Pediatric Neuromuscular Electrical Stimulation Upper Extremity Intervention

This course is designed for pediatric therapists and should be used to supplement the information provided in the following courses:

• Upper Extremity Neuromuscular Electrical Stimulation
• Lower Extremity Neuromuscular Electrical Stimulation

Neuromuscular electrical stimulation provides activation below the level of spinal cord injury to retrain movement through sensory input and external electrical stimulation. The unique parameters associated with the stimulation, specifically the high frequency (100 Hz – 300 Hz) and wide pulse width (1,000 μS – 3,000 μS), drive neural plasticity within the spinal cord. During the activity, multiple muscles are simultaneously stimulated to produce appropriate trunk, upper extremityRefers to an arm., and lower extremityRefers to a leg. movement patterns. The muscles are chosen based on the Participant’s needs and the task-specific item they are performing. The Participant is encouraged to focus on the task-specific item they are performing to increase the overall nervous system excitability.

Approach

Participants will learn the scientific basis, how to operate the stimulating device, electrode placement, and basic clinical decision-making for performing neuromuscular electrical stimulation with the upper extremities and trunk. This course combines didactic teaching and practical skills development with hands-on treatment of individuals with neurologic dysfunction.

Target Audience: Novice and intermediate-level courses open to physical therapists, physical therapy assistants, occupational therapists, exercise physiologists, and rehab technicians.

Prerequisites:

• Introduction to Activity-Based Therapy
• Adult Neuromuscular Recovery Scale
• Upper Extremities and Trunk NMES
• Lower Extremities and Trunk NMES.

Objectives

1. Identify appropriate anatomical landmarks to determine electrode size and placement for targeted muscle based on patient, client, and participant presentation.
2. Modify electrode size and placement to promote appropriate kinematics and optimize neuromuscular recruitment.
3. Discuss clinical decision-making for utilization of NMES and establishment of NMES parameters to achieve optimal neuromuscular activation.
4. Identify the 3 lagging items on the Neuromuscular Recovery Scale and appropriately select the muscles to be stimulated based on the degree of neuromuscular activity.
5. Understand the primary movement goal of each task and incorporate activity-based interventions during overground assessment and community integration.
6. Understand stimulation device operation.