Elec Stim. Fact or Fiction

[BarbH]

Jessica's therapist started Elec. Stim. on Monday but I remember one doctor saying it is "inappropriate" for babies and young children (Jessie's 15 months) to have this therapy done because it causes the bone to grow at a faster rate than the uninjred arm. Is this true?
Thanks,
Barb

[admin]

You wouldn't be using it on the uninjured arm would you?

[LisaL]

I have heard this also. We tried E-Stim on Hannah when she was 2years old, and stopped using it within a week. I have been told that e-stim is not recommended for children under two and probably not good until they are 3 or 4.

I hope you and Jessica are doing well.

Lisa

[Clint]

Despite what others above me have said, e-stim was recommended for Hannah by Dr. Nelson. The hope was that it would strenthen the muscles that support the scapula, thereby reducing winging. Unfortunately, it was not comfortable for Hannah. And like most 2 year-olds, she was very vocal in her displeasure with e-stim. They can be very convincing when they get like that! I suspect that had she been more tolerant, we would still be doing it, at least to a limited degree.

You can always ask other therapists or other PMR doctors in your area. Or ask Dr. Nelson/Shenaq if you are seeing them next month.

Clint

[Karen Hillyer]

Over here in the UK this type of therapy is not routinely recommended by Doctors - although one of our group members sis try it on the recommendation of her sons Physiotherapist.
When Professor Birch was asked specifically by a parent if they should try it for their child he responded that he had no objections to them trying the therapy, but he had no idea if it would actually benefit the child as he had never found any reports or studies on it's efficacy.
I would very much like to know if anyone has any information on any studies which have been undertaken or are in the process of being done as to the effects of the therapy.
I am sure more familis in the Uk would then be asking their childrens consultants for the therapy then.

[LeeAnne]

There are studies about e-stim on 2 recommended websites. We used the information here to get our insurance company to pay for TES. Go to
www.mayatek.com or
www.tascnetwork.com.

Michaela is now 7 1/2. She started using e-stim at the age of 23 months and calls it her tickle machine. She sleeps better with it on and had made tremendous functional gains even when not doing PT and OT.She even wore it in her splint at night 2 weeks after Mod Quad.

I have never heard anything about bone overgrowth from e-stim. What is promoted is that it helps suppy more blood flow to the limb thereby promoting more overall growth which is usually needed in BPI kids since, due to the decreased blood flow in the injured arm it is usually smaller than the uninjured one.

[LeeAnne]

Sorry that should be www.tascnetwork.net and
www.mayatek.com/pediatric

[admin]

I think we need to clarify: estim or tes. They are both "electrical" stimulation, but they work differently.

E-stim or nmes or fes work by sending an electical signal the mimics the signal that would be sent by the brain. It causes a contraction of the muscle.

TES or threshold electrical stimulation works by stimulating via a very light current. It is worn at night, 6 nights per week. It is intended to increase circulation to the muscles and to grow weaker muscles into stronger muscles.

It is my understanding that while TES can be used on smaller kids (as long as the sticky pads fit), E-stim is not usually used on kids under 2.

Those families that I have spoken to who use TES attest to its usefulness and success. They say their kids have more fluidity in the affected arm, strength and generally better function. I have not used it, so I can't say for us.

I have used E-stim extensively on Juliana and to excellent results. We used it during her botox time to strengthen her biceps, we have used it to strengthen her very weak deltoids, we have used it to strengthen her scapular muscles to decrease that annoying winging. We don't use it constantly, because it is tiring to the muscles. It is something we use, then stop, then use. We use it as fes (fuctional electrical stimulation) because I was taught that way by our first therapists and because it makes sense to me. That is, she doesn't just wear the machine, she wears the machine while doing tasks that are associated with the muscles we are stimming. Bending elbow exercises while stimming the biceps, etc.

I haven't spoken to Maureen Nelson in a while, but if someone sees her, perhaps they can ask her what she thinks of estim on young kids.

Juliana tolerated it well. Though she would go through some phases when it really bothered her. Early on, she had so little sensation in her arm, that you could dial the machine up to a billion and she couldn't feel it. Now, she can tell you when it bothers her.

The other thing I liked about fes, was that it made her more aware of her arm.

hope it helps,
claudia

[admin]

There has never been an independent, double blind study carried out to prove these devices work, that is what the UK doc is probably referring to. The links provided and studies referred to are from the makers of the unit, not independent research.

[Karen Hillyer]

thanks LeeAnne
I will check out those sites tomorrow - completely co-incidentally, about an hour after I posted that message, another parent in our group called me and during our conversation she mentioned that her daughter has been using a similar ( posibly the same)
E stim unit since March this year!
So I shall be very interested in reading these reports.