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Thread: E-stim PT in SoCal?

  1. #1

    E-stim PT in SoCal?

    I joined this community not because I have a SCI but because I have muscle flaccidity and atrophy. I would like to start e-stim with a PT.

    Any recommendations for PTs in Los Angeles or Orange Counties (preferably Long Beach 90815) who have some of depth of knowledge and experience using e-stim for muscle flaccidity and atrophy? Or a particular specialization? Or a database that might help me? A search of the APTA website didn't find any reference to PTs with expertise using e-stim.

    Thanks,
    Chris

  2. #2
    Senior Member
    Join Date
    Apr 2016
    Location
    Cincinnati, Ohio, USA
    Posts
    2,217
    Best trainers (not PTs) for SCI in the Long Beach area are at Strides SCI in San Juan Capistrano. There's also a group of former Project Walk folks up in LA. If you need contacts for either I can get them for you. I don' think any do estim as a normal therapy - do you want muscle stim? Flaccid paralysis requires something like the Den2x but it's not available in the US.
    T3 complete since Sept 2015.

  3. #3
    What is the cause of your "muscle flaccidity and atrophy"? E-stim is not going to cure the underlying disease process, and may actually be contraindicated. You will need a physician's referral/prescription for a physical therapist to treat you in California.

    (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.

  4. #4
    Senior Member
    Join Date
    Apr 2016
    Location
    Cincinnati, Ohio, USA
    Posts
    2,217
    Here's another group that rose from the ashes of Project Walk in the LA area:

    https://www.facebook.com/abilitiesre..._uPB5ZKotmwgtw
    T3 complete since Sept 2015.

  5. #5
    Hi Chris

    My company, NeuroEx www.neuroex.net , operates in Southern California and is in the Long Beach area weekly. We use the Myolyn FES bike.

    I co founded the Project Walk program ( https://www.linkedin.com/in/ericharness ) and left in 2015 to start NeuroEx. We are a mobile activity based training program. We bring the equipment and expertise to you.

    As KLD stated you will need a Dr Rx to use FES.


    Eric Harness, CSCS
    Founder/President
    Neuro Ex, Inc
    Adaptive Performance and Neuro Recovery

  6. #6
    Quote Originally Posted by Snowman View Post
    Hi Chris

    My company, NeuroEx www.neuroex.net , operates in Southern California and is in the Long Beach area weekly. We use the Myolyn FES bike.

    I co founded the Project Walk program ( https://www.linkedin.com/in/ericharness ) and left in 2015 to start NeuroEx. We are a mobile activity based training program. We bring the equipment and expertise to you.

    As KLD stated you will need a Dr Rx to use FES.
    What are your feelings on higher parameters? RTI got fda approval for 3000 pulse width and I understand Myolyn doesn’t believe in them. I do not respond to traditional US approved estim but do get a visible contraction to higher pulse width. What would you do with a client that presents like that?

  7. #7
    Quote Originally Posted by Lyerly View Post
    What are your feelings on higher parameters? RTI got fda approval for 3000 pulse width and I understand Myolyn doesn’t believe in them. I do not respond to traditional US approved estim but do get a visible contraction to higher pulse width. What would you do with a client that presents like that?
    Hey Lyerly, Matt from MYOLYN here. I just wanted to share my thoughts on the higher parameters and clarify our position on them.

    In the literature, there are two kinds of wide pulse stimulation discussed that I'm aware of. Both use pulse widths over 500 microseconds. The first kind uses extremely high pulse widths (100,000+ microseconds) to directly activate the muscle fibers. This is how the den2x stimulator from the RISE project works. The RISE researchers demonstrated that stimulation pulses with pulse widths exceeding 100,000 microseconds and over 80 milliamps could, over a period of 3-5 months, activate and build denervated muscles, whereas stimulation using traditional parameters (i.e., 500 microseconds or less), typically don't cause denervated muscles to contract. Such wide pulses are extremely high in energy and are physically unbearable to any but those without sensation (to quote the research, "...tolerated only in patients with no pain sensibility"). Nevertheless, such stimulation does activate denervated muscles where traditional stimulation normally does not.

