Basic functional electrical stimulation (FES) of extremities: an engineer's view.

The historical development of electrical stimulators producing contraction of paralyzed muscles is briefly presented. The influence of electrical stimulation parameters (amplitude of pulses, frequency, pulse duration, and duration of a pulse train) is explained. Special attention is paid to the description of the muscle recruitment curve. The phenomenon of reversed recruitment order, resulting in fatiguing of electrically stimulated muscle, is presented. The properties of surface electrodes (electrode size, polarity, resistance, and distance between electrodes) are examined. The use of surface electrodes made of metal plate or wire mesh, silicone impregnated with rubber, and conductive adhesive gel are discussed. The design of electrical stimulator circuits is also presented.