Neuromuscular Electrical Stimualation (NEMS) – Dennis McMasters, OT
Electrotherapeutic agents are interventions which use electricity and the electromagnetic spectrum to , facilitate tissue healing, improve muscle strength, endurance, range of motion, decrease edema, modulate pain, decrease the inflammatory process, modify the healing process and used as an adjunct/preparatory method to increase participation in activities of daily living tasks. NEMS is used to selectively evoke muscle contraction through stimulation of the intact or partially intact peripheral nervous system. Some of the main contraindications for the use of NEMS on patients are as follows: pacemakers, bladder stimulations, cancer, myasthenia gravis, muscular dystrophy; multiple scelerois; patients unable to provide clear feedback regarding the level of stimulation; skin disorders. Please consult further resources for a more indepth discussion of all precautions and contraindications for tby he use of NEMS with patients. One of the important aspects in the use of NEMS is the placement of the electrodes on what muscle group is being stimulated and the goal of the program. A electrode placement chart should be utilized to determine proper placement, so the desired result can be obtained. The therapist should always monitor a patients skin condition and electrode placement prior to application and following treatment. Some of the most common applications for the use of NEMS are: increasing or maintaining active range of motion and strength; muscle re-education; relaxation of muscle spasms & spasticity; tendon excursion and decreasing edema and wound healing. Please consult more indepth resources for specific protocols, treatment guidelines and ways to incorporate functional activities so the desired outcome is obtained for greater independence completing activities of daily living for the patient. Some of the resources to consider are: Physical Agent Modalities by Dr. Alfred G. Bracciano. Also Physcial Agents in Rehabilitation by Dr. Michelle H. Cammeron.