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Non-Invasive Transcutaneous Electrical Stimulation
IN FOCUS offers Non-invasive electrical stimulation.
Kristin makes it easy. With so many names (FES, EMS, NMES, Neuromodulation, Spinal Stimulation, TENS...)
and so many components
our EASY E-STIM Program puts it all IN FOCUS
Treatment is provided to maximize motor learning, body control, muscle and nerve health, and overall function.
In additional to Motor Learning. Benefits may also Include:
Muscle rehabilitation and strengthening
Increasing Circulation
Prevention or Reducing Muscle Disuse Atrophy
Improving Range of Motion
Nerve Function Improvement​
Enhanced Recovery​
Bladder and Bowel Control
Muscle re-education
Relaxation of muscle spasms or spasticity ​
Neurological Rehabilitation
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We establish comfortable parameters for sensory and motor depolarization.
Depending on your personalized e-stim program it may feel like a tap or tickle at the skin, or muscle contraction.​
Check Out Dr. Kristin Girshin's recent publications below on the use of Spinal Neuromodulation for children and adults with cerebral palsy:
Learn More Below:
Dr. Kristin's Approach: Easy E-Stim
History of Electrical Stimulation
Mechanisms of Electrical Stimulation
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Individualized Neuromodulation Programs.
Electrical stimulation (e-stim) therapy is far from a universal remedy. It is not a one-size-fits-all and requires a high level of impairment diagnosis of nerve function and movement patterns. Its efficacy can vary from one individual to another, and medical conditions, movement patterns, and developmental age demand tailored approaches.
In addition to providing treatment, Dr. Girshin teaches her structured approach to other therapists, on how to design comprehensive programs for their patients and clients to maximize function.
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Below are our 3 key Components
DEVICE
What device should I use?
When contemplating the utilization of electrical stimulation devices, it is crucial to seek guidance from a healthcare professional or therapist that is trained in electrical stimulation for proper application.
Electrical stimulation devices come in various forms and are used for a wide range of purposes, we know what to look to ensure devices are simple, fit you and your needs, and maximize rehabilitations outcomes. Knowing electrical discharge, customizable configurations, and functional capabilities are a few key features you need to consider.
Additionally, the market for e-stim devices is in a constant state of evolution, with new technologies and innovations regularly emerging.
If you are interested in trying a device currently available on the market, we provide numerous in-service events throughout the year in collaboration with vendors to learn more.
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PARAMETERS
What parameters do I use?
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In electrical stimulation, "parameters" refer to the specific settings and characteristics of the electrical signals used to stimulate nerves, muscles, or tissues.
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These parameters are adjustable and play a crucial role in determining the effectiveness and safety of the stimulation. Common parameters in electrical stimulation include: Frequency, Pulse Width
Amplitude, Waveform, Duty Cycle, Ramp Time, Burst Mode, Polarity, Synchronization. Parameters are based on the individual patient's needs, the condition being treated, and the desired outcomes. Incorrect parameter settings can lead to ineffective or uncomfortable stimulation.
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Our evaluations provide impairment and functional diagnosis of nerve and muscle responses for optimal
e-stim parameters and outcomes.
TRAINING
What should I do to support reaching my health and movement goals? & How much?
Now that you have your device and the appropriate support for management and dosage of e-stim parameters, how you train and what you train matters. Here is where working with a doctor of physical therapy specialized in e-stim treatment matters most. Activity Based Training is a broad term used with e-stim. treatment.
Our training prioritizes physics of developmental movement, active motor learning, and a whole body approach to meet functional movement goals and promote changes in neural pathways.
We use e-stim with sequenced movements to optimize synaptic plasticity to induce adaptive changes in the nervous system. Our therapy treatment is hands on providing tactile input, in addition to visual cues, and verbal feedback. Organizing sequenced movement patterns, alignment, and motor learning principals is what "sparks" the change.
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If you have questions about whether e-stim training is the right choice for you or your child, please don't hesitate to contact us.
History of Electrical Stimulation
The history of electrical stimulation (e-stim) in medicine is a fascinating journey that spans centuries. From ancient civilizations to modern times, electricity has been harnessed for various therapeutic purposes.
