A Neuromuscular Electrical Stimulation (NMES) device can be useful for treating muscle disuse atrophy, muscle spasms, and muscle re-education. Immobilized patients find a NMES stimulator to be useful for maintaining and strengthening muscle.
In this blog article we will review when neuromuscular electrical stimulation (NMES) may be used as an adjunct therapy modality during rehabilitation.
The FDA defines a device used for neuromuscular electrical stimulation with the following definition from 21 CFR 890.5850:
"A powered muscle stimulator is an electrically powered device intended for medical purposes that repeatedly contracts muscles by passing electrical currents through electrodes contacting the affected body area."
A muscle stimulator (identified as a powered muscle stimulator by the FDA) includes a hand-held device that acts as an interface between the pre-set therapy programs and the user. The device is connected by lead wires to electrodes that are applied to the patient's treatment site. The device transmits an electrical signal through the wires to the electrodes which passes through the skin to the nerves of the targeted muscle(s). The treatment is painless when applied correctly and poses no health risks when applied over healthy skin.
Many NMES devices include pre-set programs the user can choose from or will be recommended by the treating medical professional. There are 4 main parameters that define a pre-set program:
The amplitude (also known as the intensity) is variable and chosen by the user during a therapy session. The amplitude is increased, or decreased, based on the amount of the desired muscle contraction. The amplitude is measured in Amps or Volts based on the manufacturer's electronic circuit design and assigned a numeric scale representing the lowest setting (zero) to the maximum safe output (greatest scale number).
Some NMES devices do not include pre-set programs. These devices are set by manually selecting the desired parameters. Be certain you understand what parameters are right for your rehabilitation if you choose this type of NMES device.
NMES therapy is used to elicit a muscle response (contraction) by sending an electrical signal to the motor neurons. The electrical signal results in the motor neurons contracting the muscle fibers in a manner similar to voluntary muscle contractions. This is accomplished with the use of a NMES device connected by wires to electrodes applied over the target site. The stimulation of muscles is a useful adjunct treatment during rehabilitation to avoid muscle disuse atrophy, edema, muscle re-education, and spasms.
Physical Therapist applying electrodes prior to NMES treatment.
Your medical professional will determine if adding NMES therapy is appropriate for your rehabilitation process. NMES stimulation is often started before manual physical therapy such as after a cast is removed or when muscle spasms are present that prevent manual physical therapy.
The FDA defines the Indications for Use of a medical device in 21 CFR 814.20(b)(3)(i) as: "A general description of the disease or condition the device will diagnose, treat, prevent, cure, or mitigate, including a description of the patient population for which the device is intended." The general indications for use that apply to a powered muscle stimulator are specific to the conditions that can be treated by the device.
Indications for use that have been approved by the FDA for powered muscle stimulators include:
FDA warnings* for powered muscle stimulators include:
*Be sure to review the warnings and precautions in the user manual of your NMES stimulator before use.
The medical professional overseeing your rehabilitation process will provide instructions on the frequency of use, duration, and stimulation parameters. Some muscle stimulation treatments may be performance once daily while others can be performed more than once per day.
It is recommended not to exceed the manufacturer or medical professional's recommendation for daily treatment. While unlikely but possible, you could perform too many muscle stimulation treatments resulting in excessive muscle fatigue.
The team of experts at Elite Medical Supply is here to help identify the right NMES device for your recovery. We offer a quality NMES stimulator to compliment your physical therapy and rehabilitation program. Take a look at our selection of electrical stimulators by clicking here.
When you're ready to order a brace or need assistance making a choice we're here to help. You can reach us at 866-712-0881, send us an email, or fill out a contact form.