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 Burridge JH, Swain ID, Taylor PN. (1998). Functional electrical stimulation: a review of the literature published on common peroneal nerve stimulation for the correction of dropped foot. Reviews in Clinical Gerontology 8; 155-161
Abstract
A person who has a dropped foot is unable to lift the toes clear of the ground during the swing phase of walking. Such a problem is seen in people who have either a peripheral nerve lesion, as a result of trauma or disease, or an upper motor neuron lesion. It is the latter that responds to neuromuscular stimulation; lesions of the lower motor neurons result in destruction of the neural pathway so that muscle contraction can be achieved only through direct stimulation of the muscle fibres.
Burridge J, Taylor P, Hagan S, Wood D, Swain I. (1997) The effects of common peroneal nerve stimulation on the effort and speed of walking: A randomised controlled clinical trial with chronic hemiplegic patients. Clin Rehabil 11. 201-210.
Abstract
Objective: The purpose of this study was to measure the effect of the Odstock Dropped Foot Stimulator (ODFS), a common peroneal stimulator, on the effort and speed of walking. Design: A randomised controlled trial. Subjects: Hemiplegic patients who had suffered a single stroke at least six months prior to the start of the trial whose walking was impaired by a drop-foot. Interventions: The treatment, functional electrical stimulation (FES) group, used the stimulator and received a course of physiotherapy; the control group received physiotherapy alone. Main outcome Measures: Changes in walking speed measured over 10 metres and the effort of walking measured by physiological cost index (PCI).
Results:
- 32 subjects completed the trial, 16 in the FES group and 16 in the control group.
- Mean increase in walking speed between the beginning and end of the trial was 20.5% in the FES group (when the stimulator was used,) and 5.2% in the control group.
- Improvement was also measured in PCI with a reduction of 32.6% in the FES group (when the stimulator was used) and 1% in the control group.
- No improvement in these parameters was measured in the FES group when the stimulator was not used.
Conclusion: Walking was statistically significantly improved when the ODFS was worn but no 'carry-over' was measured. Physiotherapy alone, in this group of subjects with established stroke, did not improve walking. (Return to Top)
Liberson W, Holmquest H, Scott M. (1961). Functional electrotherapy: Stimulation of the common peroneal nerve synchronised with the swing phase of gait of hemiplegic subjects. Arch Phys Med Rehabil 42. 202-205 (Return to Top)
Taylor PN, Burridge JH, Wood DE, Norton J, Dunkerly A, Singleton, C, Swain ID. (1999) Clinical use of the Odstock Drop Foot Stimulator its effect on the speed and effort of walking. Arch Phys Med Rehabil 80: 1577-1583.
Abstract:
Objective: To assess the clinical effectiveness of the Odstock Dropped Foot Stimulator by analysis of its effect on Physiological Cost Index (PCI) and speed of walking. This Functional Electrical Stimulation (FES) device stimulates the common peroneal nerve during the swing phase of gait.
Design: A retrospective study of patients who had used the device for four and a half months.
Subjects: 151 patients with a dropped foot resulting from an upper motor neurone lesion.
Setting: The Medical Physics and Biomedical Engineering Department of a District General Hospital specialising in the clinical application of FES and a Neurophysiotherapy Department in a separate hospital. Main outcome measures: Changes in walking speed and effort of walking, as measured by PCI over a 10m course.
Results:
- There was a 92.7% compliance with treatment.
- Stroke patients showed a mean increase in walking speed of 27% (p<0.01) and reduction in PCI of 31% (p<0.01) with stimulation and changes of 14% (p<0.01) and 19% (p<0.01) respectively whilst not using the stimulator.
- Multiple sclerosis patients gained similar orthotic benefit but no "carry-over".
Conclusions: The measured differences in walking with and without stimulation were statistically significant in the stroke and multiple sclerosis groups. In this study use of the stimulator improved walking. Those with stroke demonstrated a short term "carry-over" effect. (Return to Top)
Taylor PN, Burridge JH, Dunkerley AL, Lamb A, Wood DE, Norton JA, Swain ID. (1999) Patient's Perceptions of the Odstock Dropped Foot Stimulator (ODFS). Clin. Rehabil 13: 333-340.
Abstract:
Objective: To determine the perceived benefit, pattern and problems of use of the Odstock Dropped Foot Stimulator (ODFS) and the users' opinion of the service provided. Design: Questionnaire sent in a single mail shot to current and past users of the ODFS. Returns were sent anonymously. Setting: Outpatient based clinical service. Subjects: 168 current and 123 past users with diagnoses of stroke (CVA), multiple sclerosis (MS), incomplete spinal cord injury (SCI), traumatic brain injury (TBI) & cerebral palsy (CP). Intervention: Functional Electrical Stimulation (FES) to correct dropped foot in subjects with an upper motor neurone lesion, using the ODFS. Main Outcome Measures: Purpose designed questionnaire.
Results:
- Return rate 64% current users (mean duration of use 19.5 months) and 43% past users (mean duration of use 10.7 months).
- Principal reason cited for using equipment was a reduction in the effort of walking.
- Principal reasons identified for discontinuing were an improvement in mobility, electrode positioning difficulties and deteriorating mobility.
- There were some problems with reliability of equipment.
- Level of service provided was thought to be good.
Conclusion: The ODFS was perceived by the users to be of considerable benefit. A comprehensive clinical follow up service is essential to achieve the maximum continuing benefit from FES based orthoses. (Return to Top)
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