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sudden diminishing FES response

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  • sudden diminishing FES response

    Hi all,

    Quick question - has anyone ever experienced a sudden non-response to FES and loss of spasticity/tone?

    The question is for a complete C4/5 injury - approx 2 years post injury. FES response has diminished in one leg

    Cheers for the help in advance!

    FPF

  • #2
    Yes, about five years after injury. Up until that time I could ride for one or two hours on a FES bike with resistance. Over a span of a month or two I got to where even with no resistance my legs would give out in 5 or 10 minutes. I still ride it but most of the work is coming from my arms.

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    • #3
      Oh no! Is this with the Anatomical Concepts machine?
      Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

      T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

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      • #4
        Sorry, no the question isn't for me. I am still responding fortunately. The question is for a friend.

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        • #5
          Oh whew! Bad for the friend though - hope this gets sorted.
          Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

          T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

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          • #6
            RT300 and I have widely varying day to day performance. Last summer I was riding at 7.5kcal/hr now down to 5.1 Even in the last week that has varied between 6.6 and 5.1 some rides I start at 1.98 resistance and 36 rpm and am using max stimulation in 7 minutes other days same start point but I can gradually increase rpm to 40 and only use 95% stim in a 75 min ride. I can't work out why, same breakfast, sleep, time of day and we take time to position chair to pedals.

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            • #7
              So, other than some neuro change, the things I can think of that seem to affect FES response are:
              1. electrode age
              2. electrode interface (clean skin, interface spray)
              3. electrode positioning (strongest impact I've noticed)
              4. muscle/neuro fatigue

              I also suspect that there's something in the Sage (I have Sage 7) electronics that ages or requires regular recalibration. Perhaps the temperature of the head unit affects the current measurement circuit?

              I know I have noticed reducing results on the RT300 that I use, but no similar reductions from a hand-held, Globus unit. My RT300 is in need of service so I'm no longer using it and trying to get a new one through insurance (wish me luck).
              T3 complete since Sept 2015.

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              • #8
                As far a physical changes, issues that may need to be explored include:
                1. Possible peripheral nerve "burn-out" or damage due to excessively high stimulation OR peripheral neuropathy from other causes (such as diabetes, alcoholic peripheral neuropathy, etc.). An EMG may be needed.
                2. A syrinx involving the cord at the level of the reflex arcs involved in the stimulation. MRI or CT of the cord to rule this out

                (KLD)
                The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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                • #9
                  Thanks all.

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                  • #10
                    Originally posted by SCI-Nurse View Post
                    As far a physical changes, issues that may need to be explored include:
                    1. Possible peripheral nerve "burn-out" or damage due to excessively high stimulation OR peripheral neuropathy from other causes (such as diabetes, alcoholic peripheral neuropathy, etc.). An EMG may be needed.
                    2. A syrinx involving the cord at the level of the reflex arcs involved in the stimulation. MRI or CT of the cord to rule this out

                    (KLD)
                    KLD, wouldn't a simply "knee hammer" reflex response test be a good start at a qualitative evaluation as to whether something has happened to the reflex arc?
                    T3 complete since Sept 2015.

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                    • #11
                      Yes, of course a physical exam would be where you would start. Assessment of spasticity and spinal reflexes would be part of that exam.

                      (KLD)
                      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                      Comment

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