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Functional Electrical Stimulation to Improve Mobility

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Functional Electrical Stimulation in Neurorehabilitation

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Abstract

Drop foot is a common problem in neurological disorders such as stroke, multiple sclerosis, traumatic brain injury, and incomplete paraparesis resulting in insufficient elevation of the forefoot during the swing phase of the gait cycle. In many cases, the weakness of the drop foot is associated with spasticity and more complex motor problems, leading to frequent falls.

Functional electrical stimulation (FES) is a therapeutic modality to “correct” drop foot during walking. The peroneal nerve is stimulated using surface electrodes placed on the most superficial course over the head of the fibula. Stimulation of the peroneal nerve induces activation of the anterior tibialis muscle and the peroneal muscle group, resulting in dorsiflexion and eversion of the foot. By using a pressure-sensitive heel switch or an accelerometer, stimulation is synchronized with the gait cycle.

This article reflects the clinical effects of FES with both one-channel and two-channel simulators on gait economy. Alternatively, the nociceptive withdrawal reflex (NWR), elicited by electrical stimulation on the sole of the foot can enhance dorsiflexion of the foot and, in particular, hip and knee flexion during the gait cycle.

In the following, the differentiation of orthotic and therapeutic effect will be discussed in more detail. The orthotic effect is basically understood as the prompt improvement of walking, directly induced by the FES, compared to walking without FES. To achieve a therapeutic effect and the associated activation of the motor cortex and corticospinal pathways, daily stimulation for at least 6 months is necessary.

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Authors and Affiliations

  1. Danube-University Krems, Department for Clinical Neuroscience and Prevention, Krems, Austria

    Michaela M. Pinter

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  1. Michaela M. Pinter
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Correspondence to Michaela M. Pinter .

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Editors and Affiliations

  1. Department Neurorehabilitation STIWELL, MED-EL, Innsbruck, Tirol, Austria

    Thomas Schick

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Pinter, M.M. (2022). Functional Electrical Stimulation to Improve Mobility. In: Schick, T. (eds) Functional Electrical Stimulation in Neurorehabilitation. Springer, Cham. https://doi.org/10.1007/978-3-030-90123-3_7

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  • DOI: https://doi.org/10.1007/978-3-030-90123-3_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-90122-6

  • Online ISBN: 978-3-030-90123-3

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