Upper Extremity & Trunk Neuromuscular Electrical Stimulation

Prerequisite: Adult Neuromuscular Recovery Scale (NRS)

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.

Neuromuscular electrical stimulation, an activity-based therapy, provides high frequency, wide pulse width, task-specific stimulation to generate a motor output while increasing the central state of excitability in the spinal cord. Neuromuscular electrical stimulation is provided via the Restorative Therapies Incorporated Sage unit with Xcite software and the use of lead wires to 12 different muscle groups based on the targeted item from the Neuromuscular Recovery Scale. Tasks are performed with and without stimulation to transfer the improved neuromuscular capacity into the home and community environment.

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.

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.
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