help can be provided with set up, placement of electrodes and ongoing adjustments and support.

Saebo electrical stimulation devices

Two cost effective electrical stimulation devices, that are easy to set up, are provided by Saebo. These have the benefit of a free trial period for clients and online support. I am able to assist with set up, trialling devices and ongoing support in person.

Here is a demonstration of the SaeboStim Pro being used for wrist and finger extension.