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Non-Invasive Transcutaneous Electrical Stimulation 

IN FOCUS offers Non-invasive electrical stimulation. 

Treatments may including: FES, EMS, NMES, Spinal Stimulation, etc.

Treatment is provided to maximize motor control, muscle and nerve health, and overall function. 

 

Electrical stimulation can play a vital component in:

Muscle rehabilitation and strengthening

Decreases spasticity 

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

Treatment is provided at comfortable parameters for sensory and motor activation.

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:
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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 significantly from one individual to another, and distinct 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. 

Below are our 3 key components to getting started with an electrical stimulation program.

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.

PARAMETERS

What parameters do I use? 

In electrical stimulation, "parameters" refer to the specific settings and characteristics of the electrical signals used to stimulate nerves, muscles, or tissues.

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.

Dr. Girshin continues to do research and advance e-stim parameters and therapy techniques used in treatments for children and adults. 

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. 

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. We're here to provide you with the information and guidance you need.


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! 

​  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.

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. 

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. 

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. 

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

At IN FOCUS we specialize in electrical stimulation and neuromodulation of muscles and nerves for motor learning.

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