E-stim has ancient beginnings. Ancient Egyptians and Greeks were among the first to document the use of electric fish (such as the electric catfish) for pain relief. They used electricity from the fish to treat conditions like headaches and arthritis. Amazing Right!
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​ In the 18th century Luigi Galvani, an Italian physician, made significant contributions to the understanding of electricity and its effects on living organisms and laid the foundation for the field of electrophysiology.
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In the 19th century, Michael Faraday's work led to the development of the first electrical generators and the study of electromagnetic fields. This laid the groundwork for the generation and control of electrical currents for medical applications. These devices were used for various purposes, including pain relief and muscle stimulation.
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In the late 19th and early 20th century Jean-Martin Charcot, a French neurologist, used electrical stimulation to study and treat patients with neurological disorders like Parkinson's disease. In 1891, the first implantable electrical stimulation device was introduced by Dr. John Wesley Emerson.
The development of electronic technology has led to the creation of more sophisticated electrical stimulation devices. These devices are used to manage a large number of medical conditions and improve muscle and motor function.
Neuromodulation techniques, such as spinal cord stimulation (SCS) have expanded the possibilities for electrical stimulation in medicine, enabling more precise and targeted treatments.
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Today, electrical stimulation plays a vital role in the field of medicine, offering innovative solutions for neurological disorders.
At IN FOCUS, we provide excellence in the treatment of electrophysiology.
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Mechanisms of
Electrical Stimulation
Neurons communicate with each other through electrical impulses called action potentials, which travel along their axons.
These electrical signals allow information to be transmitted from one neuron to another and play a crucial role in activating and learning movement control. The mechanisms of neuroplasticity of the brain and spinal cord function encompasses various mechanisms, including: Synaptic Plasticity, Structural Plasticity, Functional Reorganization, and Cortical Remapping. The mechanisms of electrical myostimulation also influence neuroplasticity. Below are a mechanisms that play a roll in the drastic changes that may be accomplished with electrical stimulation.
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Activation of Neural Pathways: Electrical myostimulation involves applying electrical impulses to muscles, which in turn activate the motor neurons and nerves that control those muscles. This activation can lead to increased neural firing and repeated patterns of neural activity, contributing to the strengthening of neural pathways associated with muscle control.
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Motor Learning and Skill Acquisition: Repeated and controlled muscle contractions induced by electrical myostimulation can mimic patterns of movement used in motor tasks. By pairing electrical stimulation with specific movements or tasks, individuals may enhance their motor learning and skill acquisition processes. This is particularly useful in rehabilitation settings where patients need to relearn or improve motor functions for growth or after injury or surgery.
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Neural Reorganization: The repetitive activation of muscles through electrical myostimulation can lead to changes in the brain's organization of motor maps. As certain muscles are stimulated more frequently and intensely, the corresponding regions of the brain may undergo adaptation and reorganization to accommodate the increased input from those muscles.
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Cortical Excitability and Inhibition: Electrical stimulation of muscles can influence cortical excitability, meaning it can either enhance or inhibit the activity of the primary motor cortex. This modulation of cortical activity can impact the strength and efficiency of neural connections, potentially leading to changes in motor control and function.
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Functional Recovery: In some cases of neurological injuries or conditions, such as stroke or spinal cord injury, electrical myostimulation can be used as part of a comprehensive rehabilitation program to promote recovery and regain lost functions. The repetitive and targeted muscle contractions facilitated by myostimulation can help rewire neural circuits and improve functional outcomes.
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Combining with Other Therapy treatments: Neuromodulation through electrical myostimulation must be used with training. The synergistic effects of combining these therapies can enhance neuroplasticity and improve overall outcomes.
It's important to note that while electrical stimulation promotes neuroplasticity and functional recovery, its effectiveness can vary based on individual factors. These include factors such as the nature of the injury or condition, the timing of intervention, the patient's overall health, the use and protocols of training. Electrical stimulation training should be guided by trained healthcare professionals who can tailor the treatment to the individual's specific needs and goals.