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The Effects of Functional Electrical Stimulation on Walking in Hereditary and Spontaneous Spastic Paraparesis
Article first published online: 28 AUG 2012
© 2012 International Neuromodulation Society
Neuromodulation: Technology at the Neural Interface
Volume 16, Issue 3, pages 256–260, May/June 2013
How to Cite
Marsden, J., Stevenson, V., McFadden, C., Swain, I. and Taylor, P. (2013), The Effects of Functional Electrical Stimulation on Walking in Hereditary and Spontaneous Spastic Paraparesis. Neuromodulation: Technology at the Neural Interface, 16: 256–260. doi: 10.1111/j.1525-1403.2012.00494.x
Financial Support: J Marsden was funded by a Medical Research Council Clinician Scientist Fellowship.
Conflict of Interest: In April 2006 the clinical and commercial activities of Department of Medical Physics and Biomedical Engineering were “spun off” from Salisbury NHS Foundation Trust to form a company Odstock Medical Limited (OML). OML is the manufacturer of the ODFS device used in this project. The majority share holding in the company remains with Salisbury NHS Foundation Trust. Members of the FES group at Salisbury District Hospital, including the authors of this manuscript (IS and PT) have been allocated “token shares” that may in the future have monetary value. A proportion of the 4th and 5th author's time is seconded to Odstock Medical Limited to provide clinical FES treatment and general support. However, they remain an employee of Salisbury NHS Foundation Trust, which receives remuneration for the seconded time. Paul Taylor has two patents in his name relating to the ODFS. These are assigned to his employer Salisbury NHS Foundation Trust, which in turn licenses the intellectual property to Odstock Medical Limited.
- Issue published online: 4 JUN 2013
- Article first published online: 28 AUG 2012
- Received: August 10, 2011 Revised: April 2, 2012 Accepted: June 10, 2012
- Functional electrical stimulation;
- hereditary spastic paraparesis;
Objectives: To investigate in people with spastic paraparesis (SP): 1) the factors contributing to foot drop and reduced toe clearance while walking; 2) short-term effects of bilateral functional electrical stimulation (FES) of the common peroneal nerve.
Materials and Methods: Long term (>0.5 years) users of FES with SP were compared to matched controls (N = 11 per group). Ankle strength and plantarflexor stiffness and walking kinematics were objectively recorded. The effects of FES on: 1) perceived efficacy; 2) muscle torque and ankle motion; 3) clinical outcome measures and walking kinematics were assessed. Results were compared using an analysis of covariance.
Results: Ankle weakness and stiffness is higher among people with SP. Higher plantarflexor stiffness is associated with reduced swing phase dorsiflexion; higher toe clearance while walking is associated with increased hip flexion. FES increases dorsiflexor torque, improves toe clearance and dorsiflexion in swing phase, and significantly improves walking speed (p < 0.05).
Conclusions: There are multiple causes of tripping in people with SP; FES reduces foot drop and improves walking speed.