The Pulse

Effects of Poor Posture and the Use of Patterned Electrical Neuromuscular Stimulation (PENS) to Achieve Improved Alignment and Function

Posted by ACP on Aug 27, 2018 10:07:23 AM

Posture affects an individual’s ability to balance in a seated or standing position, assess their surroundings, reach overhead, breathe, eat, and move safely. As one ages, posture generally declines, resulting in a more forward flexed position. When there is injury or neurologic impairment (such as CVA), further compromise to one’s posture and positioning can occur. Improved postural alignment of the neck, upper back and trunk with stretching, strengthening, and electrical stimulation can greatly impact an individual’s safety and quality of life.

Neck Posture Related Research: With forward head posture, forced vital capacity (FVC) was reduced because of changes in lung capacity caused by abnormal spinal posture.¹

March capture - blog 1

Protocol and Purpose:
• PENS upper extremity biphasic neck protocol applied during or preceding therapeutic exercise2
• To improve neck posture, enabling improvements in an individual’s ability to breathe, swallow, and safely interact with their environment

Thoracic Posture Related Research: Shoulder external rotator strength declined by 8% following five minutes in a forward head, rounded shoulder sitting position.3

March capture - blog 2


 Protocol and Purpose:
• PENS upper extremity triphasic thorax protocol applied during or preceding therapeutic exercise2
• To improve upper thoracic posture which may have an effect on one’s ability to breathe, reach overhead, and balance


Trunk Posture Related Research: Using a combination of core muscle strengthening and NMES over the posterior back muscles yielded an additive effect on the recovery of trunk balance in patients with acute or subacute stroke who have poor sitting balance.4

March capture - blog 3

Protocol and Purpose:
• PENS lower extremity triphasic trunk protocols applied during or preceding therapeutic exercise2
• Apply either separately for trunk flexion or extension or combined using the bifurcated lead wires
• To improve trunk posture, allowing for improved safety with sitting and standing balance, transfers, and during gait

1. Kang J: Correlation between pulmonary functions and respiratory muscle activity in patients with forward head posture. J Phys Ther Sci. 30(1): 132-135; Jan 2018.
2. ACP’s Patterned Electrical Neuromuscular Stimulation (“PENS”) Omnistim® Pro and Omniversa® Lab
3. Pheasant S: Shoulder External Rotator Strength in Response to Various Sitting Postures: A Controlled Laboratory Study. Int J Sports Phys Ther. 13(1): 50-57; Feb 2018.
4. Ko EJ: The additive Effects of Core Muscle Strengthening and Trunk NMES on Trunk Balance in Stroke Patients. Ann Rehab Med. 40(1): 142-151; Feb 2016.

Topics: Fall Prevention & Balance, Clinical Tip, Orthopedic