There is one major part of my rehab that I have so far failed to mention, but it is probably the thing that I do the most and it is something that I think has such amazing potential.
Functional Electrical Stimulation (FES) is basically a way of activating paralysed muscles. The muscles are directly stimulated by placing electrodes on the muscle and connecting them up to the stim box, which then delivers a low level of pulsed electrical current that creates a contraction in that muscle. A spinal injury doesn’t affect the actual muscles in the lower limbs, it just affects the ability of a signal from the brain to contract that muscle. So in the past (before FES) people with spinal injuries would find that their muscles atrophy and they are left with very skinny legs and all sorts of secondary problems as a result. Nowadays, however, this is not the case. If used regularly, FES keeps the muscles in much better condition and can help with spasms and pressure sores amongst other things.
That’s the science-y bit in its most basic form…The way I think of FES is that it basically gives an electric shock to the muscles that make them contract.
I knew absolutely nothing about FES until Andy (Prime Physio) told me that this should be the first piece of equipment we bought with the fundraising money, so we did. FES comes in all sorts of forms, but we bought the FES bike, which I think is probably the most widely used product.
I could have taken a picture of my exact bike, but it looks exactly like this stock image, except mine is currently doubling up as a clothes stand in front of the radiator while my washing dries (Another great use for it that I surprisingly haven’t seen advertised!)
The bike allows me to connect up pretty much all the muscles in my legs and then I’m good to go. Ok the picture above isn’t exactly like my bike as it has failed to show all of the wires that are required. There are a fair few, but I have become quite a pro at setting myself up with electrodes all over my legs and wires connecting the electrodes to the stim box (the white box on top). I cycle every day for at least an hour, and the bike has various gears so that I change the resistance as my muscles get stronger. As a result I have got pretty decent muscles in my legs and I definitely do not have skinny paralysed looking legs. As much as I would love to have model-like stick thin legs, it wouldn’t be very healthy for me and would probably create more problems. I would look great in skinny jeans though!
More recently, the software of the stim box has been developed and it can now be used without being connected up with the bike. It can basically be used to target any paralysed muscle, as shown in the pictures…
The FES can then be used to assist with various exercises…
And even more recently I have tried FES rowing, where my quads are connected up and they contract at the appropriate time (they are triggered via a remote) to assist with the rowing action…
So as I have probably quite poorly explained, but have hopefully shown by the photos, FES is extremely versatile. These are only a couple of the exercises I do at Standing Start and Prime Physio that can be helped by FES because the possibilities are pretty much endless. Although the connecting of the wires and setting up can be slightly time consuming, it is definitely worthwhile. The stim box is effectively my new brain for sending messages to my muscles telling them to contract, and I’m hoping it’s only a matter of time before they use FES to assist with walking.