Post Stroke Rehab: ODFS pace to improve running and avoid dependency on FES after practice

Mr. Saurin Dalal aged 44, male patient suffered from Right MCA stroke in Sep 2016 and presented to us in Jan 2017 with difficulty in walking and aim to achieve running ability. On Observation, we found hyperextension on left knee (Knee push back in weight bearing phase) and poor dorsiflexion during swing phase. On examination, undoubtedly, found weak gluts and poor calf muscle recruitment compared to other leg. We had addressed some weakness in Upper limb but his major concern and worry was running ability and poor knee control. We trained him with FES (ODFS PACE) for L. foot-drop for 15 days. ODFS pace helps to correct foot drop and is so advanced that one of its functions allows running as well.

Versatile quality and certain parameters adjustment of this device allows to correct dorsiflexion (lift the foot up) and reduce hyper-extension of knee (push back knee in weight bearing) while in mid-stance. Appropriate facilitation of muscles to support running with FES with precise placement of electrode, with Mr. Dalal, we achieved running with initial phase of 5 minutes to 15 minutes in 15 days.

We noticed improvement with his mobility and ability run without ODFS Pace as well. This means it does not cause dependency but allow muscles to retrain and retain ability to do the task without it too. This case was only 6 months old where his wish to run was fulfilled but we had another who was 3 year old stroke who also has achieved running ability.

That patient was from Jodhpur, RAJDADISA hospital; young male patient having three year old stroke, had similar clinical presentation of poor dorsiflexion and hence difficulty in ground clearance during swing phase. After thorough examination and precise placement of ODFS pace, he was able to run, with speed of 7km/hr on very same day. In following days with proper training with device, he was able to run without the device within few days only. (Video attached below.)

For Physiotherapist:

Why we choose ODFS pace for getting him in Running post Stroke? There are certain functions and parameters out of many which allowed and make possible to running for foot drop patients.

ODFS pace allowed followings:

We are able to set Rising ramp (time in ms) which allowed contraction followed by foot switch activation and timely manner contraction for dorsiflexion.

It has who functions out of many which are extension time and falling ramp : this two functions allowed contraction biceps femoris and peroneal + Tib Ant. To continue contract and allow eccentric contraction to prevent hyper extension while midstance and push off phase.

Flexibility in positioning of electrode along and polarity to helps with emphasis on contraction of muscles for eg. Strong contraction on Biceps femoris or Tib ant / peroneal – Also, It is biphasic asymmetrical (or symmetrical) waveform with ability to change frequency varies from 20hz to 60hz to help in reduction of fatigue.