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Question:
I have your home study course and have a patient who already has the TES units. He has spastic diplegia with rhizotomy. He used the TES units for about 4 years after his rhizotomy (when he was three). He is now 12 and we are interested in using them again. I am confused about the polarity. Why is the active electrode the positive electrode with TES rather than the negative electrode with NMES? I would also like to E-stim his trunk and gluts. He has 2 units. Can I do both sides of his trunk and both gluts at the same time?
Answer:
I assume that the units will still work if they are the NT2000-TES units.
NT2000-TES
Put new batteries in them and give them a go. If the wires are stiff when you flex them, they will have to be replaced. Please call 1-877-827-2242 for new wires.
The TES units work by encouraging blood flow to the targeted field. It does not depolarize the nerve to cause a contraction. We found, by trial and error, that it is more comfortable with the (+) pin proximal and the (-) pin distal. The NMES placements are to motor points and the (-) pin is placed to facilitate the depolarization with higher current levels. With the newer EMG-STIM unit, we use the same placements as with the TES and find that it works well with about 1/3 of the current density.
Most teens with post Rhizotomy are placed on the following pattern. Just check that he does still have normal or decreased reflexes in the legs.
Unit one – Trunk-Abdomen and Gluteal
Unit two – Quadriceps and Tibilalis Anterior
Use both units on the same side of the body one night and the other side the next night.
I usually have them do it 6 nights a week and to use it on the right on even days and the left on odd days. It evens out and is easy to remember. I do not have them treat both sides at the same time. I do not know why it is, but people complain that it is hard to sleep and so compliance goes down. This way, with all the units and wires on one side, they sleep better. It also helps to put the units and excess wires in a runners pouch. Another option is to have a 2 unit holder made from a soft material that is designed to hold the TES units.
Auntie Frannie's Flannel Fannies
It is a great time to start back as he goes through puberty.
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