The RISE Stimulator for flaccid paralysis is a new development in the area of electrical stimulation. Unlike the traditional FES system, the RISE Stimulator can be used in a flaccid (non-spastic) paralysis, better known as a low transverse lesion.
Mark Durrant (SCI T11 / T12) about the RISE Stimulator
USE THE RISE STIMULATOR IF FES DOES NOT WORK
In some cases, the FES system can’t be used. The RISE stimulator makes it possible to stimulate degenerated muscles. Sometimes it is possible to stimulate the muscles in the legs in such a way that the patient can stand up upright.
The muscles in the legs are being assisted by the electrical impulses. The RISE works independently. Currently, it can’t yet be combined with one of our BerkelBike models.
Thomas Maas (SCI TH8) about the RISE Stimulator
THE RISE STIMULATOR IS VERY SUITABLE FOR
• A flaccid paralysis • A peripheral nerve injury • A plexus brachialis injury
ADVANTAGES OF THE RISE STIMULATOR:
• Increased muscle mass • Increased fiber size • Decreased fat tissue • Decreased connective tissue • Restored muscle tissue structure • Improved blood circulation • Improved skin condition
Piet van der Meer (SCI T12) about the RISE Stimulator
USE THE RISE STIMULATOR
Its easy-to-use and compact size make the RISE Stimulator unique and perfect for home use. You only need to wet the sponge covers for the electrodes and place them on the muscles that are to be stimulated. Elastic bands keep the electrodes in the right place during stimulation. The stimulation process can be easily controlled with the controls and can be observed on the screen.
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WHO BENEFITS FROM THE USE OF THE RISE STIMULATOR?
A flaccid paralysis is caused by a transverse lesion that damages the nerves and is characterised by a complete loss of muscle function. Due to the nerve damage, there are no uncontrolled contractions or spasms. Examples of conditions that may benefit from the use of the RISE are plexus brachialis, transverse lesions with Cauda Equina syndrome and conus medullaris syndrome.
Degenerated muscles can only be stimulated directly. This means that the muscles are not stimulated through their corresponding nerves, but that the electrical impulses are applied directly to the muscles. In order to induce muscle contraction by direct stimulation, longer and more powerful electrical impulses are required than with indirect stimulation (as in FES, which provides for indirect electrical stimulation that is only suitable for paralysed muscles with intact motor nerves).
The RISE Stimulator has an electrical output with impulses up to 300 mA, with durations up to 200 milliseconds. Our FES-system, on the other hand, provides indirect electrical stimulation that is only suitable for paralysed muscles with intact motor nerves.
INCREASE OF MUSCLE MASS
With regular use, the RISE Stimulator can promote muscle build-up and recovery. The following pictures of an MRI scan show how the muscle mass in patients’ legs has increased after regular training with the RISE Stimulator.
Both pictures show a cross section of the leg muscles of two people. The top four photos are from one person, the bottom four of the other. The left-hand pictures were taken before treatment and the right-hand pictures show the condition after four years of regular training with the RISE Stimulator.
Black/white = cross-section of bone
Red = muscle tissue
RECOVERY OF MUSCLE TISSUE
Electrical stimulation not only causes an increase in muscle mass, it also helps in the recovery of muscle tissue. Photo A is a picture of a muscle taken lengthwise with an electron microscope. Normally, vertical lines should be visible in the muscle tissue. However, this muscle has been inactive for about ten months and the structure has almost disappeared.
Photo D shows the same muscle after one and a half years of stimulation with the RISE Stimulator. The difference is striking; the structure of the muscle tissue, as shown by the vertical lines, is now clearly visible.
MUSCLE FIBERS AFTER FLACCID PARALYSIS
On the right you will see optical microscopic images showing the muscle fibers of the muscle.
Photo A was taken from a healthy muscle. Here you see large and healthymuscle fibers.
Photo C is a muscle of a person who has had a spastic muscle paralysis (UMN) for twenty years. Here, the muscle fibers have shrunk.
When we look at Photos E and G, taken from two people with a flaccid paralysis (LMN), you see that the muscle fibers have shrunk even more.
In spastic paralysis, the muscles are still active in a way because of the spasms. For this reason, the muscle fibers remain better intact than in a flaccid paralysis.
MEDICAL CONDITIONS AND RESTRICTIONS
Whether the RISE Stimulator is suitable for you, will depend on your medical condition. Because the stimulation is much more powerful than is observed in nerve stimulation, there are more exclusion criteria: stimulation on top of metal implants is prohibited. People with a pacemaker, bladder stimulator or artificial circulation pumps also need permission from their attending physician. Additionally, the RISE Stimulator should not be used during pregnancy because there is insufficient testing for pregnant women.