Neuromuscular Electrical Stimulation
Dynamic-task-specific approach to neuromuscular electrical stimulation (TASES) is evidence-based, for children or adults with cerebral palsy. Electrical stimulation (ES) can activate muscles and provide sensory and motor input and awareness to the user. This increased muscle awareness and ability of the muscle to contract assists muscle and movement function. The child’s joint range of motion increases, the muscles become more active, and benefit from movement and function immediately and over time. The difficult part of using ES is deciding which muscles are needed. ES has many names, neuromuscular electrical stimulation (NMES), functional electrical stimulation (FES), and task-specific electrical stimulation (TASES). All these methods want to improve muscle function, range of motion, and muscle strength. ES is beneficial to improve muscle function in other conditions besides cerebral palsy if exercise is indicated and there is an intact nerve.
Task-specific electrical stimulation (TASES) is used to provide sensory and motor input when the muscles are typically contracting while the patient is engaged in and initiating movement with a motivating goal or activity. A remote switch is used during dynamic activity to ensure the needed or typical timing of the stimulation. The therapist needs to consider the biomechanics and kinesiology of the activity and muscles involved when deciding which muscle to stimulate in what position and at what time.
The settings for TASES are different than those traditionally used. The goal is that the user learns from sensory and motor (muscle contraction) input during the stimulation. The simulation is felt by the child to learn that the muscle is there and can be used. It is desired that a muscle contraction occur, but it is always within the user’s tolerance, and a high contrition rate is not a goal. It is above a sensory-motor level and not below, as muscle hypertrophy could not occur. The amplitude is raised as the tolerance is increased and needed for the task. It does not need to be at a high level to increase muscle function or the child’s voluntary contraction.