What are the parameters for FES and the differences between that modality and NMES?
Answer
General parameters for FES are going to be biphasic pulsed current or burst modulated altering current. It is 20 to 60 pulses per second. The pulse duration is 200 to 600 microseconds. Amplitude is going to be just enough to achieve the appropriate functional level. Whatever it is I am trying to do, if it is reduce the subluxation or if it is to dorsiflex the ankle to neutral for foot clearance for example, that is how I am going to adjust the amplitude. The duration is going to be very task specific and specific to the body part and intervention that we are doing.
Regarding the difference between FES and NMES. The parameters for FES will have a shorter pulse frequency if you look at pulse frequency being 20 to 60. In traditional NMES, there is a longer pulse frequency and you will most likely have lower amplitude in FES as compared to traditional NMES. Again, the amplitude for FES will only increase until I get the contraction and the movement that I need to accomplish the task versus NMES where you typically are going to have an amplitude that is as high as they can tolerate because your goal is generate a contraction that is between 60% to 70% of their max voluntary contraction. Amplitude is going to be lower and the pulse frequency will be a little bit lower for the FES protocol as compared to what you may have learned for traditional NMES.
Jill Seale, PT, PhD, NCS
Jill has been a licensed physical therapist for 24 years. She received Board Certification in the area of Neurologic Physical Therapy from the American Physical Therapy Board of Clinical Specialties in 2004 and recertification in 2014. She has practiced almost exclusively in the field of Brain Injury and Stroke rehabilitation. She has a variety of teaching experiences, in physical therapy academia as well as in the health care community at large. She is currently faculty in the DPT program at South College. In addition, she teaches in several online and onsite continuing education programs across the nation. She has taught and presented in the areas of neurological pathology, rehabilitation, gait, orthotics, mentoring, and research, and is currently involved in clinical research in stroke rehabilitation, orthotic management, and gait analysis/rehabilitation.
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