Functional Electrical Stimulation
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What is FES?
Functional Electrical Stimulation (FES) is the application of computer-regulated electrical impulses to the skin in a waveform that mimics the motor neuron signal the brain sends to the muscle to cause a contraction. It is considered “functional” electrical stimulation because the waveform replicates the normal contraction of the muscles being stimulated, just as if the brain itself had initiated the contraction. It therefore has the ability to treat both muscle spasms and muscle atrophy.
FES feels like a deep muscle massage because the software mimics the electrical signals produced naturally between the brain and the body. FES treatments do not require sedation and horses can be ridden shortly after their treatments in most situations.
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What does FES Help?
FES has major benefits to help a wide variety of horses. Beyond preventative maintenance of the completive horse some of the most common cases include:
Muscle Spasms
Muscle Atrophy
Tendon Strain/Tear
Lumbar & Sacral Pain
Limb Edema
Kissing Spine
Each situation is addressed and treated individually. Protocols vary for each diagnosis provided including differences between a tendon strain and a tendon tear. Case by case protocols facilitate the ability to bring your horse through rehabilitation in the best possible way.
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How is FES different from a TENS Unit?
• FES is designed to stimulate motor and sensory nerves.
• FES replicates the body’s own electrical impulse to generate a muscular response.
• FES uses low voltages to obtain deep muscle movement (9-11 Volts).
• FES provides computer-regulated signals, generated by software, for a clean & precise waveform.
• FES uses a balanced-biphasic waveform for stimulation that does not produce ion accumulation.
• TENS is designed to stimulate sensory nerves, not motor nerves.
• TENS sends an impulse to confuse the sensory pathways to “gate” or block the pain sensation.
• TENS produces a strong, stinging sensation if muscle contractions are induced.
• High voltages are required to obtain deep muscle movement (120 Volts).
• TENS uses an unbalanced waveform. Waveform adjustments are necessary to avoid accommodations by the body so that the signal remains effective.
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How Often Does the Horse Need Therapy?
The number of treatments necessary will depend on the results desired, the severity of the injury, and the longevity of the injury.
Injuries usually require a concentrated series of treatments until improvement is observed. Once desired results are observed, then maintenance can include therapy once every few months if necessary.
Typically two treatments are done within 24 to 48 hours. Following those 2 sessions, a plan can then be made to bring the horse through their rehabilitation process as quickly as possible.
Generally, horses in heavy training and showing and those at peak performance can benefit from therapy once every few weeks.
During strenuous training periods, treating the horse may prevent compensatory problems due to the stress and strain of training. Treatment can also maximize the horse's ability to progress through the training.
A typical treatment period is 35-45 minutes.
Which Horses Benefit from FES?
Horses rehabilitating from an injury or surgery can benefit greatly from the use of FES, as treatment utilizes therapy goals to improve the quality of healing and reduce recovery time. In addition, horses with acute or chronic injuries involving muscles and joints will benefit from FES therapy.
Past injuries can cause long-term muscle tightness and soreness in the horse that may go undetermined for periods of time. FES therapy has the ability to help relieve chronic tension in sore muscles, resulting in pain relief and performance enhancement.
Recent injuries can also be treated. By addressing the injury quickly, the horse's level of comfort will immediately improve and the risk of compensation injuries will be limited. FES can alleviate swelling in limbs and joints as well as long-term edema cases. Wounds have been shown to heal much more quickly with the use of FES therapy.
FES is an excellent complement to chiropractic and acupuncture treatments. The reduction in spasticity due to FES applications can improve the effectiveness of chiropractic and acupuncture procedures, as well as improve compliance by the horse to these treatments.
Horses in serious training will dramatically benefit from FES therapy. Sometimes these horses will not appear clinically lame. However, the rider will feel a lack of willingness, slow progress in training, and a lowered quality of movement as training progresses. Horses treated in these early stages of poor performance will have a lower risk of a serious overuse or compensation injury later in their career.
Indications & Benefits
•In need of movement of constricted muscle and tendon tissue and associated ligaments
• Painful contractions and splintering of muscles as a result of injury (muscle spasms)
• Desire for muscle movement to increase the level of circulation of blood and lymph
• Removal of edema
• Breaking the pain-spasm-pain cycle
• Reduce cross-fibering during healing
• Increase range of motion
• Re-education of muscle
• Strengthening of muscle after injury
• Reverse wasting of muscle (used in EPM rehabilitation)
• May decrease healing time for bone fractures after acute phase
• Assist in readjustment of dislocations
• Healing of wounds
Contraindications
• Cannot be used over: cardiac pacemakers, electrical implants, metal implants, carotid sinus, epiglottis, abdomen
• Acute injury – Diagnosis of the problem must be obtained before treatment
• Active bleeding – Hemorrhaging may increase with stimulation
• High Fever – A secondary problem may exist that needs treatment
• Infection – Potential for spreading a localized infection because of increased blood flow
• Blood Clots – Therapy may dislodge clots due to increased circulation
• Dislocation – Therapy may actually allow undesirable readjustment if performed on adjacent sites
• Pregnancy – Therapy applied close to uterus may initiate contractions
• Cancer – Therapy may break loose bits of cancer and increase spread throughout the body