Stroke

Conventional therapy in improving mobility in Stroke patients involve the use of a wheelchair or walking aids like a walking frame, stick or crutches. If a patient is able to walk about, this ability is often hampered by a dropped foot. This occurs when the muscles of the lower leg are not strong enough to lift the foot upwards when bringing the foot forwards off the ground. As a result, the foot catches resulting in stumbling and even falling. To avoid this, patients often compensate by either hitching the hip, or swinging the leg outward. The conventional treatment might include the use of a dropped foot splint, or Ankle-Foot Orthosis (AFO), which is a plastic support worn inside the shoe.

Functional Electrical Stimulation, or FES offers an alternative to this treatment, encouraging active movement of the foot, and by constantly taking the foot through full range of movement with walking, avoids stiffening up of the ankle. Improvements are reflected in objective tests, recording the speed of walking and the effort of walking by measuring the heart rate. Common reports are of walking being made easier, quicker, and safer, with patients feeling a lot more confident in walking about. The problem of having to wear larger shoes in order to fit the splint in is also solved. Carry-over of these improvements is often found when looking at unstimulated walking too, indicating a training effect of stimulation. Other improvements are also found in decreasing spasticity and improving range of movement, and peripheral circulation. Improved symmetry is also encouraged due to the nature of the foot switch-stimulation relationship.

Two channelsof stimulation are also used at times, in order to integrate another set of muscles into the walking pattern. This might include the hamstring muscles to improve the knee bending when bringing the foot forwards, or to the gluteal muscles to bring the body over the effected leg when standing.

Exercise stimulation may also be applied to the leg in order to improve the effect of the above-mentioned systems. This could be done using the 2-channel or 4-channel stimulator. Improvements have been found using exercise stimulation to the shoulder, easing shoulder pain, and reducing subluxation. This is when a gap appears in the shoulder joint, as the muscles are unable to keep the arm in place. There have also been reports of improved sensation following electrical stimulation.