Frequently Asked Questions

What is functional electrical stimulation (FES)?

  • FES is a therapy method where nerves are stimulated with electrical current in order to cause a muscular contraction. The aim is to produce a functional movement.

For which clinical pictures can the training be used?

  • Generally applicable in lesions with an intact lower motoneuron
  • Spinal Cord Injury
  • Stroke
  • Traumatic Brain Injury (TBI)
  • Multiple Sclerosis
  • Guillain-Barre Syndrome
  • Parkinson’s Disease
  • Chronic Polyarthritis (Rheumatoid Arthritis)
  • Cerebral Palsy
  • ALS (Amyotrophic Lateral Sclerosis)
  • Orthopaedic Diseases
  • Muscle weakness due to impaiments of the peripheral nerve

Note: Patient’s individual physical condition or contraindications may forbid an FES application. Please consult your doctor before use!

Which muscle groups can be stimulated?

  • Generally every paralysed muscle with an intact lower motoneuron
  • The surface of the muscle must be large enough for electrode placement

What are the contraindications for FES therapy?

FES and the RehaMove should not be used by a few people:

  • Who use cardiac pacemakers
  • with unhealed fractures in lower extremities if the legs shall be trained; in upper extremities, the area of the shoulder girdle and upper ribs if the arms shall be trained
  • with damages of the rotator cuff or the potential luxation of the shoulder joint, if the arms shall be trained
  • with epilepsy
  • with known allergies to electrode gel
  • with metal implants underneath or near the muscle groups which are to be stimulated
  • pregnant women should desist from using stimulation because the possible adverse effects are unknown and have not yet been rigorously investigated

Which training duration is recommended?

  • depending on the patient, the clinical picture, and the training aim
  • patient should be able to get used to the therapy
  • training start: 5-10 minutes as the muscles are untrained and fatigue quickly
  • up to 1 hour training per day is possible when training regularly
  • higher therapeutic effect when training 3-4 times per week for 30 minutes

How does the stimulation work?

  • Electrical pulses activate the peripheral motor nerves leading to the corresponding muscles
  • Pulses pass between two electrodes and thus activate the nerves between the electrodes
  • Each nerve has a particular threshold (all-or-nothing principle) triggering an action potential
  • Activation can take place when stimulation intensity is high enough (increase pulse width or current) in order to exceed this threshold

How many muscles/channels can be stimulated simultaneously?

  • Up to 8 stimulation channels/ 8 muscles

Which electrode size is used for which application?

  • in general: the bigger the electrode the better (more comfortable for the user due to a lower current density)
  • electrode size depends on the area of the muscle to be stimulated: for small muscles it’s recommended to use small electrodes and the other way around
  • electrode forms: oval or rectangular

Where adhesive electrodes have to be placed?

  • centrally on the muscle belly
  • for a higher therapeutic effect, electrodes have to be placed with a handbreadth between them
  • shave if necessary to improve electrode adhesion and skin contact

Is it possible to use different electrodes?

  • due to guarantee and warranty claims we recommend the use of HASOMED electrodes
  • adhesive electrodes of the company HASOMED can be used for up to 15 applications
  • application note: adhesive electrodes should not be used on skin where e.g. body lotion has been applied

In which way is the movement synchronised with the stimulator?

  • stimulator and MOTOmed communicate via data cable
  • data exchange of all relevant parameters (angle or position of the crank arm, rpm adn rotational direction, symmetry, gear, time, distance)
  • stimulation sequences of controlled channels are triggered by angle-based MOTOmed data; thus, the stimulator “knows” when to stimulate which muscle

How endurance and strenght can be trained?

  • for strength training higher frequencies are necessary (starting with 30 Hz)
  • for endurance training only lower frequencies are used (up to 30 Hz)

What is the ramp for?

Is it possible to adapt the current with increasing training duration?

  • depends on the patients adapting threshold and sensitivity
  • during training, current can be adjusted for each channel; frequency and pulse width can be adjusted for all channels

With which motion trainer can the RehaStim2 be used?

  • only use the RehaStim2 with the MOTOmed Viva 2 (without light version) as arm and leg trainer

When is the adaptive training used?

  • in general: therapist decides on the patient group to be treated
  • adaptive training: adapts automatically to the patient’s performance
  • stimulation is adapted to the residual muscle function of the patient
  • mostly used in incomplete and central paralysis: stroke, TBI
  • adjustment of a maximum and minimum pulse width:when a certain speed is reached, stimulation will stop slowly, stimulation starts again below this speed

When is the constant training used?

  • in general: therapist decides on the patient group to be treated
  • constant training: stimulation intensity remains constant even if the patient pedals faster and more powerful
  • mostly used in complete paraplegia

How does the sequence training work?

  • RehaStim can be used without MOTOmed as a stand-alone device
  • cyclical movements of arms and legs can be trained (e.g. grasping, flexion)

When is sequence training used?

  • for activation or movement od single muscles
  • in order to increase training intensity, e.g. alternating activation of quadriceps muscle
  • Sequence training is used where the RehaMove cannot be applies, e.g. when reinitiating complex motion sequences like grasping
  • RehaStim includes templates for the most common applications e.g. FES walking, crawling, sit-to-stand or shoulder stabilization

How can I get the sequence training?

  • can be activated via additional licenses for present stimulators

What is the difference between percent and second mode in sequence training?

  • percent sequence training includes all templates for gait training/FES walking in percentage according to the natural gait phases in a complete gait cycle
  • second squence training includes templates in seconds (start + duration of each single muscle in seconds)

What effect has the button “Period” in the percentage-sequence training?

  • duration of the complete sequence is adjusted
  • periods are adjustable in seconds

What effect has the button “Interval” in the second-sequence training?

  • there is always a break between single sequences
  • break times can be selected in steps of one second

Which trigger types are available?

  • Sequence training offers a manual or automatic triggering
  • an additional external trigger software with external single or double trigger is available