Functional Electrical Stimulation (FES) for Spinal Cord Injury

• Using small electrical impulses to activate specific muscles and nerves, such as contracting muscles to move a foot or lift an arm.
• Electrical impulses can be used to block signals that send messages about pain and improve body functions, such as bowel and bladder controls.
• Restoring muscle movement to perform activities like:
• Move hand to grasp and release objects.
• Hold a pen to write.
• Stand and walk short distances.
• Sit upright and improve posture.
• Regain the sensations of pressure, touch, and temperature.
• Restoring breathing by stimulating the diaphragm, thus stopping the use of ventilators.
• Making male erection and ejaculation possible.
• Regaining bowel and bladder control.
• Reducing pain by stopping signals of pain messages.
• Stimulating gluteus muscles to prevent pressure sores due to sitting.
• Building muscle mass to decrease the risk of fractures.
• Increasing blood circulation.
• Helping to manage weight through the ability to exercise.

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

• An electrode, to which the wires from the box are attached.
• Wires that lead from the box and carry the electrical impulses.
• An external small electrical box called the neuromuscular electrical stimulator unit.

• Attached to the surfaces of the skin with sticky pads.
• Placed directly under the skin (percutaneous placement).
• Fully embedded deep into the muscle (implanted) or the area surrounding the targeted nerve. This involves a surgical procedure.

• Neurologist.
• Physical therapist.
• Neuromuscular rehabilitation therapist.

• Broken wires.
• Electrodes that move after placement.
• Irritation at the site of electrode placement.
• Infections at the site of electrode placement.
• Encapsulation (scar tissue formation around the electrode).
• The risk of inability to MRI in any future health problems, because of the wire and other metal components used in FES systems.

• FES uses computer technology to send low-level electrical impulses to specific muscles in your body (legs, arms, hands, or other areas), to activate them.
• The electrical stimulation can cause your muscles to contract, which may promote increased muscle bulk or muscle control.
• It prevents muscle atrophy.
• The muscle activity may help reduce muscle spasms.
• It can lead to improved bladder and bowel functions.
• FES activates the muscles of people with spinal cord injury, so they may be able to move and function independently.

FAQ

What is functional electrical stimulation (FES) shock?

Functional electrical stimulation (FES) delivers a shock to your affected muscle, activating nerves and making the muscle move. You relax your hand then contract the wrist extensor muscle to cause movement. This movement triggers an electric shock, which causes greater movement of the hand. 

How much does a functional electrical stimulation (FES) system cost?

An FES system costs between $4,000 and $14,000 and is typically not covered by insurance. The manufacturers have yet to convince Medicare to pay for the device.

What does functional electrical stimulation (FES) feel like?

FES usually starts at a very low level, causing a tingling “pins and needles” feeling on the skin. The current is then slowly increased until it is strong enough to make the muscle contract. This level (the smallest current needed to make the muscle contract) will be used for the treatment.

Can functional electrical stimulation (FES) cause pain?

FES is a non-invasive treatment option that does not cause any pain, but it does produce tingling sensations on the skin. The electrical current is supplied by a small unit which is a similar size to a mobile phone.

What does a functional electrical stimulation (FES) do?

FES applies small electrical pulses to paralyzed muscles to restore or improve their functions. FES is commonly used for exercise, but also to assist with breathing, grasping, transferring, standing, and walking. It can also lead to improved bladder and bowel functions.