FES

Functional electrical stimulation (FES) is a new approach which helps people suffering from drop foot with their walking. With FES, electrical stimulation is provided in a safe way so that a person's leg muscles are activated at the right moment to lift their foot and therefore makes walking easier.

Who is FES for?

FES can potentially help anyone who has a drop foot (ie. weakness of the dorsi-flexors) due to brain or spinal cord damage.

It can be suitable for people who have had a stroke, head injury or spinal cord injury, or with multiple sclerosis or Parkinson's Disease. However it cannot help people who have damage of the peripheral nerve such as peripheral neuropathy and Guillan-Barré Syndrome.

It is not suitable for people who are pregnant, or with heart problems, poorly controlled epilepsy or poor skin condition on their legs.

Benefits

The benefits of FES include:

• making walking easier because FES reduces the amount of energy needed to walk. People with drop foot have to compensate for the lack of activity of their foot by hitching their hip or increasing their knee and hip bend
  
• preventing muscle wastage due to inactivity. With some people, it can also help to strengthen muscles
  
• allowing a wider choice of footwear since the FES equipment is less bulky than a typical splint. The equipment is also lighter than an ordinary splint
  
• preventing falls which are caused by tripping over a foot because FES helps to lift the foot and clear the toes from the floor.

How does FES work?

FES is provided through a control box which is attached to the waistband, with wires leading to electrodes attached to the lower leg. The box stimulates the nerves electrically, which then activates the leg muscles. This replicates normal nerve and muscle action during walking.

Starting with FES

An initial assessment is needed to check the patient's suitability and to ensure they are getting the desired result of their foot lifting. If the patient then wants to continue with FES, they will need to purchase their own FES equipment, which can be ordered through heads up!.

We will supply the patient with their equipment at the second session. The optimum settings and electrode positions will be finalised at the session, and the patient will also taught how to put the equipment on and take it off. There will then be a review a week later to ensure that the equipment is being used correctly and to solve any problems.

Follow-up sessions are necessary at 6 weeks, 3 months and 6 months to ensure that patients are getting the best usage out of the equipment.

Then patients will need to be seen every twelve months to check the settings and electrode positions so that the equipment works as efficiently as possible.

Using FES?

The equipment can be used as much or as little as required. It's entirely up to the individual. Some people will want to use it all day whereas others will use it for specific situations, such as walking longer distances.

History of FES

The FES equipment was originally developed in the 1960's by a doctor but it was not until the 1980's that research in the US showed its clinical effectiveness.

FES has only been available in the UK since 1995, when it has been provided by the Salisbury NHS Trust. heads up! is one of the first clinics outside Salisbury to provide it.

In 2000, FES was named as a recommended treatment in the Royal College of Physicians' National Clinical Guidelines for Stroke for "improving ankle dorsiflexion and gait performance" .

FES article

One of our former physiotherapists, Dawn Burrow, has written an article Correcting Foot Drop After Stroke about using Functional Electrical Stimulation. It appeared in Stroke News, the leading stroke magazine in the UK.

To read the article, click here. It's in Adobe Acrobat format. Its size is 320Kb so it may take some time to download.

Booking an initial assessment

To book an initial assessment or to find out more information, please ring Sally Watt, our Practice Manager, on (01306) 888171.

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