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Functional Electrical Stimulation (FES) is used for muscle reeducation, reduction of spasticity, delay of atrophy, and muscle strengthening. FES stronger stimulation than other forms of electrical stimulation. The efficacy of FES in improving function has been substantiated in the literature. Treatment programs employing FES - activation of muscular tissue through the intact peripheral nervous system - can be broken into five major categories, according to the goal of treatment. These broad areas would include the use of FES to: (1) a direct excitation onto the alpha motoneuron, through peripheral stimulation of the Ia myotatic sensory system and ascending afferent information, which will be integrated at conscious and subconscious level of the CNS. (2) The quality of a stimulated muscle contraction is determined by combination of many parameters, including stimulus amplitude, pulse duration, stimulus frequency, and duty cycle. (3) A unit that has a pulse duration between 200 and 400μsec will be more than adequate for FES applications. (4) The neuromuscular plasticity is critically important to return of function using muscle re-education and facilitation applications. (5) Prior to using FES as an electrical orthosis, the patient should build up endurance in the muscles to be stimu1ated during the gait cycle.
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