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The Biber Protocol®

Is it NMES?

Is it NMES? Check out this video and learn.

Criteria for NMES

A true NMES protocol will have ALL of the following elements:

  • Adjustable parameters
  • Range of parameters chosen are consistent with standards in the industry
  • Electrode placement consistent with anatomy and physiology that elicits an identifiable and normal movement pattern associated with swallowing (ex. submental placement)
  • Interrupted pulses mode with adequate muscle recovery time, typically 1:3 work to rest ratio
  • Ramp up of about 2 seconds
  • NMES protocol combined with task specific activities i.e the act of swallowing is specifically timed with the stimulation on cycle
  • Different parameters for different populations
  • Comfortable stimulation with amplitude sufficient to recruit motor units
  • Treatment time between 15-30 minutes 


Definition

NMES: Neuromuscular electrical stimulation is the use of electrical impulses that excite the peripheral nervous system to evoke an action potential through a transcutaneous medium. In simpler terms the electrical stimulus tells the nerves to tell the muscle (or muscles) to move.  

Evidence

For more detailed information about the science of electrotherapy and the standards of a true NMES for dysphagia protocol, please click below:


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