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FES...a means to an end

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  • FES...a means to an end

    I don't know what everybody's take on this is...but this morning, I put my stim unit on my quads. With a walker, I was able to stand.

    Now this to me looks like a viable means of making many, many people independent of their wheelchairs. Not a decade from now....NOW.

    Now I know that there are commercial "FDA APPROVED" walking "solutions" out there. Buy they simply cost too much and therefore aren't practical for everyone in the community.

    What is a stim unit except a DC current loop? They sell stim units on TV for $49.95. Why should we pay $10000 for an FES bike?

    I want an inexpensive, practicle way OUT of the wheelchair. Braces don't do the job, they are too bulky. NOW.

    Eric Texley
    Eric Texley

  • #2
    OK, so I talk to my orthotics dude this morning, right? I'm looking for a a lock which will allow freedom in the knee joint, i.e. I want to lock the brace at 5 deg, 10 deg, 15 deg from the locked position and have freedom to move my leg. Why??? Because I want to TRY to lock my legs and promote recovery, while at the same time having the protection of the brace so as not to fall over.

    What answer do I get? "That doesn't exist." Hmmm. That's interesting...I wore a pair of braces at Dr. Bohbott's in France which could do this. He sent me a fax with the manufacturer of the locking mechanism. I want to have my braces fit with them.

    But of course, that lock doesn't exist.

    OK, "Sir, can you make the holes bigger in the brace so that I have some freedom?" I'd be skirting my responsiblity.

    Does anybody have a pair of braces with locks that provide some degree of freedom in the knee joint?

    Eric Texley
    Eric Texley

    Comment


    • #3
      braces

      Originally posted by Eric Texley:

      OK, so I talk to my orthotics dude this morning, right? I'm looking for a a lock which will allow freedom in the knee joint, i.e. I want to lock the brace at 5 deg, 10 deg, 15 deg from the locked position and have freedom to move my leg. Why??? Because I want to TRY to lock my legs and promote recovery, while at the same time having the protection of the brace so as not to fall over.

      What answer do I get? "That doesn't exist." Hmmm. That's interesting...I wore a pair of braces at Dr. Bohbott's in France which could do this. He sent me a fax with the manufacturer of the locking mechanism. I want to have my braces fit with them.

      But of course, that lock doesn't exist.

      OK, "Sir, can you make the holes bigger in the brace so that I have some freedom?" I'd be skirting my responsiblity.

      Does anybody have a pair of braces with locks that provide some degree of freedom in the knee joint?

      Eric Texley

      Comment


      • #4
        Braces

        Originally posted by LJ Webber:

        Quote: "Originally posted by Eric Texley:
        OK, so I talk to my orthotics dude this morning, right? I'm looking for a a lock which will allow freedom in the knee joint, i.e. I want to lock the brace at 5 deg, 10 deg, 15 deg from the locked position and have freedom to move my leg. Why??? Because I want to TRY to lock my legs and promote recovery, while at the same time having the protection of the brace so as not to fall over.

        What answer do I get? "That doesn't exist." Hmmm. That's interesting...I wore a pair of braces at Dr. Bohbott's in France which could do this. He sent me a fax with the manufacturer of the locking mechanism. I want to have my braces fit with them.

        But of course, that lock doesn't exist.

        OK, "Sir, can you make the holes bigger in the brace so that I have some freedom?" I'd be skirting my responsiblity.

        Does anybody have a pair of braces with locks that provide some degree of freedom in the knee joint?

        Eric Texley"
        Eric, I've been trying to find someone who maybe has come up with a new design for leg braces. All I can find is what was availble 30 years ago. It seems that by now something more attractive and lighter would have been invented. I outgrew mine years ago, so I cut them off below the knee and hopped around with a walker, good exercise but not practical for getting around from place to place. Then I broke my left femur in half exercising, so i haven't tried anything with braces in years, but am ready to go back to a long leg brace, and like you would want the knee locks to be adjustible for tension. I haven't called anyone in my area yet, but plan to do so soon. I'll let you know what I find.

        Comment


        • #5
          Problem is

          The Cheap Stim Units like the ones on TV Don't have enough power and therefore will not work for most SCI people. With a good FES bike, there is plenty of power and it is able to put variable resistance against the muscles and therefore build bulk, something you just can't do with a cheap stimulator. FES is different from just Stimming muscles, it is hitting the muscles with Voltage in a sequence to make the legs do meaningful work and that is to pedal a stationary bike. This also requires a biofeedback loop so as to not overwork the muscles and cause damage since most with sci have no sensation. It is pretty complex and not really mass produced and I can imagine Liability insurance is not cheap due to all these lawsuits these days, thus the high price. Curtis

          "Life is about how you
          respond to not only the
          challenges you're dealt but
          the challenges you seek...If
          you have no goals, no
          mountains to climb, your
          soul dies".~Liz Fordred
          "Life is about how you
          respond to not only the
          challenges you're dealt but
          the challenges you seek...If
          you have no goals, no
          mountains to climb, your
          soul dies".~Liz Fordred

          Comment


          • #6
            Hmmm. I'll check into what you say about various voltage applications. My understanding of fatigue is somewhat different. When a given amount of current is applied to the muscle, the amount of strength which I get peaks after several contractions. Then, as the muscle is used, it begins to fatigue. The strength of the contraction lessens until the muscle cannot contract any longer with the same current applied to the muscle.

            I ordered a book which dicusses FES for both innervated and deenervated muslces (which I was told wasn't possible!) I'll let you all know what I find.

