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Typical stimulation protocols used in clinical FES involves trains of electric pulses. Biphasic, charged balanced pulses are employed as they improve the safety of electrical stimulation and minimize some of the adverse effects. Pulse duration, pulse amplitude and pulse frequency are the key parameters that are regulated by the FES devices.
In layman's terms, this electrical stimulation mimics the action of healthy muscle to improve function and aid in retraining weak muscles and normal movement. Functional Electrical Stimulation (FES) is commonly used in 'foot-drop' following stroke, but it can be used to help retrain movement in the arms or legs. [citation needed]
Neurostimulation is the purposeful modulation of the nervous system's activity using invasive (e.g. microelectrodes) or non-invasive means (e.g. transcranial magnetic stimulation, transcranial electric stimulation such as tDCS or tACS). Neurostimulation usually refers to the electromagnetic approaches to neuromodulation.
Transcranial direct current stimulation (tDCS) is a form of neuromodulation that uses constant, low direct current delivered via electrodes on the head. This type of neurotherapy was originally developed to help patients with brain injuries or neuropsychiatric conditions such as major depressive disorder.
Sensory stimulation therapy (SST) is an experimental therapy that aims to use neural plasticity mechanisms to aid in the recovery of somatosensory function after stroke or cognitive ageing. Stroke and cognitive ageing are well known sources of cognitive loss, the former by neuronal death , the latter by weakening of neural connections .
In 2018, a major review of upper limb interventions following stroke found significant positive effects for constraint and task specific-therapies and the supplementary use of biofeedback and electrical stimulation. However, they concluded that the use of Bobath therapy was not supported. [19]
Electrical brain stimulation was first used in the first half of the 19th century by pioneering researchers such as Luigi Rolando [citation needed] (1773–1831) and Pierre Flourens [citation needed] (1794–1867), to study the brain localization of function, following the discovery by Italian physician Luigi Galvani (1737–1798) that nerves and muscles were electrically excitable.
The electrical stimulation used in HWT differs from other forms of electrical stimulation such as TENS in terms of its waveform; it is intended to emulate the H waveform found in nerve signals, thus permitting the machine to use less power while attaining greater and deeper penetration of its low-frequency current.
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