Guide to electrical stimulation therapy for stroke patients

[@ve2775]

Dr Tara this is the best explanation I have received thus far for the usage of e-stim… thank you!

[@neelamsharma2196]

Undoubtedly. Never seen an expert like her .

[@zitaorosz1975]

Thank you so much . I appreciate all the help we receive through your videos. You were born to be a physical therapist because you are so passionate about helping sick people. ❤️ God bless you!

[@lillianhartley5771]

I am soon getting vivistim. I have seen great results from this. I can't wait for this joirney.

[@neelamsharma2196]

Great info , thank you . Just an eye opening observation that Physiothrepist puts tens and does documentation and that is totally counter productive . And this is the usual practice . Thanks for telling that .

[@meiselle]

Dr Tara, thank you so much for this resource!! I’ve becime a caretaker for my dad just 2 months back and it’s been tough figuring things out through trial and error. Your content has been very comforting for my family to understand how to help my father’s rehabilitation journey with more knowledge and reason, which has been very reassuring for us to know that we’re doing something right/productive! 🙏🏻

[@kensalamba324]

Thanks for this priceless info 👏🏻👏🏻👍🏽Looking forward to Part 2

[@darkodarkovic7827]

This is the simplest possible presentation of the function of motor action, I would like to add the "main controller" - the cerebellum, but that expands the story. In my many years of therapy, unfortunately, I have seen the most bad applications of NMES, I would call it fitness for the lazy. Very little FES, I think it benefits the most with, of course, targeted exercises that you constantly present to us, because that's how we create a routine for agonists and antagonists. Thank you, have a nice week.

[@calicornnor6892]

Oh thank you for giving me thorough information, much needed

[@revdocrandy]

I used e-stim in the first few months of therapy on my leg, shoulder, arm, hand, as well as face. That ended when I had a seizure (thankfully only one, 4+ years ago), but I always thought it was helpful, especially in the earliest stages (the only part I experienced it). By the way, we couldn’t be certain what caused the seizure, but out of caution, decided to discontinue it.

[@BR9900-w5l]

I use one every day and believe it's helped a lot in wrist and finger extension..

[@PT28WritingSignCally]

I recovered nearly 200+ pts of stroke... ES helps a lot in 1st 3 weeks with the combination an designing of required NDT,,pnf,,tonomatics,,, Exercises,,,, positioning,, functional analysis etc etc

[@rajeshravindran930]

Great information , Thanks a lot for this detailing 🙏 I was using one with out knowing these facts!

[@martisleister9197]

Have you done a video showing mirror therapy? How would one do mirror therapy for the hamstring?

[@mrstevek118]

First time I got my arm to move was with a tens by a pt

[@absolutelyflying]

Can you do a video about mindset? Watched a lot of your videos but haven’t run across anything about mindset after a person who’s in the early stages of stroke recovery. For my situation, my brother who recently was diagnosed with a left ischemic stroke and seems to always be emotional by crying. Are there any information about stages or strategies to help him be less emotional and more motivated to get well? Thank you. Love your videos and content. ❤️🙏

[@SweetCarolineeeee]

Did you end up doing a second video? I can’t find it

[@panagiotischristo]

I have MS....end up going for physiotherapy and was blessed to be on FES....it helped me walk big time... however was only on it one month and was given a TENS device which didn't help...and later on Botox for three/four months (which my opinion doesn't work). Thanks for video....take care.

[@rehabhqofficial]

Hi Peter! Great to see you this week! Thanks for sharing your experiences.

[@jboyce1976]

How do you use this for pins and needles

[@joaquimrodriguez8961]

Thank you for the explanations, I currently use the L300-go and the H200, by Bio ness.

[@yaronkl]

very interesting. what can you tell us about neurotrac devices

[@brendalytwyn9518]

Hi Tara you did mention the FES Bioness but you didn’t say whether you liked it or not or whether it should be used at all times. I have one but tend to only put it on when I’m outside walking but maybe I should be wearing it all the time even inside walking what do you think?

[@aaronoyster9627]

Tara, (9:31) you said NMES is very useful used in conjunction with a functional activity (as well as with mirror therapy). Since you seem to refer to EMS as virtually synonymous with NMES, I'm assuming that what you're saying about NMES holds true for EMS? By using them in conjunction with a functional activity, does that mean we actually try to use the muscle being simulated (as opposed to just letting the current simulate the action)? For instance, if the electrodes of my EMS unit were placed on the anterior Tibialis, would actually trying to bring the ankle into dorsiflexion while the EMS stimulates it be more beneficial & not counterproductive?

