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Functional electrical stimulation (FES) for correction of dropped foot
FES is increasingly being seen as a first line intervention to improve the mobility of people with neurological disability. Paul Taylor has pioneered its use within the NHS.
Dropped foot is the inability to lift the foot as the leg swings forward when walking. It is caused by weakness in the muscles that lift the foot and/or excessive activity (spasticity) in the
Paul Taylor antagonist muscles. Dropped foot increases the risk of falls, reduces mobility and participation in activities of daily living.
WHAT IS FES AND HOW DOES IT WORK?
Functional Electrical Stimulation (FES) is the production of functional movement in paralysed or weak muscles by the application of small pulses of electrical current to the nerves that supply them. The Odstock Dropped Foot Stimulator (ODFS®) Pace was developed at Salisbury District Hospital. It stimulates the common peroneal nerve at its most superficial point where it passes the head of fibula, using self-adhesive skin electrodes. Stimulation is timed to the walking cycle by using a pressure switch placed in the shoe under the heel. Stimulation begins when the heel is lifted from the ground and ends just after heel strike. Stimulation causes the foot to lift and stabilises the ankle when it is returned to the ground. Stimulation feels like pins and needles and most people quickly become used to the sensation.
I have been using a single channel stimulator for foot drop, due to MS, for 5 years. I wear it every day and it has allowed me to carry on working full-time. It is the single most helpful thing in this journey as a patient, and has allowed me to remain as active as possible.
The ODFS® Pace is primarily used as a long-term assistive device. However, therapeutic training benefit has been demonstrated in people who have a dropped foot due to stroke, spinal cord injury, Parkinson’s and some people with MS. It can also be used in early gait re-education to help facilitate a normal gait pattern, including the retraining of knee and hip control. Because FES can reduce spasticity though activation of reciprocal inhibition, it is often a more effective mobility intervention than passive orthotics and can enable greater range of movement.
THE MAIN EFFECTS OF THE ODFS® PACE (FES DEVICE) ARE:
Increased safety due to reduced tripping and increased stability in stance, reducing falls by 72 % Increased walking speed, functional ambulation category and distance range Reduced effort of walking Greater confidence, independence and quality of life
The ODFS® Pace is a practical device with adherence to treatment at one year of 86%. FES can be used to assist walking in any neurological condition resultant from an upper motor-neuron lesion (lesion within the brain or spinal cord above T12). This includes stroke, MS, spinal cord injury, traumatic brain injury, cerebral palsy, hereditary spastic paraplegia and Parkinson’s disease.
FES for correction of dropped foot is a recommended treatment in NICE guidelines IPG278 and ANPT clinical guidelines.
OML provide training courses for clinicians wishing to use FES in their clinical practice. Please visit our website for further details. ■
web: www.odstockmedical.com email: enquiries@odstockmedical.com tel: 01722 439 540
