Dynamic Solution for Dynamic Problem
Certified Clinician Dr. Rashmikant Shah who has been trained in UK started using FES first time in India. After practicing 8 years in UK, he has his own venture Healthy Future, Neurorehabilitation center in India.
FES is small pulses of electrical stimulation to the nerves that supply paralysed muscles.The stimulation is controlled in such a way that the movement produced provides useful function.The technique is used as an aid to assist walking as well as practising functional movements for therapeutic benefit.The most common use of FES is for people with drop foot.
What is Foot Drop: Dropped foot is the inability to lift the foot while walking and to advanced the leg forward in stepping motion during walking. It is common impairment that limits walking following the damage to brain or spinal cord. It can occur due to weakness or paralysis of the muscles involved in lifting the foot or over activity (spasticity) of the muscles that push the foot down. As a result, the toes may catch the ground as the foot is swinging forward and there is an increased risk of going over on the ankle when the foot is put back on the ground.
Who Can Benefit from FES?
FES can be very effective where movement has been lost due to nerve injury / disease within the brain or spinal cord. This is called an upper motor neurlesion. This includes people who have:
- Multiple sclerosis (MS)
- Spinal cord injury, T12 and above (SCI)
- Parkinson’s disease
- Cerebral palsy (CP)
- Head injury (HI)
- Familial or hereditary spastic paraparesis (F or HSP)
- Other conditions affecting the spinal cord or brain
PLEASE NOTE: FES is not suitable for lower motor neuron conditions. This is where the nerve that runs from the spinal cord to the muscle is damaged. This is the case in conditions such as:
- Peripheral nerve lesions
- Poliomyelitis (Polio)
- Motor neuron disease
- Guillain-Barr Syndrome
How it Works:
These stimulators typically run off a 9 volt battery, use self adhesive electrodes to attach to the skin, over the area that requires stimulation. By placing the electrode pads over the required muscles or nerves, one can target a specific movement or function. The stimulation is controlled in such way that the movement produced provide useful function. The FES is designd to be long term orthosis and used on a daily basis for walking activities. The device can be used in working hours and worn all days. The stimulation can be paused at any time when ever the user is resting.
What is the benefit of using FES:
Dorsiflexion (foot-lift) and eversion (turning out of the foot) in swing phase of gait produces:
- Increased Confidence and Independence when walking due to reduced trips and falls
- Increased walking safety due to reduced incidence of tripping
- Reduced Walking effort (less Fatigue) and increased speed –ability to walk longer distance
- Reduced Spasticity in affected leg ad improve Range of motion at the ankle and knee.
- Reduced Compensatory moment e.g. hip hiking, circumduction
- Improve ankle stability in weight bearing resulting in greater stability
What Does Treatment Involve?
Procedures will vary depending on your condition and which clinic you attend but a typical procedure is as follows.
You will first attend a initial assessment clinic to assess the suitability of FES treatment for you. At this appointment a physical examination will be made and FES tried.
If FES is a suitable treatment, you will then be asked to attend again on few consecutive days for treatment and usage of FES. To you will then be asked to return to the clinic for follow up assessments at;
- 4-6 weeks
- 3 months
- then at 6 monthly intervals or yearly if appropriate for as long as FES is used
The clinic sessions normally take about one hour.