In this first article in the “Bridging the Gap” series of articles, I want to encourage you and I to start thinking about motor training for physical rehabilitation as if we were training an elite athlete.

There is no such thing as the perfect product. Any product has to meet the individual requirements and preferences of the user. However, the Tek RMD is an exceptional, one-of-a-kind type of product, that allows people with lower limb paralysis or weakness to stand and move around in an upright position. It was designed with paraplegia due to a spinal cord injury in mind, but recent enhancements have extended the appeal to those with other neurological conditions.

A fundamental issue in getting the best out of the Tek RMD is being able to get on and of it safely and effectively. In this article we review the most commonly used approaches

How to we test for denervated muscle? As we will see in this article, a number of conditions can lead to denervation. Sometimes the extent of this denervation is hard to establish with equipment commonly available to the therapist. Perhaps the therapist tried “conventional” neuromuscular electrical stimulation (NMES) and could not produce a muscle contraction even with quite high intensity settings. Hence denervation was suspected, but without really being able to determine it’s extent.
The RISE stimulator provides a handy protocol that allows the presence and extent of denervation to be established and monitored over time. This article describes the process. First lets review some information on what exactly causes denervation, it’s consequences and the benefits of electrotherapy. We can then describe how the RISE unit can give is a denervation “benchmark”.

Things happen that can take our lives off track. A catastrophic injury, stroke or other neurological condition is never part of anyone’s life plan. Rehabilitation and physical recovery is going to be viewed as a unique challenge or an insurmountable burden we have to face.

Our clients need help in seeking realistic and achievable goals and they need the guidance and the technology to act. However. just as important will be working through the steps that take us from intial inspiration through to the creation of a habit. Adherence to a rehabilitation programme is always necessary irrespective of the technology or therapy input we provide.

The European RISE study showed that complete lower motor neuron lesions resulting in denervated muscle could be successfully treated at home using a particular form of electrical stimulation. The project showed that both the muscle tissue quality and bulk could be rescued with regular use of this stimulation.

We work with the Stimulette RISE which is direct outcome from this work and builds upon a significant amount of fundamental and applied research. In this article, we consider why starting such therapy early is beneficial and for whom.

Functional Electrical Stimulation, or FES for short, is a very powerful tool in the hands of a capable therapist but is sadly still poorly understood and less often seen in clinical practice than it deserves. I think there are a number of reasons for this.
The first problem is perhaps the fact that using electrical energy for therapeutic effect has a long and sometimes colourful history. This may have led to the whole idea of using electricity as being associated with “quackery”.

Another problem has perhaps been the fact that FES requires some technical as well as clinical know-how. It should be obvious that the nature and form of the electrical energy should be well understood as this is necessary for safe and effective application. This is not helped by the fact that there is no consistent use of terminology and practical guidance is often lacking about evidence supporting it’s use.