How to we test for denervated muscle? As we will see in this article, a number of conditions can lead to denervation. Sometimes the extent of this denervation is hard to establish with equipment commonly available to the therapist. Perhaps the therapist tried “conventional” neuromuscular electrical stimulation (NMES) and could not produce a muscle contraction even with quite high intensity settings. Hence denervation was suspected, but without really being able to determine it’s extent.
The RISE stimulator provides a handy protocol that allows the presence and extent of denervation to be established and monitored over time. This article describes the process. First lets review some information on what exactly causes denervation, it’s consequences and the benefits of electrotherapy. We can then describe how the RISE unit can give is a denervation “benchmark”.

Functional Electrical Stimulation, or FES for short, is a very powerful tool in the hands of a capable therapist but is sadly still poorly understood and less often seen in clinical practice than it deserves. I think there are a number of reasons for this.
The first problem is perhaps the fact that using electrical energy for therapeutic effect has a long and sometimes colourful history. This may have led to the whole idea of using electricity as being associated with “quackery”.

Another problem has perhaps been the fact that FES requires some technical as well as clinical know-how. It should be obvious that the nature and form of the electrical energy should be well understood as this is necessary for safe and effective application. This is not helped by the fact that there is no consistent use of terminology and practical guidance is often lacking about evidence supporting it’s use.

In this article, we look at the efficiency of FES Cycling and see that there is actually lots of room for improvement when it comes to metabolic efficiency and power output.

Of course that does not mean that they should not be used. Much research over decades shows the benefits for users from regular training. FES Cycling performance is good enough to produce results if people use these products. The benefits are greater than those via passive cycling alone.

However, any engineer who looks closely at the technology will realise that there is much that can be improved when it coms to FES cycling exercise. This is what engineering aims to do - refine and improve things for the benefit of society. Improving the technology could produce a greater health benefit for the same or less effort so it's worth striving for. It should also be said that this is no trivial challenge. All electro-mechanical systems that interact with the human body tend to offer design difficulties that are not obvious to the casual observer.

Combining a passive/active exercise bike with synchronised FES (Functional Electrical Stimulation) is a well-researched and well-known exercise modality for persons to use after a spinal cord injury or other neurological condition.  One of the benefits often sought by our spinal cord injured clients is preservation of bone density and we will look at the evidence for this in this article. Bone is a dynamic tissue - it responds to the needs placed upon it - getting stronger under load and weaker in the absence of load. Paralysis after a spinal cord injury and lack of activity that loads the bones results in a loss of bone strength and increased risk of fractures.. FES Cycing is one way of helping to prevent this.

Skeletal muscle denervation is caused by damage or injury to the nerves that supply a muscle. This can occur as a result of a number of different conditions, including trauma to the spine or a peripheral nerve. Denervation can also result from infection, inflammation, and certain medical procedures. In some cases, denervated skeletal muscle may be caused by diseases that affect the nerves, such as amyotrophic lateral sclerosis (ALS) or Guillain-Barré syndrome. Denervation can also occur as a complication of surgery, such as when a nerve is accidentally damaged during an operation.

Muscles can recover from denervation, despite the loss of nerve supply to a muscle. Sometimes this recovery happens with little intervention necessary. At Anatomical Concepts we are typically working with individuals where some intervention is indicated.

FES Cycling with the RehaMove system is a foundation in Claire’s routine. In this short video she describes how she discovered FES Cycling, why she felt it was important to continue to exercise the parts that were paralysed as well as the parts that weren’t, and the benefits she has seen from doing so.