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Rehabilitation Made Easier for Stroke Survivors with Foot Drop

Thirty percent of stroke survivors facing rehabilitation are left unable to walk without assistance. The most common impairment is known as foot drop: the inability to flex the foot while walking.

Foot drop results in the inability to properly lift the foot while walking. The toes will drag resulting in an inefficient stride, fatigue, and an increased risk of falling.

The most common solution currently for foot drop is a plastic ankle brace called an ankle foot orthosis (AFO). AFOs can be quite effective, but restrict flexibility and motor recovery at the ankle.

Recently, Functional Electrical Stimulation (FES) systems were developed to allow wearers to maintain an easier, more consistent stride. An FES system administers a low level current that tells the muscles to flex the foot precisely when needed. The wearer receives all the benefits of an active muscle contraction including strengthening, normalized range of motion, and improved circulation. Also, the fact that the contraction occurs at the right point of the gait cycle means improved sensory feedback to the brain, thus facilitating the recovery of cognitive motor control.

Different FES systems utilize various sensors to trigger stimulation. Traditionally an FES system is triggered by the amount of weight bearing through the heel. Alternatively, the WalkAide system generates stimulation based on the wearer’s movement. An accelerometer and tilt sensor detect where the leg is in space and respond with appropriate stimulation. Because there is no need for a heel sensor, the system can be self-contained, and can be worn with any type or shoes or with no shoes at all.

Currently systems like the WalkAide are used as temporary and lifelong solutions for foot drop. Research has found that an FES system worn for 1 hour per day for 5 days over the course of a 12 week program reduced foot drop, increased gait speed, improved symmetry of walking, decreased spasticity and decreased the energy required to walk. Stroke survivors that spent a year wearing the device on a daily basis demonstrated cumulative increases in gait speed and decreases in fatigue from walking. 

To find out if an FES system is right for you, speak with your physical therapist about the available options.

By: Dr. Helen Rogers PT, PhD., Neurologic Physical Therapist specializing in FES technology and Director of Clinical Research for Innovative Neurotronics, creator of the WalkAide FES System.

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"Stroke survivors that spent a year wearing the device on a daily basis demonstrated cumulative increases in gait speed."

Available Solutions

A Functional Electrical Stimulation system activates muscle function in stroke survivors with foot drop, allowing for a consistent stride. FES systems have potential for neuromuscular recovery not possible with conventional braces. There are three FES devices available in the US:

  • WalkAide: A single component system that senses motion of the leg and generates electrical stimulation based on the wearer’s stride.
  • Bioness L300: A three-component system that generates electrical stimulation based on the amount of weight placed on the wearer’s foot during walking.
  • Odstock Pace: A two-component system that generates electrical stimulation based on the amount of weight placed on the wearer’s foot during walking.
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