[@MoniqueShaq22]

Very informative can’t wait to see the second video

[@fatimanoor6734]

Do we apply in kids withs internal fits??

[@kenytrogaming]

hello dr. tara what about electro magnetic pulse theraphy? does it help with stroke patients better?

[@frannymoore]

I can't wait for your next video. I've been using one while doing exercises but not sure I'm putting them in right places. I want to use on my hand and wrist as well. Thanks!

[@jonwhisler6967]

is part to of thiseries available yet?

[@jovanstrezovski8167]

Is it possible person that should excercise dorsal flexion and CAN make on his own dorsal flexion through the FES/NMES to get excessive eversion or inversion all the time?We try all possible solution,all settings,spots,and all sizes of electrodes.What can be the problem?

[@calicornnor6892]

I was wondering if EMS would be beneficial for anoxic brain injury patients

[@fredkotthaus1518]

Thank you,Dr Tobias for the information contained in this video. Is there any way to get a guide on where to place the pads, I've looked online and the ones that I have found are written with the medically educated in mind. I'm thinking that the reasoning behind that is one should have a therapist working with you. However that's not an option for me.

[@britneywalters3483]

Do you have any videos that give examples on how to do the goal directed/task oriented exercises? I've been doing mirror therapy and estim separately since my stroke 7 months ago. I'm hoping t learn more about how to implement that to regain function in my hand or work on the connection. thanks!

[@mariasuggett6141]

Am new and so glad I found you! 14 years after a brain bleed my left hand is very weak. I want my life back! I have the Chattanooga and need the right therapist. I will be asking for a great therapist in my area. Loved your video - it was like Xmas early! I will be looking at your other videos. Thank you so much!

[@virtuosoproductions4589]

Should do a video on bulging of joins from ankle to the hip.

[@qmr0n]

So could EMS help with building very weak muscles if used when working out?

[@ridhwaanaqureshi716]

does this work for those who suffer from drop foot as I have MS?

[@niya5914]

Canbyou make a video on usage of Russian Currents in stroke..

[@Alex-bd4ov]

Hello anyone, does it help with the autonomic nervous system, bladder and sensation if you are C (incomplete) on the ASIA scale.

[@rexeffect7122]

You didn’t mention Restorative Therapies Rt300 FES bike.

[@nuha6805]

For a licensed therapist, what do I need to have in order to be able to use FES for my patients? Is there a specific certification that I need to have? Or is it enough to attend courses regarding FES?

[@andrewzanas9387]

Exciting stuff, Tara. I love that you continue to remain open to experimentation with new methods of rehab from research you continually do within multiple cross-disciplines of bio-mechanics, psychology, and the neurosciences. I don't know of any therapist who thinks as deeply as you do about your profession. Will definitely have to invest some time studying all of this new information you have provided us. Those are very cheap devices. Sorry. Inexpensive, not cheap, hey?

[@rehabhqofficial]

Hi Andrew! Great to see you this week! I am glad you found this video "informative" :) E-stim is by no means a "cure", however, as I state in this video, I think it can be a great addition to a well rounded rehab program :). Thanks again for checking in this week! I hope you have a great week!

[@lorilee5200]

Is there a FEM unit you recommend?

[@satpaulgupta9975]

Respected Tara, Kindly advise if trans dermal therapy would be of help for mobility regaining In the case of stroke patient

[@joannekavanagh5792]

I live in Ireland and I have foot drop having got it with my m.s. Can you tell me where I can buy this. Thank you Joanne

[@lizarddronedude3617]

Wished I had seen this before buying the Saebostim at 4times the price

[@neelamsharma2196]

Also want to know if walk aid can be helpful in walking as I have a drop foot . Here in Canada walk aid is not available now . I would appreciate if you can help Me I can order it from US

[@rehabhqofficial]

Thanks for this question! I have been using (and recommending) walk aid/bioness for nearly a decade. With that said, over the years, I have become less convinced that it is worth the money (approx. $5K USD). For those that have some active ankle dorsiflexion, I have seen that over time they actually show less active movement when the device is not on. And for those with zero ankle dorsiflexion, I have not had anyone where I have seen a therapeutic effect. My opinion (as of 5/1/22) is that some sort of active assist brace/AFO makes the most sense (for restoring active ankle dorsiflexion). Now, all of this said, "drop foot" is a symptom of several different medical conditions. There are many medical conditions that cause drop foot where movement recovery may not be possible. I hope that helps!

