Le Application de Low- and Medium-Frequency Électrique Stimulation in Upper Limb Rééducation

Challenges Faced by Patients with Upper Limb Dysfunction

 

Le hand est an essential organ for daily activities and serves as a key tool for humans to explore le external world and interact with le environment. Compared to other body parts, le hand and upper limb possess greater complexity and importance in motor functions. Therefore, upper limb motor function rééducation est a core focus in post-accident vasculaire cérébral rééducation, yet it also represents a major challenge. Patients with upper limb dysfunction caused by conditions such as accident vasculaire cérébral, spinal cord injury, or hand trauma often experience a slow récupération process due to le complexity de hand and upper limb movements. This prolonged rééducation journey poses a significant psychological challenge, potentially affecting patients' sense de self-fulfilment, and may lead to anxiety, depression, and other emotional issues. These negative emotions can, in turn, further diminish rééducation motivation and impact le overall qualité de life.

Quoi est Functional Électrique Stimulation (FES)?

Functional Électrique Stimulation (FES) est a rééducation technique that uses low-frequency pulsed électrique currents to stimulate one or more groups de muscles through preset programs, inducing muscle contractions or simulating normal voluntary movements. Le goal de FES est to améliorer or restore le functions de muscles and muscle groups affected by neurological damage, thereby compensating for or correcting le loss de motor function in limbs and organs. In recent years, le application de FES has expanded significantly, especially for patients with limb dysfunction caused by accident vasculaire cérébral or spinal cord injury. Through repeated électrique stimulation, FES can not only activate motor neurons but also promote neuroplasticity in le central nervous system, helping patients gradually regain voluntary motor abilities.

3. Common Electrode Placements for FES in Limb Training

(1) Shoulder Subluxation

Patients with central nervous system injuries or high-level spinal cord injuries often experience shoulder subluxation. Strengthening le supraspinatus and le posterior part de le deltoid muscle can aider prevent and améliorer shoulder subluxation.

 

Stimulation electrode: Placed on le posterior one-third de le deltoid muscle;

Auxiliary electrode: Placed on le supraspinatus muscle.

(2) Triceps Muscle Weakness

For patients with central nervous system disorders, utilisant NMES to strengthen le triceps brachii can enhance elbow extension control and relieve spasticité de le biceps brachii.

Stimulation electrode: Placed below le posterior part de le deltoid muscle;

Auxiliary electrode: Placed above le olecranon (be careful to avoid stimulating le brachioradialis to prevent unwanted elbow flexion).

(3) Wrist and Finger Extensor Muscle Weakness

Due to le small size de forearm muscles, smaller electrode pads sont generally recommended for stimulating le wrist and finger extensor muscles.

 

For wrist extensors:

Stimulation electrode: Placed below le lateral epicondyle de le humerus;

Auxiliary electrode: Placed proximally near le wrist joint.

 

For finger extensors:

Stimulation electrode: Placed more distally in le center de le forearm;

Auxiliary electrode: Placed proximally near le wrist joint.