            Eric Texley
            Eric Texley

            Comment


            • #7
              Braces

              Originally posted by LJ Webber:

              Eric, I've been trying to find someone who maybe has come up with a new design for leg braces. All I can find is what was availble 30 years ago. It seems that by now something more attractive and lighter would have been invented. I outgrew mine years ago, so I cut them off below the knee and hopped around with a walker, good exercise but not practical for getting around from place to place. Then I broke my left femur in half exercising, so i haven't tried anything with braces in years, but am ready to go back to a long leg brace, and like you would want the knee locks to be adjustible for tension. I haven't called anyone in my area yet, but plan to do so soon. I'll let you know what I find.
              Hi guys,
              I've been having the same problem. I use a full length caliper on my left leg, which breaks allowing me to bend my knee to sit down, but I have to walk with it locked in place. It's starting to cause a bit of back pain and I've been trying to find something that will allow me to lock the knee at, say, around 10-15 degrees. The orthotics guys I go to keep telling me that there's nothing available.

              The neoprene braces that athletes use to support their knees have adjustable hinges so what's the problem? Grrrrrrrr. I mean, come on. We can put a man on the moon but we can't come up with an adjustable leg brace? [img]/forum/images/smilies/mad.gif[/img]

              Perhaps we need to put our thinking caps on and come up with one ourselves.

              Comment


              • #8
                That's EXACTLY what I was looking for. I know they exist, because my brace in France had one. I'll let you know what I come up with...

                Eric Texley
                Eric Texley

                Comment


                • #9
                  Well...Articulations for knee and ancle joints do exist. If I can't get knee and ancle articulations here in the US, I'll go back to France and get them.

                  "The world is ROUND!" "Flat" "ROUND like a baseball" "Flat like your head" (Quote from Looney toons...)

                  Eric Texley
                  Eric Texley

                  Comment


                  • #10
                    Braces

                    Eric Texley wrote : I had a pair of braces made in
                    the clinic off Dr. BOHBOTH in France with special
                    knee locks.
                    I am interesting in this because I live in Belgium
                    and the braces here are made with parts off a German firm Otto BOCK who has an almost complete
                    monopoly position in the BENELUX and many other
                    coutries but the locks are not so safe and indeed
                    there was little or no change over the last decades. Is it possible to post the addres off the
                    French manufacturer on this forum or if not I will
                    give you my personal e-mail addres.
                    Thanks,
                    Tshombe.

                    Comment


                    • #11
                      The next possibility is a knee immobilizer. It will give me some freedom of movement to practice locking my legs and develop recruitment and muscle strength. But it will also assist me with locking my legs. Besides, I fairly tired of wearing body armour. It's too heavy...!

                      I am quite curious what a stim regimen does to voluntary recruitment over time. Common sense tells me there is no correlation. But one would expect that stimming the peripheral nerve would stop it from "shutting down" as is discussed in this forum.

                      Recently, I got a book on "Thereputic modalities" There is a whole section of the book dedicated to stimming denervated muscle for the purpose of preventing atrophy till such time as the peripheral nerves heal.

                      Eric Texley
                      Eric Texley

                      Comment


                      • #12
                        Does anyone have any idea about the dynamics of a stim current which are required to keep a muscle contracted for a long period of time? My experience with my stim is that I can keep my quads contracted for maybe a minute. After that, the muscle will no longer stay contracted. Of course, this is fatigue since all of the fibers in the muscle would not normally remain contracted that the same time. But how could you arrange a stim that would maintain a contraction--for, say, standing?

                        Eric Texley
                        Eric Texley

                        Comment


                        • #13
                          Eric, the main reason why stimulators and other devices are expensive is because they are all low-volume. Companies can afford to ramp up manufacturing and lower costs when they make millions of televisions, radios, and other consumer goods. They don't have to get FDA approval or establish safety. Also, there are many Mom-and-Pop operations, companies with 10 or 20 people working in them, that are making simple stimulators and selling perhaps a couple of thousand of the devices per year. The economics of the situation are such that they cannot be made cheaply under such circumstances.

                          What is the solutions? First, I think that the field may consolidate in the coming years and a few major manufacturers will emerge as the dominant companies. These companies should be able to sell in large volume and thereby reduce the costs. Second, I think that a great deal of savings can be achieved by making flexible stimulator devices that have component parts that can operate from a single controller device. This way, one single device can then be used for multiple purposes simply by swapping components. This would enlarge the market for each device. Third, it would be useful for the consumer community to establish an organization that could rate the devices and ensure that standards are met, instead of depending on the FDA or federal agencies. After all, they do this for stereo sets and cars, why not FES devices?

                          Wise.

                          Comment


                          • #14
                            So where can I get a reference about the specifics of an electrical signal that would promote a sustained, strong, muscle contraction? What kind of exercises do I have to go with my FES unit to achieve this?

                            Eric Texley
                            Eric Texley

                            Comment


                            • #15
                              My orthotist tells me "at your level, we use bail locks rather than step locks for braces."

                              Whatever person who though "falling" backwards and using a chair to help unlock the braces needs a brain examination. As it is I had to rig one of them up to unlock so I can sit.

                              And I'm absolutely, positively overbraced. No question about it.

                              You all are SO RIGHT! The idea that this technology hasn't evolved since FDR....I saw a video on RGOs...that's supposed to be technological advancement? Yeah, maybe in body armour.
                              Eric Texley
                              Eric Texley

                              Comment

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