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Combining Foot Drop Stimulation with an Ankle Foot Orthosis (AFO) for Walking

A common assumption may be that fitting an ankle foot orthosis (AFO) is sufficient to address walking difficulty after neurologic impairment such as stroke, MS,  traumatic brain or spinal cord injury. However, patients fitted with an AFO to assist walking can, in many cases, benefit from a foot drop stimulator as this intervention can be […]

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FES to assist walking with MS

In some individuals, MS may result in weakness of the lower limb (leg) muscles and difficulty with walking, Decreased walking endurance may also limit ability to walk  even short distances out of doors or in the home. Through its effect in augmenting the force of a muscle contraction and eliciting movement lost due to MS, […]

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The Bilateral Effect of FES on Hemiplegic Gait

Slow, inefficient gait with abnormal gait parameters are common findings when assessing walking post stroke. While loss of affected limb foot strike angle is a common finding we may additionally see compensatory change where foot strike angle in the non affected limb is similarly abnormal. Example 2 graph (grey area= normal range)  illustrates the bilateral […]

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Assessing with FES: Clinician & Patient Factors

Generation of a motor response to facilitate FES assisted gait in stroke patients may, at times, require clinician “perseverance”. In applying FES for gait -consideration of factors influencing the stimulation response is necessary. Presence of adipose tissue, adjustment of stimulation parameters & electrode positioning all play a part in individual patient motor responses to stimulation. Stimulation parameters […]

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Clinical Considerations in Patient Assessment for a Dropped Foot Stimulator

Individuals with a diagnosis of hemiplegia (from stroke or acquired brain injury) or multiple sclerosis or incomplete spinal cord injury can all benefit from FES (functional electrical stimulation) and it should be considered when gait restoration or improvement is a clinical goal. As the presentation of motor loss in stroke vs MS vs SCI is different […]

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FES or AFO to improve hemiplegic gait post stroke

  A 2015 study  by Bethoux et al., investigating dropped foot stimulation (DFS) versus an ankle foot orthosis (AFO)  to assist gait post stroke, reported  DFS to be “not inferior “  to an AFO in improving gait components in stroke subjects. (Long-Term Follow-up to  a Randomized Controlled Trial comparing FES ro an AFO for Patients […]

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Long term use of dropped foot stimulation in Stroke & MS

  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 […]

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Use of FES in Gait Retraining after Stroke

Blog 7 video The accompanying video to this post shows the initial, immediate gait change possible with application of an Odstock Pace dropped foot stimulator. Gait parameters – heel contact, stance phase & stride length on the affected left limb are improved with activation of paretic ankle dorsiflexors. Early intervention with dropped foot stimulation can significantly […]

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FES in MS 2

  FES is indicated in MS patients who present with progressive difficulty in their ability to walk. When considering FES intervention for gait improvement the patient assessment should include careful evaluation of all lower limb musculature and, particularly, the hip flexors and ankle dorsiflexors. As dropped foot stimulation (DFS) primarily addresses difficulty with swing phase […]

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“FES on the Fly” Part 1

What is “FES on the Fly”? Essentially an application of therapeutic NMES or FES as a precursor to an activity, such as walking. For example, neuromuscular electrical stimulation (NMES) can be used to: facilitate a muscle contraction provide joint range of motion (ROM) strengthen muscle & reduce muscle atrophy provide proprioceptive input The accompanying picture shows […]

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