As one of the researchers who is currently involved in 2 studies using FES in critical care units at the University of Maryland Medical Center in Baltimore, I can share with you several observations explaining why it is not consider standard of care option despite the current evidence of effectiveness.
- Most patients only stay 1-2 week before moving to other locations and during the stay they are bombarded with numerous testing and treatments. If setting up the FES takes 10-15 min therapist do not have the time to set it up. In our research it only take 1-2 min.
- Current evidence is strong that NMES/FES can significantly slow down (not prevent) muscle atrophy during 2 weeks of daily stimulation but if we can not demonstrate that it helped to discharge the patient faster from the ICU (which will save a lot of money) we will not be able to justify the added cost of the FES intervention. I hope our studies will show such saving and that maybe a turning point in favor of FES.
- To date, FES is offered very sporadically and generally for very short 4-6 weeks while most patients are likely to need it for much longer time, namely for most patients throughout the continuum of care. To achieve it all FES should be designed as wearable, wireless system that can be applied anywhere ICU, rehab centers, outpatients, and at home