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Long term use of dropped foot stimulation in Stroke & MS

February 17, 2019

 

Background: In Great Britain, patients may be funded for Odstock dropped foot stimulators under the UK National Health System. Under this model, patients fitted with Odstock technology undergo re-assessment of their walking at 6 and 12 month intervals. This has enabled collection and analysis of walking data over a 10 year period of dropped foot stimulator use by both stroke and MS patients.

A study, originally published in the Journal of Rehabilitation Medicine, (Ref: J Rehabil Med 2013; 45: 154–160):  THE LONG-TERM COST-EFFECTIVENESS OF THE USE OF FUNCTIONAL ELECTRICAL STIMULATION FOR THE CORRECTION OF DROPPED FOOT DUE TO UPPER MOTOR NEURON LESION (Taylor P, Humphreys L & Swain, I) concluded that FES, used to correct dropped foot, is an effective long-term intervention, with a median duration of usage of 4 years. They also reported that, over the period of patient review, the long-term effectiveness of the intervention was demonstrated “by stable increases in walking speed when FES was used” .

Specific data form the study highlighted:  1) a 45% overall increased walking speed in the stroke group with a 24% training effect (increased walking speed when tested without FES) 2) in the MS group, a 29% increased gait speed was seen with FES but a significant training effect was not seen 3) 68% of those reviewed achieved meaningful changes in walking speed with 39% improving their functional walking category.

The study highlights both the value of long term data to guide dropped foot stimulation as a clinical intervention for gait improvement and the benefit of follow up assessment to track progress from the technology in patients with neurologic impairment.

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