Functional Electrical Stimulation (FES)
Functional electrical stimulation (FES) uses low level electrical pulses to activate nerves and muscles during performance of a useful functional task e.g. grasping, cycling or walking. It is most commonly used for people who have been paralysed due to injury to the brain or spinal cord.
Neuromuscular Electrical Stimulation (NMES)
NMES uses low level electrical pulses to activate muscles supplying motor nerves. Unlike FES, NMES is most commonly used to engage nerves and muscles to increase strength as opposed to a functionally useful task such as grasping or walking. NMES is frequently used to increase strength in weak or paralysed muscles prior to FES treatment. The terms NMES and FES are often used interchangeably.
Transcutaneous Electrical Nerve Stimulation (TENS)
The term TENS is most often used to describe high frequency low level electrical pulses that provide a sensory experience that can be helpful for managing pain. The difference with electrical stimulation being used for pain is that there is no muscular contraction rather the parameters are set to provide a sensory experience to the skin.
Spinal Cord Stimulation (SCS)
SCS involves using electrical pulses applied directly to the sensory part of the spinal nerve in the spinal cord – the dorsal spinal roots. Most commonly this is through the use of a surgically implanted device. SCS has also been applied to the spine non-invasively via electrodes on the surface of the skin. SCS has most frequently been used clinically for pain management. There is ongoing research into the use of SCS, invasively and non-invasively, as a sensory control input in a number of areas eg. walking, standing, bowel, bladder and spasticity. An important complementary variant is stimulation of sacral anterior nerve roots, which contain motor fibers for activating the bladder muscles – detrusor and sphincter.
Clinical Applications of Electrical Stimulation
Electrical Stimulation has been used in research and treatment interventions for a wide variety of applications. Please note that some of these applications are currently only being used as research interventions.