    The second kind of stimulation uses more moderate pulse widths (1,000+ microseconds). This type of stimulation activates muscles by recruiting motor neurons through reflex pathways through the spinal cord through a "sensory volley". From my understanding of the literature, this type of stimulation may have some advantages when it comes to fatigue resistance, but it's otherwise similar to traditional FES (500 microseconds), albeit at much higher intensities (which, again, are unbearable for those with sensation).

    I think that RTI's higher parameters put the somewhere in between these two different types of stimulation. RTI's use of pulse widths up to 3,000 microseconds can elicit contractions from the muscles of people with flaccid paralysis and/or peripheral nerve injury. In fact, when customers with lower motor neuron injury ask me about FES-cycling, I point them to RTI in the hopes that they'll be able to get some contractions going, despite the higher price. That being said, the available research suggests that even higher pulse widths (100,000+ microseconds) are needed to achieve all the benefits demonstrated by the RISE group for people with complete lower motor neuron injuries.

    So, we do believe in the power of higher pulse widths, as evidenced by the research. We don't currently use them because there are many things to consider when adding such high stimulation intensities, and at this moment the benefits have yet to outweigh the costs. That equation is subject to change though.
    Co-founder & CTO of MYOLYN - FES Technology for People with Paralysis - Empowering People to Move

  8. #8
    Strange that Chris wanted so much information, but has not come back to our forums to see the responses to his questions. Hasn't logged on to the site since the day posted.

    (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.

  9. #9
    Quote Originally Posted by Matt Bellman View Post
    Hey Lyerly, Matt from MYOLYN here. I just wanted to share my thoughts on the higher parameters and clarify our position on them.

    In the literature, there are two kinds of wide pulse stimulation discussed that I'm aware of. Both use pulse widths over 500 microseconds. The first kind uses extremely high pulse widths (100,000+ microseconds) to directly activate the muscle fibers. This is how the den2x stimulator from the RISE project works. The RISE researchers demonstrated that stimulation pulses with pulse widths exceeding 100,000 microseconds and over 80 milliamps could, over a period of 3-5 months, activate and build denervated muscles, whereas stimulation using traditional parameters (i.e., 500 microseconds or less), typically don't cause denervated muscles to contract. Such wide pulses are extremely high in energy and are physically unbearable to any but those without sensation (to quote the research, "...tolerated only in patients with no pain sensibility"). Nevertheless, such stimulation does activate denervated muscles where traditional stimulation normally does not.

    The second kind of stimulation uses more moderate pulse widths (1,000+ microseconds). This type of stimulation activates muscles by recruiting motor neurons through reflex pathways through the spinal cord through a "sensory volley". From my understanding of the literature, this type of stimulation may have some advantages when it comes to fatigue resistance, but it's otherwise similar to traditional FES (500 microseconds), albeit at much higher intensities (which, again, are unbearable for those with sensation).

    I think that RTI's higher parameters put the somewhere in between these two different types of stimulation. RTI's use of pulse widths up to 3,000 microseconds can elicit contractions from the muscles of people with flaccid paralysis and/or peripheral nerve injury. In fact, when customers with lower motor neuron injury ask me about FES-cycling, I point them to RTI in the hopes that they'll be able to get some contractions going, despite the higher price. That being said, the available research suggests that even higher pulse widths (100,000+ microseconds) are needed to achieve all the benefits demonstrated by the RISE group for people with complete lower motor neuron injuries.

    So, we do believe in the power of higher pulse widths, as evidenced by the research. We don't currently use them because there are many things to consider when adding such high stimulation intensities, and at this moment the benefits have yet to outweigh the costs. That equation is subject to change though.
    Thanks for the post. I actually own the RISE and have used it for years to reverse muscle atrophy and convert fatty tissue back into healthy muscle tissue. I still use it but have been using RTI units with higher pulse widths but have been limited by the power of the units. I have to almos max our power to get contractions so for me to do quads hams glurs calves and tibs with soleus i need 3-4 units. So for me that $60-80K. Not sure why RTI can’t fix the power issue and make bigger power units. I hate that they are the only game around Bc I think their service is poor.

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