Thanks for all who wrote wellcome to me!!! its great!!!ANNIE
-----Original Message-----
De: Barry Ashby <[log in to unmask]>
Para: [log in to unmask] <[log in to unmask]>
Fecha: Miércoles 16 de Junio de 1999 10:48
Asunto: Re: FYI and the role of Estim in PT.


>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
>>>
>>
>