Functional Electrical Stimulation (FES) for Spinal Cord Injury

Overview

What is functional electrical stimulation (FES) for spinal cord injury?

Functional electrical stimulation (FES) is a treatment method in which low level electrical impulses are applied to nerves or muscles to improve or restore muscle function in people with spinal cord injuries.

What is the spinal cord and how does it work?

The spinal cord is a bundle of nerve fibers and nerve cells that is enclosed by the spine and extends from the brain to the lower back. The spinal cord and the nerves that branch off from it is a shared, two-way communication highway that links to all of the body’s muscles, joints and organs to the brain. Together, the brain and spinal cord make up the central nervous system, which controls most of the body’s functions.

What happens to the nervous system after a spinal cord injury?

When the spinal cord is injured, the signals from the brain no longer reach their intended destinations. The extent of the loss of muscle and bodily functions depends on where the spinal cord injury occurs and the amount of damage to the nerve cells. Damage can range from significant, long-term paralysis to less severe spinal cord injuries that heal over time. Loss of function occurs below the level of the injury, so the higher the site of the injury along the spinal cord, the greater the possible loss of voluntary control over muscle and bodily functions.

How does functional electrical stimulation (FES) help people with spinal cord injuries?

Functional electrical stimulation (FES) activates muscles in people with spinal cord injuries so they may be able to move and function independently. More specifically, FES uses small electrical impulses to activate specific muscles and nerves. These electrical impulses trigger the desired function, which might be, for example, contracting muscles to move a foot or lift an arm. The electrical impulse can also be used to block signals that send messages about pain and restore or improve some bodily functions such as bowel and bladder regulation.

What other functions can be restored with the use of functional electrical stimulation (FES)?

Functional electrical stimulation can restore function to your legs, arms, and organs. FES can:

• Restore muscle movement to perform such activities as:
  • Move hand to grasp and release objects.
  • Hold a fork to eat.
  • Hold a pen to write.
  • Stand, step and walk short distances.
  • Sit upright/improve posture.
  • Move from sitting to standing position.
  • Regain the sensations of pressure, touch, and temperature.
• Regain bladder and bowel control.
• Restore breathing by stimulating the diaphragm to eliminate the need for a ventilator.
• Treat or prevent pressure sores/ulcers due to sitting by stimulating gluteus muscles.
• Provide male erection and ejaculation.
• Reduces pain by blocking signals that send messages about pain.

Exercising muscle tissue not only gains strength and tone but also results in a number of related general health benefits, such as:

• Decreases the risk of fractures by building muscle mass.
• Increases blood circulation.
• Helps manage weight through the ability to exercise.
• Reduces the risk of cardiovascular disease and diabetes with improvements in general health.
• Regains lost bone mass.
• Reduces muscle spasms and the effects of spasticity.
• Allows unassisted coughing to clear secretions, which reduces the risks of pneumonia and other lung infections and choking hazards.
• Prevents and reverses muscle atrophy (shrinking and weakening of tissue due to lack of use.)
• Improves the quality of life for people with a spinal cord injury.

Who is not a candidate for functional electrical stimulation (FES)?

In general, people who are not candidates for functional electrical stimulation (FES) are those with:

• Other implanted electrical devices.
• Cancer.
• Osteomyelitis.
• History of thrombosis/hemorrhage.
• Epilepsy.
• Severe muscle spasticity/contractures.
• Osteoporosis.
• A current pregnancy.

Talk with your doctors and therapists about these conditions, other medical conditions you may have and any other concerns about if FES is right for you.