Bien Venida Ana

At 10:56 PM 6/14/1999 -0300, you wrote:
>Hello!!! i am a PT from argentina,i am also in the list reading messages and
>obtaining a lot of information...I work with children also an NDT here and i
>work with postural reeducation(Kabbat, Souchard and Bobath tecniques,if it
>is easy to understand...) i am looking for more information here about
>children treatments, what can you recomend me? Ana Villaflor PT
>-----Original Message-----
>De: D. Fiore <[log in to unmask]>
>Para: [log in to unmask] <[log in to unmask]>
>Fecha: Lunes 14 de Junio de 1999 03:50
>Asunto: FYI and the role of Estim in PT.
>
>
>>Hi everyone,
>>
>>I have been inactive on the list for awhile now.  I have enjoyed a lot of
>>the information shared and some I have inquired about the effectiveness and
>>theory behind it for usage in therapy with my patients.Recently, I have
>>come to find time on my hands since full time employment in pediatrics is
>>becoming more difficult to find due to insurance companies/HMO"S limiting
>>physical therapy services  to children that have been identified thorough a
>>comprehensive evaluation.
>>
>>Let me introduce myself since I have been lurking as a ghost PT. I have
>>been a pediatric physical therapist for 10 years and have dealt with
>>various ages and types of children and adults with cerebral palsy. I am NDT
>>certified with a curiosity about combining the positive features of sensory
>>integration. Recently, I had a great informative conversation with Dina, a
>>member on the list who was kind enough to share her thoughts and personal
>>experiences about NACD. I am now reading more to expand my horizons on the
>>subject thanks to her feedback.
>>
>>In April I read an excerpt from someone who was interested in Estim and why
>>it was so difficult to find PTs'  who treat adults with cerebral palsy. I
>>would like to expound on that subject if that someone is still out there.
>>
>>I went to a course that was given in Charlottesville,Virginia regarding
>>NMES, TES TENS(what has been addressed by Ms. Elizabeth Thiers, OTR another
>>member on the list)and FES. All of these types of Estim are utilized by
>>some physical therapists' for strengthening, pain relief and biofeedback
>>during treatment of clients with cerebral palsy. I am summarizing the
>>outline to help shed some light on the subject. I have used Estim as you
>>had described in your comment about Estim and its' benefit. A treated an
>>adult with CP-quadriparesis with a TENS unit to provide pain relief and
>>reduction in paraspinal spasms from long term sitting in his customized
>>wheelchair. I soon had to discontinue therapy due to HMO constraints but at
>>least I know he has a home program that includes the TENS unit to reduce
>>his spasms and provide him with comfort while he is in his wheelchair for
>>the entire day at the sheltered workshop.
>>
>>Summary of the lecture by Katherine L. Parker MSPT on NMES, TES, TENS and
>FES:
>>1. Neuromuscular Electrical Stimulation(NMES)is high intensity electrical
>>stimulation applied over muscle points for short duration to grow muscle
>>fibers for strengthening and motor learning. This unit is supervised by a
>>therapist during therapy sessions only.
>>2. Therapeutic Electrical Stimulation(TES): Proposed by Dr. Pape of
>>Mayatek, Inc. who has studied various cases of providing low level
>>stimulation at the sensory level. The unit is worn overnight increasing the
>>number of muscle fibers to fire since the "Estim fires the fittest fibers
>>first". It is more comfortable for patients to tolerate and her research
>>has shown good results in increasing the sensory awareness of the weak
>>muscle for better biofeedback during intensive muscle strengthening.
>>However, questions have been raised about her research design since her
>>sample sizes are small and randomization is difficult. Dr. Pape continues
>>to publish her research on TES and train therapists' in TES and how to
>>administer the treatment to patients.
>>3. Transcutaneous Electrical Stimulation(TENS)is low intensity high
>>frequency electrical stimulation used to fatigue muscles in spasms for pain
>>relief, increase blood flow to the area for proper nutrition to the muscle
>>tissue. It is applied for long or short duration depending upon it's use.
>>The effects how are temporary unless the movement or postural deformity is
>>corrected in the person's lifestyle.
>>4. Functional Electrical Stimulation(FES):High intensity electrical
>>stimulation with surface or implanted electrodes positioned for active
>>muscle contraction to improve function and/or serve as functional orthosis.
>>(Very expensive and invasive by implanting electrodes and reimplanting if
>>they become dislodged).
>>
>>I hope this clarifies your curosity about Estim and its' use by
>>therapists'. You all may have many questions so please feel free to comment
>>and I will do my best to get back to you with the research. My response is
>>not as prompt as some of our members so please be patient. I will try to be
>>a friendly Casper ghost PT when I can.
>>
>>D. Moll MS, PT
>>
>