[@neelamsharma2196]

Thanks fir the quick response . I do wear AFO . Only thing is it’s great hassle to wear and u find it heavy and can’t drive with it . But ok May be one day there is hope for the people with drop foot 😊. And again thanks for doing amazing job

[@khadijahqureshi9149]

Hi.. I'd like to thank you.. I took guidance from your videos and they've really helped me a lot in improving my hand's movement including the elimination of spasticity.. My hand is a lot better now but my hand shivers.. it would be great if you could guide how to strengthen the muscles of affected hand.. 💕☺️

[@rehabhqofficial]

Thanks for watching and for sharing your story! I will make a note of your request for future videos :)

[@legendary8838]

I’ve been using this for over a year and for hours at a time and I’m not seeing improvement, what could be the issue?

[@rehabhqofficial]

Thanks for watching. Did you state hours at a time? Is that correct? If so, please watch this video again. I think I answer this particular issue as far as things to avoid when using NMES :)

[@tveasy5172]

You are not alone. More, the current can made drop sensitivity of nerves. After few intentions have to left this therapy.

[@kstewart8014]

Hi Tara, Ive been using a tens/nmes unit for about 18 months daily on my tib anterior and calves. I do kind of agree with you in regards to the nmes function not helping with the brain to muscle connection allowing you to consciously move the affected muscle since the electrical pulses are doing it for you. But my question for you is , in your opinion does it still keep the muscle itself stronger versus the muscle not being used at all? I hope that made sense. And thank you in advance If you are able to respond. (On a side note, I can move my left foot up and down a little bit without the nmes but I consciously move it along with the estim) (Also,Is there a way to contact you or staff with a question on your Rehab HQ website in regards to membership? I don't see a contact option)

[@anjumafshan1297]

Thank you God bless you 🙏

[@kishakisha17]

Is this ok to do if you heart issues

[@rehabhqofficial]

You must talk to your doctor before using electrical stimulation.

[@birdie0021]

Regarding NMES, what if you don't have a brain problem, (Upper neuron problem), but do have a nerve problem from a lumbar fusion. Which has produced drop foot and very weak tibia muscles that lift the toe. Would NMES provide strengthening of those muscles and be a worthwhile therapy? Thanks in advance for your comment. BTW how far are you from Tampa, FL. Do you take new patience? Thanks again..

[@RosaBrandDesigns]

I am so frustrated by the PT company my doctor recommended. It cost me $500/visit (you read that right), and I still can only walk a few feet and my affected hand is useless. I had my stroke in December. I had hoped to have at least a third of my capabilities back by now, but only have a fraction of where I should be. Your videos are getting me much closer to my goals. So, thank you!!! Question: would EMS or the other stimulation devices help with fingers so I can type on a keyboard again?

[@rehabhqofficial]

Hi Rosa! I am sure others share your frustration. Neuro rehab is a long road and it is normal to feel a little frustrated now and again. As far as your question about typing......there is no "magic cure" for hand movement. EMS has been shown to have some benefit in functional hand movement but it is by no means a "cure". I hope that answers your question. Have a great week!

[@strokeandthegarden9496]

I HOPE YOU ARE WALKING BETER NOW...FIND ANOTHER PT THERAPIST...AND STAY MOTAVATED... JUST KEEP MOVING THATS BEEN THE KEY FOR ME... STRETCH ALL DAY ... I DONT THINK A HR GOES BY THAT I DONT STRETCH MY HAND ALEAST 10 MIN...FINGE MOVEMENT FOR ME IS STILL LACKING... SOME DAYS ARE GOOD...I CAN OPEN THEM ALL THE WAY... SOME BAD IT SEEMS LIKE THEY JUST DONT WANT TO WORK.. BUT TYPEING FOR ME PROB NOT HAPPEN FOR A WHILE.. IM ABOUT 6 MONTH POST BASIL GANGLIA STROKE ....REHABING ON MY OWN AND KZbin..... THANK YOU TARA FOR YOUR VIDEOS

[@privatenexus5764]

OK, ordered the unit, it has been delivered, and now where is the part 2 video??? I personally am interested in building my hamstrings strength and stamina One thing I really like about this unit I didnt realise untill it arrived, as compared to another I found, it uses easily replaceable AAA batteries, instead of an internally rechargeable but non-user replaceable battery. ie basically dump the device as the battery dies, or suffer its performance degrading over time as the battery degrades.

