The Application of Low- and Medium-Frequency Electrical Stimulation in Upper Membro Reabilitação - Acidente Vascular Cerebral Center

Challenges Faced by Pacientes with Upper Membro Dysfunction

 

The mão is an essential organ for daily activities and serves as a key tool for humans to explore the external world and interact with the environment. Compared to other body parts, the mão and upper membro possess greater complexity and importance in motor functions. Therefore, upper membro motor função reabilitação is a core focus in post-reabilitação de AVC, yet it also represents a major challenge. Pacientes with upper membro dysfunction caused by conditions such as acidente vascular cerebral, spinal cord injury, or mão trauma often experience a slow recuperação process due to the complexity of mão and upper membro movements. This prolonged reabilitação journey poses a significant psychological challenge, potentially affecting pacientes' sense of self-fulfilment, and may lead to anxiety, depression, and other emotional issues. These negative emotions pode, in turn, further diminish reabilitação motivation and impact the overall quality of life.

What is Funcional Electrical Stimulation (FES)?

Funcional Electrical Stimulation (FES) is a reabilitação technique that uses low-frequency pulsed electrical currents to stimulate one or more groups of muscles through preset programs, inducing muscle contractions or simulating normal voluntary movements. The goal of FES is to melhorar or restore the functions of muscles and muscle groups affected by neurological damage, thereby compensating for or correcting the loss of motor função in membros and organs. In recent anos, the application of FES has expanded significantly, especially for pacientes with membro dysfunction caused by acidente vascular cerebral or spinal cord injury. Through repeated estimulação elétrica, FES pode not only activate motor neurons but also promote neuroplasticity in the central nervous system, ajudando pacientes gradually regain voluntary motor abilities.

3. Common Electrode Placements for FES in Membro Training

(1) Shoulder Subluxation

Pacientes with central nervous system injuries or high-level spinal cord injuries often experience shoulder subluxation. Strengthening the supraspinatus and the posterior part of the deltoid muscle pode ajudar prevent and melhorar shoulder subluxation.

 

Stimulation electrode: Placed on the posterior one-third of the deltoid muscle;

Auxiliary electrode: Placed on the supraspinatus muscle.

(2) Triceps Muscle Weakness

For pacientes with central nervous system disorders, usando NMES to strengthen the triceps brachii pode enhance elbow extension control and relieve spasticity of the biceps brachii.

Stimulation electrode: Placed below the posterior part of the deltoid muscle;

Auxiliary electrode: Placed above the olecranon (be careful to avoid stimulating the brachioradialis to prevent unwanted elbow flexion).

(3) Wrist and Finger Extensor Muscle Weakness

Due to the small size of forearm muscles, smaller electrode pads are generally recommended for stimulating the wrist and finger extensor muscles.

 

For wrist extensors:

Stimulation electrode: Placed below the lateral epicondyle of the humerus;

Auxiliary electrode: Placed proximally near the wrist joint.

 

For finger extensors:

Stimulation electrode: Placed more distally in the center of the forearm;

Auxiliary electrode: Placed proximally near the wrist joint.