The Electrophysical Forum aims to provide an interactive platform for questions, comments, discussion and opinion related to the use of Electro Physical modalities in therapy. It is supported by an Internationally renowned expert panel and a broad sphere of clinicians, researchers, educators and students. Active participation is welcomed.

Sign up to start posting >>>

Ask a question and get it answered by your peers and respected experts

Answer a question and be recognised, raising your international profile

Create a link to us from your website, blog or social media platform.

Is chronic myeloid leukemia a contraindication for e-stim? Is there any research to support use of estim with client with CML?

I am working on a SCI inpatient rehab program. I have a question about using FES with a 72 year old client with T12 AIS C SCI and who has multiple co-morbidities.
Client generally has grade 1-2’s for muscle strength in LE and I would like to use FES over quads, hamstrings, tib ant, gastroc for strengthening.
Client’s co-morbidities include chronic myeloid leukemia diagnosed over 15 years ago, which she is receiving medication treatment for. She also has osteoporosis, congestive heart failure and a history of recurrent PE (no PE currently and on anti-coagulation indefinitely). She has history of multiple fractures at T3, T11, L1, L2, L3 and L5 as well as a sternal fracture, sacrococcygeal #, left rib # and left wrist #. These occurred when she fell from a ladder about 8 weeks ago. She is currently using a power w/c. We are working on transfers bed <-> w/c +1pSBA and bed mobility. She is using tilt table at 70 deg x 15 minutes, rest, then x 10 min. We are completing strengthening and ROM for 4E and trunk. She is also practicing sitting balance exercises. She is making improvements with sitting balance, bed mobility and transfers.

I was reviewing the CPA document for electrophysical agents: Contraindications and precautions. On CPA document, it says E-stim (all forms) should not be applied to:

  • Regions of known or suspected malignancy. My question: Is chronic myeloid leukemia a contraindication for e-stim?
    I asked attending physician she was unsure about this question. Leukemia is a blood borne cancer and client’s chronic cancer has been stable with medication treatment. I asked an assistant professor at U of T and she indicated that "Cancer is considered an absolute contraindication for electrical stimulation due to its ability to stimulate cell division. Estim also has an effect on circulation. So based on the info you provided, I would not use electrical stimulation with this patient."

Also on CPA document, it says NMES should not be applied to

  • Any area unstable due to recent surgery, bone fracture or osteoporosis. In this case she has no fractures to LE where I would be applying estim, but she does have osteoporosis. I spoke with attending physician and she suggested to start low and go slow regarding osteoporosis, which I feel comfortable proceeding with in this regard.

Jonathan Russell

1 month ago

Back to General Electrotherapy

Post a reply


1-1 of 1

Reply to this discussion

You cannot edit posts or make replies: