Have you ever seen a friend or family member lose a limb after an accident or a stroke? When that happens, that person becomes very helpless and unable to perform even their daily tasks. So today, we are talking about a special treatment that can "wake up" the muscles that have become inactive due to the signals from the brain not reaching the muscles properly.
Simply put, what is FES?
The full name of FES is Functional Electrical Stimulation . Simply put, it involves sending a very small, controlled electrical current to your nerves and muscles. Just like a signal from the brain, the muscle contracts when it receives this electrical signal. This treatment helps to re-mobilize the muscles and restore their function.
Many people think that this is painful because it involves electricity. In fact, this is not a painful treatment. However, you may feel some discomfort. It may feel like a tingling sensation, or like pins and needles. Sometimes it may even feel like a slight burning sensation. Your doctor or physiotherapist will make sure that the intensity of this electrical current is at a comfortable level for you.
What are the benefits of FES therapy?
This treatment is like giving muscles that cannot move on their own an external help and exercise. Imagine, when you are unable to walk or lift weights due to some disability, the muscles involved gradually weaken and atrophy. FES treatment can strengthen those muscles again.
Let's see what the main benefits of this treatment are in the table below.
| Usefulness | A simple explanation |
|---|---|
| Restoring muscle movement | It helps restore movement to a limb, such as a disabled arm or leg. |
| Urinary and fecal control | It stimulates the muscles of the bladder and rectum, helping them regain control. |
| Making breathing easier | By stimulating the diaphragm, the large muscle in the chest, reliance on a ventilator can be reduced. |
| Preventing Bed Sores (Pressure Sores) | It stimulates the muscles in the buttocks area of patients who remain in the same position, preventing the formation of bedsores. |
| Improving sexual function | It helps with erection and ejaculation in men. |
| Pain reduction | In some cases, pain can be relieved by blocking pain signals from reaching the brain. |
| Making swallowing easier | It stimulates the muscles in the throat and helps to overcome difficulty swallowing food and liquids. |
What conditions is this treatment most commonly used for?
FES therapy is particularly useful for muscle weakness caused by damage to the central nervous system, that is, the brain or spinal cord.
Here are some of the main uses of this treatment:
- Spinal cord injury
- Stroke
- Foot drop caused by multiple sclerosis
- Cerebral palsy
- Traumatic brain injury (TBI)
- Muscle weakness after brain or spinal cord surgery
Imagine that after a stroke, the path of signals from the brain to the hand is blocked. Even though the muscles in the hand are fine, the hand is paralyzed because there is no command to work. What FES does is bypass that blocked path and send a signal directly to the muscle to "work."
Who is FES treatment suitable for? Who is it not suitable for?
This treatment is not suitable for everyone. Your doctor will decide whether this is right for you. In general, this treatment may be suitable for you.
When this treatment may be right for you
- If you have muscle weakness.
- Partial or complete loss of function in a part of the body (paralysis).
- If you have a condition that affects the central nervous system.
- If your ability to move has been affected by an accident.
Before starting treatment, your doctor will do a small test to see if your body will respond to it. Sometimes, if the nerve fibers between the spine and the muscles are damaged, the body may not respond to it.
Cases when this treatment is not suitable
If you have any of the following conditions, your doctor may recommend another treatment option instead of FES. Be sure to discuss this with your doctor.
| When should FES therapy not be performed? |
|---|
| If you have any implanted electronic devices (e.g. pacemaker). |
| If you have cancer. |
| If you have bone infection (osteomyelitis). |
| If you have a history of blood clots (Thrombosis) or excessive bleeding (Hemorrhage). |
| If you have epilepsy. |
| If you have severe muscle spasticity or contractures. |
| If you have osteoporosis. |
| If you are currently pregnant. |
What are the parts of the FES device?
FES devices come in many shapes and sizes, but there are a few common parts to almost all of them.
- Neuromuscular electrical stimulator unit: This is the small box that produces electrical signals.
- Wires: These are the wires that carry electrical signals from the box. Some new devices work without wires, using radio waves.
- Electrodes: The other end of the wire is connected to these electrodes. These are the ones that are connected directly to the body and stimulate the nerves or muscles.
There are several types of electrodes:
1. Surface electrodes: These can be applied to the skin like a sticker. These are most commonly used for short-term treatment.
2. Percutaneous electrodes: These are placed under the skin by a doctor through a small incision.
3. Implanted electrodes: For long-term treatment, these are surgically implanted into the muscle or near a nerve.
Your medical team will decide which device is right for you, which muscles to stimulate, and how much electricity to give.
What are the risks and complications of FES treatment?
Like any treatment method, FES can have some risks.
| Risk type | Description |
|---|---|
| When using electrodes attached to the skin (External) | |
| Inconvenience | The numbness felt during treatment may be uncomfortable for some people. |
| Skin allergies | Redness and itching of the skin may occur where the electrodes are attached. |
| Muscle pull | If the stimulation increases, the muscles may feel tired. |
| When using surgically implanted electrodes | |
| Infections | There is a risk of infection at the site where the electrodes are implanted. |
| Equipment errors | Wire breakage or electrode movement may occur. |
| MRI tests | Due to the presence of metal parts in the body, it may not be possible to undergo MRI scans. |
If you experience any unbearable discomfort, pain, or skin changes during this treatment, inform your doctor immediately . Don't hide it.
What is the difference between TENS and FES?
Many people get confused about the two treatments, TENS and FES. Although both use electrical stimulation, they serve two different purposes.
- TENS (Transcutaneous Electrical Nerve Stimulation): This targets sensory nerves . The main goal is to reduce pain, not to contract muscles.
- FES (Functional Electrical Stimulation): This targets motor nerves . The main goal is to stimulate muscles, move them, and create activity.
Simply put, you can remember that TENS is for pain and FES is for movement .
Take-Home Message
- FES is a treatment that uses small electrical signals to restore movement to inactive muscles.
- This is very useful for weakness caused by conditions such as stroke and spinal cord injuries.
- This treatment is not painful, but you may feel some discomfort, such as numbness.
- This is not suitable for people with implanted devices such as pacemakers, pregnant women, and some other patients.
- Always talk to your doctor about whether this treatment is right for you and any questions you may have.
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