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Tuesday, September 23, 2014

Pros and Cons of Functional Electrical Stimulation for MS-Related Foot Drop

Nerve damage often leads to MS foot drop, causing people to drag their foot behind them. Functional electrical stimulation devices aim to end that.

© 2014 Bioness Inc.

FES devices aren't for everyone with MS-related foot drop, but knowing the benefits and risks can help make an informed decision.

Foot drop is one of the scourges of multiple sclerosis. You can have so much weakness in the front of your foot that it’s hard to walk without dragging your toes, making you more prone to falling. Enter functional electrical stimulation (FES) devices.

They can help people with MS-related foot drop walk normally again or at least with a much-improved gait. Though FES devices aren’t for everyone, they’re something to consider.

Functional Electrical Stimulation and MS Foot Drop
Foot drop usually results from damage to the peroneal nerve, the nerve that helps control the muscles on the front and sides of the legs and the top of the foot, and affects how well you can lift your foot at the ankle. People with foot drop often overcompensate and lift their leg higher when walking, which becomes exhausting and can lead to pain.

Most of my patients have foot drop, whether mild or more severe, says Nesanet Mitiku, MD, PhD, an assistant professor at the Corinne Goldsmith Dickinson Center for MS at Mount Sinai Medical Center in New York City. It's a very prevalent MS occurrence.

An FES device has electrodes that directly stimulate the leg in order to correct foot drop. It’s strapped around the leg just below the knee and sends low levels of electrical stimulation to the peroneal nerve, telling it to lift the foot as you walk. Current devices are the WalkAide, Bioness L300, and Odstock Dropped Foot Stimulator Pace.

The Latest FES Research
There’s limited research on how well FES devices work for people with MS. Most studies have been done on people who've had a stroke, according to the National Multiple Sclerosis Society. However, two small studies on FES devices and MS found very positive results.

In one, researchers looked at 40 people with MS who were on a rehabilitation program that included cycling with an FES. They noted improved motor skills and stability after the therapy in 75 percent of those with primary progressive MS, 71 percent of those with secondary progressive MS, and 55 percent of those with relapsing-remitting MS.


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