Introduction

PRACTICE:
Judy is currently in private practice in Alamo CA. She obtained her physical therapy education at Columbia University and New York University. She specializes in cerebral palsy and works with children with CP and other movement disorder problems. Her interests are in helping children achieve motor learning, motor control, muscle strength and ROM by using electrical stimulation together with movement science and motor learning ideas.

CONSULTATIONS:
Consultations are available for your child in person or by sending a video tape. Please inquire for more information and for instructions on the video tape at info@judycarmick.com

METHODOLOGY:
Dynamic-task-specific approach to neuromuscular electrical stimulation, evidence based, for children or adults with cerebral palsy.

Neuromuscular electrical stimulation (NMES) is used to provide sensory and motor input while the patient is engaged in and initiating movement with a motivating goal directed task-specific activity. Task-specific NMES is also functional electrical stimulation and may be known as FES. Unused or weak muscle is stimulated intermittently during static or dynamic movement. A remote switch is used during dynamic activity to assure the needed or typical timing of the stimulation. The patient is positioned so that the muscle is at the correct length for the task. The physical therapist must determine which muscle or muscles are needed to assist the patient with the activity selected. Spastic muscle may be weak and not used during the appropriate movement and will need to be stimulated contrary to outdated beliefs. The therapist needs to consider the biomechanics and kinesiology of the activity and muscles involved when deciding which muscle to stimulate in what position and at what time.