Stroke Questions

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1. What is a stroke?

Stroke is a "brain attack", cutting off vital supplies of blood and oxygen to the cerebral cells controlling everything we do - speaking, walking, breathing. A stroke occurs when an artery becomes blocked (ischemic stroke) or ruptured (haemorrhagic stroke). Most strokes occur when arteries are blocked by blood clots or by the gradual build-up of plaque and other fatty deposits. Arteries can rupture when weak spots on the blood vessel wall break.

2. What is a CVA?

A stroke is often described as a Cerebral Vascular Accident.

3. How is stroke rehabilitation accomplished?

Most stroke rehabilitation is through by physical exercise, but the cognitive aspects of stroke rehabilitation are also very important. The intact nerves have the possibility to utilize new and different paths from the brain to build new functional synapses. Mental training is an important element in stroke rehab.

4. What is EMG?

ElectroMyoGraphic signals are called EMG. They are electrical activities originating in the brain and transported via nerve cells to the muscles. These signals cause the muscles to contract. Often EMG signals are disturbed after a brain attack leading to paralysis of muscles.

5. What is NMES?

NeuroMuscular Electrical nerve Stimulation (NMES) is the application of an electrical stimulus for muscle rehabilitation. During NMES an electrical impulse is passed from a device to electrodes placed on the skin over a targeted muscle or muscle group. The stimulation causes the muscle(s) to contract.

6. What is the difference between NMES, NMS, FES and ES?

NMES is NeuroMuscular Electrical Stimulation. NMS is NeuroMuscular Stimulation. FES is Functional Electrical Stimulation. ES is Electrical Stimulation. All these are NOT EMG triggered NMES!

7. What is EMG triggered NMES?

The combination of both modalities offer superior possibilities for re-learning of otherwise paralyzed muscles. This combination method is also called EMG controlled NMES.

8. Is EMG triggered NMES, EMS and ETEM similar?

All different terms for the same: EMS stands for Electromyographic triggered electric Muscle Stimulation. ETEM stands for Emg Triggered Electrical Myostimulation. .

9. What is the basic idea behind the Biomove?

It is a state-of-the-art tool to assist in muscle rehabilitation after stroke. The re-learning process offers the possibility of utilizing new and different paths from the brain with the help of EMG triggered NMES. .

10. What has this method to do with biofeedback? ?

If, with the help of the Biomove, the patient experiences control of previously paralyzed muscles, the cognitive re-learning process improves significantly. This "feedback" is the ultimate form of biofeedback

11. Why is it important to regain control of paralyzed muscles?

It not only makes the patient more independent, but improves significantly the quality of life.

12. Do I use the Biomove in addition to regular therapy?

Yes, it is an important supplement to other home therapy.

13. Why are clinical systems used mainly at rehab centers?

Set up of clinical units is complicated and can only be done by a therapist. Sometimes this difficult-to-use unit is made available to the patient for a very limited time, which is almost never enough to obtain improvement and, more importantly, to retain improvement over time! Hence the absolute need for the patient to have a simple to use unit at home at all times. .

14. Is the Biomove system complicated to set up?

Although clinical devices are difficult to use due to the many control functions, Biomove is designed for home use by the patient without difficult set up.

15. How easy is the Biomove to use?

Very easy!

Stick on the electrodes
Set the desired level for the stimulation impulse (NMES)
Set the sensitivity for the EMG signal pick up and start moving!

16. How soon after a stroke can I start using Biomove?

It is desirable to start between one and three months after a stroke. Best results are obtained when starting not later than 12-36 months after a stroke.

17. What about motivation to continue training over time?

The achieved results increases one?s desire to continue with the training over time.

18. What success rate can be expected?

90% of all patients have significant improvement after six months. Even after just one month remarkable results are experienced in many patients.

19. What can I expect from increased EMG activity?

Stronger and more controlled muscle contractions can be expected.

20. How long after a stroke can muscle movement improve?

Even after several years, there are patients who still find application of the system very beneficial.

21. What about dropping hand?

That is the whole idea: re-learning to open and to lift the affected hand again.

22. What about gait?

Re-learn by training how to lift the dropping foot upwards again and be able to walk much better.

23. Can I "build-up" muscle strength?

Yes, by adjusting the sensitivity level. The patient can decide how easy or difficult to make the training.

24. Do my muscles get tired during training?

A resting period between each electrical stimulation impulse prevents too-frequent muscle contractions. This resting period is factory preset, but can be adjusted by the user.

25. How long is a training session?

20 to 30 minutes.

26. How often should I use the Biomove?

For best results: twice daily. .

27. For what period of time should I continue using the system?

Use it as long as you feel that you are benefitting from the training. Some patients use it for several years, even if only for a few sessions a week.

28. Does the stimulation impulse hurt?

Many precautions are built into the unit to make the stimulation impulse as gentle as possible, and only a "tickling" feeling is experienced during muscle stimulation.

29. Can I change the length of the stimulation impulse?

The optimal setting is preset, but it is possible to change the length of the electrical stimulation impulse.

30. Can I use the muscle stimulator (NMES) part separately?

Yes you can, but it is not a TENS device.

31. Can I use the EMG part separately for biofeedback?

Yes you can set the sensitivity level for the EMG signal. When this preset EMG level is reached, an LED lamp indicates delivery of stimulation impulses.

32. What is the normal amount of electricity in a muscle?

Between 100 and 300 micro volts.

33. How much electricity is still available in paralyzed muscles?

Rest values are mostly above 5 micro Volt (0.000005 Volt).

34. Is this sufficient to be detected by Biomove?

More than enough. The unit can pick up signals that are even smaller.

35. Will electromagnetic pulses disturb operation of the unit?

The built-in electronic filters very effectively suppress disturbance signals without affecting the sensitive electronics of the unit.

36. How is the unit connected to the muscles?

The "stick-on" electrodes placed over the paralyzed muscles are hooked up to the Biomove unit by a flexible cable.

37. How do I know when the stimulator gives an impulse?

An LED lamp indicates when the (EMG) "trigger level" is reached and the electrical stimulation impulse (NMES) is given.

38. What is included with the system?

It includes the basic unit along with a flexible patient cable, belt and reusable self-adhering electrodes.

39. What kind of battery is used?

One standard 9 Volt alkaline battery.

40. How do I know when to change the battery?

An LED lamp lights up when the battery needs to be replaced.

41. Why is your system substantially cheaper than other systems?

The Biomove offers exactly what the patient needs at home without confusing "bells and whistles".

42. Does this mean that other systems offer more?

Correct. In addition to the same functions as the Biomove, they offer various complicated options. These "luxuries" are heavily paid for and almost never used, even by experienced therapists. They only make practical day-to-day use at home complicated and confuse the user without making any difference in the successful use of the training system!