Deck 14: Neuromuscular Electrical Stimulation Nmes and Functional Electrical Stimulation Fes in Patients With Neurological Diagnoses

Question 1

In patients with neurological conditions who have spasticity, why is a longer ramp-up time required when stimulating the antagonist muscle?

A) Increases tolerance to the onset of the stimulation
B) Causes greater recruitment of motor units
C) Avoids a quick stretch of the spastic muscle
D) Offsets the shorter ramp-down time

Answer 1

C

Question 2

When the goal of NMES is to increase joint ROM

A) A patient with chronic contracture is more likely to respond to treatment than a patient with a recent-onset contracture.
B) High-frequency stimulation is superior to low-frequency stimulation.
C) It is important to rule out bony impairments that could be limiting motion.
D) The contraction strength should be 2/5 to minimize discomfort associated with strong-intensity stretching.

Answer 2

C

Question 3

According to the literature, which neurologically impaired populations benefit from NMES?

A) Those with cerebral palsy (CP).
B) Those with hemiplegia post-cerebrovascular accident (CVA).
C) Those with multiple sclerosis (MS).
D) All of the above may benefit from NMES.

Answer 3

D

Question 4

FES for dorsiflexion assist during ambulation

A) Cannot be performed on patients who have CP because of spasticity
B) Improves ankle dorsiflexion required during swing phase of gait
C) Can result in full recovery of muscle function in patients post-CVA
D) Has not been shown to be effective for dorsiflexion assist

Question 5

NMES applied to the antagonist muscle for patients with spasticity will reduce spasticity based on which of the following theories?

A) Reciprocal inhibition of the spastic agonist muscle
B) Recurrent inhibition via Renshaw cells
C) Sensory habituation of the antagonist muscle
D) Facilitation of parasympathetic neurons in the limb

Question 6

Which of the following is supported by the literature when performing cycling FES for patients with spinal cord injuries?

A) 10 or 20 minutes every day
B) 30 to 60 minutes three times per week
C) 10 minutes three times per day, three to four times per week
D) 60 to 90 minutes five times per week

Question 7

What is one potential advantage of using NMES on the lower body of a person with a complete thoracic-level spinal cord injury (SCI)?

A) The use of NMES improves independent ambulation speed.
B) Increased lower extremity muscle activity may result in improved density in bones prone to osteoporosis post-SCI.
C) NMES assists in weight loss, which makes transferring much easier.
D) The use of NMES prevents shoulder dislocation.

Question 8

Which of the following is known about the use of biofeedback for patients who have had a stroke?

A) Current evidence does not show support.
B) Studies confirm it is useful for recovery.
C) It is ineffective for stroke victims because of spasticity.
D) It can be combined with NMES for retraining of gait.

Question 9

Which parameters would most likely be effective when the goal of NMES is to enhance strength?

A) 75 pps, 10 seconds on : 50 seconds off, 10 minutes
B) 30 pps, 10 seconds on : 30 seconds off, 10 contractions
C) 75 pps, 4 seconds on : 4 seconds off, 10 contractions
D) 30 pps, 4 seconds on : 4 seconds off, 10 minutes

Question 10

Select an appropriate electrode placement for ambulation assist in a person with decreased active dorsiflexion during the swing phase of gait.

A) Peroneus longus and brevis muscle bellies
B) Peroneal nerve and anterior tibialis muscle belly
C) Posterior tibialis muscle belly
D) Gastrocnemius and anterior tibialis muscle bellies

Question 11

When using NMES to increase range of motion (ROM) and tissue extensibility

A) The intensity should be high enough to generate a 5/5 muscle contraction in order to overcome the soft-tissue resistance to movement.
B) The sooner the muscles fatigue, the more efficient the remaining treatment will be.
C) It is critical to choose a high frequency that will maximize force generation.
D) It is important to maximize the treatment duration at the expense of muscle overloading.

Question 12

Which set of parameters is most appropriate for treating urge incontinence?

A) 50 pps, 5 seconds on: 50 seconds off, 30 minutes, three times/day
B) 12 pps, 5 seconds on: 15 seconds off, 30 minutes, three times/day
C) 50 pps, 5 seconds on: 15 seconds off, 60 minutes, three times/week
D) 12 pps, 10 seconds on: 50 seconds off, 60 minutes, three times/week

Question 13

FES for decreasing shoulder subluxation in patients post-CVA

A) Is most effective when postponed until 6 months post-CVA
B) Should be applied to the posterior deltoid and supraspinatus muscles
C) Should be applied over the upper trapezius muscle to elevate the shoulder girdle
D) Is effective when applied for 10 minutes per day over a 3-week period

Question 14

Studies have shown that FES for upper extremity function has been effective in facilitating functional use of the extremity in which of the following patient populations?

A) Those who have had a stroke
B) Those with traumatic brain injury
C) Those having a spinal cord injury
D) All of the above

Question 15

Studies have shown that NMES for patients with neurological problems who have muscle weakness

A) May help increase muscle strength, especially in the stroke population
B) Shows minimal improvements in muscle strength
C) Results in significant increases in strength, especially in spinal cord injured patients
D) Shows no improvements in muscle strength

Question 16

Which of the following is the primary benefit of FES cycling for spinal cord injured patients?

A) Increased strength of lower extremity muscles
B) Decreased incidence of pressure wounds
C) Improved cardiovascular health
D) Facilitation of standing and walking using the Parastep system