Non-invasive Functional Electrical Stimulation in Rehabilitation Engineering

Transcutaneous (non-invasive) functional electrical stimulation (FES) activates the ascending and descending neural pathways in persons with diminished sensory and motor control after a central nervous system (CNS) disease or injury. Application of FES in early phases of rehabilitation (acute and sub-acute) has a carry-over effect in decreasing motor impairment. FES is applied to the peripheral nervous system to activate the nerves and muscles, generate functional movements, and activate efferent and afferent neural pathways to close the biological motor-sensory loop. This promotes brain plasticity, the most important mechanism in rehabilitation after brain injuries. In the case of Spinal Cord Injuries (SCI), the functional recovery is less pronounced; however, the influence on the reduction of secondary complications of paralysis (e.g., loss of muscle bulk and strength, pressure sores, cardio-vascular deterioration, diminished gastric and urinary functioning, spasticity, reduced range of movement in joints, etc.) is pronounced. The most common applications of non-invasive FES are the restoration of standing and walking, the generation of cyclic movements for pedaling or rowing, and manipulation and grasping.