Tuesday, May 1, 2012

Surface Electrical Stimulation Technology for Stroke Rehabilitation: A Review of 50 Years of Research

You'll have to ask your doctor, therapist  or stroke association to explain this to you. estim to you.
Abstract here: full 14 pages at the bottom
 http://www.ingentaconnect.com/content/asp/jmihi/2012/00000002/00000001/art00001

Abstract:
Stroke is a disabling global health-care problem, and rehabilitation is a major part of patient care. Functional electrical stimulation (FES) refers to application of controlled electrical impulses to stimulate peripheral nerves innervating paralyzed or weak muscles to improve the impaired motor function. The present paper is an update on FES for stroke rehabilitation and a critical review of the first 50 years of FES-related research. In this paper, we first trace the basic design of a FES system for foot drop correction and provide an update on different feedback methodologies. Then we summarize the literature on advances in the technology and evaluate findings obtained from clinical trials. We made a pooled analysis of four clinical trials, involving 101 participants, comparing FES therapy with no intervention or conventional physiotherapy. Our results show significant improvements in walking speed (weighted mean difference: 0.17 m/s, 95% confidence interval: 0.06 to 0.28), cadence (weighted mean difference: 0.18 steps/sec, 95% confidence interval: 0.04 to 0.31), stride length (weighted mean difference: 13.75 cm, 95% confidence interval: 3.64 to 23.85), and functional ability measured by Fugl-Meyer scores (weighted mean difference: 0.08, 95% confidence interval: 0.03 to 0.12). FES group also had improvements compared to control group in two other outcomes, i.e., lower physiological cost index and higher step length, but the pooled effect was not statistically significant. Finally, we propose a conceptual framework and offer recommendations for optimizing the FES therapy for various research and clinical applications. Overall, our findings, and those of similar studies suggest that FES has a favorable effect on gait and motor recovery in stroke patients with foot drop. The possible barriers for implementation, clinical implications and the importance of future research in these directions are highlighted.
Full paper here:
http://docserver.ingentaconnect.com/deliver/connect/asp/21567018/v2n1/s1.pdf?expires=1335848817&id=68568572&titleid=41000046&accname=Guest+User&checksum=DE0C19C8F063E9BAAF6154D850B8DD00
Someone should be able to now take each type of FES for foot drop and compare them to see which is best. Your therapist should be up-to-date on everyone of these and be able to compare them to an AFO or the many other possibilities(look here).
Walkaide
Bioness L300
XFT-2001 
ActiGait
PACE
freeStep 
STIMuSTEP 
300PV FES

1 comment:

  1. From san42
    "comment San42
    I've tried 3 of the FES devices listed that are currently available in the UK but couldn't get on with any of them because I found I was hypersensitive to the electrical stimulation/was too harsh for me to persist with for any length of time, & actually made my spasticity worse so had to stop - most upsetting , esp since I had tried TENS with great success. I've gone back to using TENS that's been gradually helping. Then my osteopath told me of "Skenar" that uses electrical stimulation of a different kind - long story short, has proved of great help & increased my rate of overall progress considerably & am gaining back sensation gradually so I've progressed from a fixed AFO to a more flexible one, (indeed, just this last week!) & can do more with my hand & arm. Progress rate is comparable, but not as good as, to the honeymoon period of the 1st 6 months post stroke - like a half way house to at least, more like when that heavenly period was tailing off before the interminable ultra-snails pace emerged.

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