Stimulation of denervated muscles using the RISE Stimulator

The RISE Stimulator is a new development in the field of Functional Electrical Stimulation (FES). By means of FES it has become possible to set paralysed muscles in motion again. For years FES has been used as a training method in order to increase the muscle mass of people suffering from spastic paralysis. Since the development of the RISE Stimulator, a training method based on electrical stimulation has also been made possible for people suffering from flaccid paralysis (lower motor neuron lesion).

This picture shows the simplicity and compactness of the RISE Stimulator. The machine can be operated easily by use of the keyboard and the display. The electrodes that are attached to the device can be placed on to the muscles, after applying the conduction gel. Elastic bands keep the electrodes in their place during the training.

A flaccid paralysis is caused by damage to the nerves of the muscles, resulting in loss of muscle function. It is therefore impossible for these muscles to have an involuntary contraction, or a spasm. The paralysed muscles can be stimulated directly with the RISE Stimulator, which enables the muscles to contract. This process requires powerful pulses, pulses that can only be produced by the RISE Stimulator. When the paralysed muscles are activated regularly by means of the RISE Stimulator, the muscles will start to recover.

The most important advantages of this method of training are:
1. An increase in muscle mass
2. The recovery of the structure of the muscle tissue
3. A decrease in the fatty tissue in the muscle
4. A decrease in the connective tissue within the muscle
5. An improvement of the blood circulation
6. The prevention of bedsore

The increase in muscle mass

As stated above, the use of the RISE Stimulator will cause an increase in muscle mass. A MRI scan clearly shows the increase of the muscle mass. The following pictures show cross sections of both legs. These are pictures of the MRI-scans of two peoples.

The top four pictures are the MRI scans of one person and the bottom four are those of another person. The left four pictures were taken before the use of the RISE Stimulator. The right four pictures were taken after two years of stimulation using the RISE Stimulator. In all of these pictures only the muscles of the upper legs have been coloured.

Caption:
Black/white = Cross section of the bone
Green = Connective tissue
Red = Muscle tissue

Recovery of the structure of the muscle tissue

The stimulation not only causes an increase in muscle mass, it also causes the structure of the muscle tissue to recover. Picture A is an electron microscope photo of a muscle in longitudinal direction. Normally, vertical lines would be visible within the muscle tissue. This muscle has not been active in about ten months because of a paralysis, which has caused the structure to disappear almost completely.

Picture D is a similar photo of the exact same muscle. However, this picture was taken after a year and a half of stimulation with the RISE Stimulator. The difference is huge: because of the stimulation, the structure of the muscle tissue has become clearly visible once again.