[@tveasy5172]

Does it help?

[@privatenexus5764]

@@tveasy5172 I found that when doing the exercise of standing, and trying to raise one side lower leg by bending only at the knee, It did help. I think instead of actually firing the muscle, it reduced stiffness / spasticity to enable me to engage the muscle. So yes.

[@Idahomie]

wheres part two' ?

[@SimonHarrisPMP]

You often say "muscles that fire together wire together" and here you talk about the 'at muscle level' control loop. I'm searching for help with upper limb. Joints are quite mobile, muscles quite strong but when I reach for things the 'wrong muscles' seem to also be on so range & speed & consistent control of movement is constrained. At the fingers and wrist there is the most frustrating, unhelpful interaction - as I move wrist up (flexion?) fingers contract and I can't stop them or open them again without moving at the wrist Have you done (or will you do) something practical with or without ems to help overcome? (Ive a saebo pro but haven't found it useful, I suspect because I was missing the advice you give here - hopefully part 2 will be direct translation of this 'theory' into do at home activity?

[@ValerieJupe]

Are you doing much weight Bearing? Can you open your hand and bring your fingers up? I would work on that. Try to get the extensors strong. Just a guess

[@Hindutvanamo]

Hi Dr Tara...I have been following you from last 2 years, watching all your videos and doing all the exercises you’ve been teaching but I’m still unable to make my foot drop & wrist drop recovered...please let me know where I’m lacking...thanks from India 🇮🇳

[@carolinecadiente1876]

Good morning Dr. Tobias, do you recommend the use of TENS if I have history of one time seizure after my covid vaccine? I am one year post stroke with hemisphegia. Thank you

[@rehabhqofficial]

Hi Caroline! This is an excellent question. Definitely no electrical stimulation without clearance from your doctor after a seizure.

[@carolinecadiente1876]

Thank you, I will clarify it with my neurologist.

[@tveasy5172]

And the stroke had been occurred after the COVID vaccination too? Interesting enough to see statistics of strokes 2019-2023.

[@mrstevek118]

Only way I used a ten’s was a pt used it on me

[@biancajooste9421]

Just wanted to ask whether you think I could try Estim with my 1 year old, he has hemiplegia. His physio has never suggested it.

[@rehabhqofficial]

Definitely not without a doctor.

[@dpaul5457]

Greetings! Is anyone familiar with ARP wave therapy?

[@glenwest1911]

This should be interesting.

[@rehabhqofficial]

Hi Glen! I hope you learned something new :)

[@sumanngon]

I still find it difficult to understand the difference between TENS, FARADIC, GALVANIC...and now NMS/NMES!

[@gregzeng]

Slightly biased, in my opinion. My drop foot and clenching of my left hand and arm come from my car accident, 40 years ago. EMS and TENS are additional to pills and Botox. On going massage and physio exercises have been continuing, since these services are 'free' to Australians as old and severely disabled, like myself. My two EMS machines are very low cost ($US 10 or 15), bought online. At lower intensity, both machines can operate as pain relieving, as required. In previous years, I have also had many hand splints. My hemiplegia makes it very tedious to put all these devices onto my one sided body. So often this is not done now. Other serious issues demand more from my long suffering wife, who is given the federal government's support, to keep my body from being in the morgue, hospital and nursing home. However, despite all these supports, old age will eventually make my body eventually collapse. So this is normal. The professional treatment staff are focused on intense, 'scientifically proven' processes. Client people liked myself and my wife are not so upright and fussy. If it works in the overall place, without too much trouble, we will be happy enough. Tens and EMS are ok, used as needed or required. Not just by extremely dedicated, uptight processionals.

[@PT28WritingSignCally]

TEns is only an specific to pain management .... Not for stroke

[@rehabhqofficial]

That is what I said in the video. No? 🤷🏻‍♀️

[@robertlongoria765]

Bioness

[@usbly]

First view 😊

[@rehabhqofficial]

Great to see you this week Umesh!

[@kreapz]

Yay you get a cookie and a gold ⭐.

[@Daniel-bv6qk]

You are very beautiful 🔝

[@AngelicaCline-i6d]

I would say no. Waste of time.