Functional Electrical Stimulation, or FES, is an alternative treatment that might be able to help stroke patients prevent falls. Falls are one of the most significant dangers people face after suffering a stroke. Many people experience difficulty in walking after having a stroke. They can lose control of some of the muscles on the affected side. If your ankle joint is weak, for example, you might find yourself at risk of falling because you’re having trouble maintaining a balanced gait.
How do we usually treat a weak ankle joint? Typically, patients get an ankle-foot orthosis (AFO), which acts as a support brace that helps the ankle joint stay in the correct position for proper balance. But a new type of treatment for this has been gaining attention, and it’s called Functional Electrical Stimulation (FES).
How does the FES device compare with traditional supportive braces?
Researchers from both Italy and Ireland decided to investigate just how helpful FES could be. In their study, they recruited 24 patients who suffered from various neurological disabilities due to stroke or multiple sclerosis. The researchers asked participants to use the FES device every day for 8 weeks. The patients increased the duration of their walking exercise gradually. During the first week, they wore the FES device for 15 minutes to an hour, depending on how much the patient could tolerate. In the second week, they went for 30 minutes to 4 hours, and in the third week, they wore the device for as long as possible. After that, the patients were asked to wear the FES support for as long as they had been able to during the third week.
So how does this FES device work? The FES support delivers electrical pulses into a nerve called the common peroneal nerve, which controls a lot of muscles of our lower leg. It activates this nerve as you swing your leg forward while taking a step. The pulsation helps you pick up your foot properly, so you don’t trip. A doctor usually sets the device at an appropriate intensity and frequency to get an optimal response from your foot.
The benefits of FES
The researchers found that this type of training helped people who had neurological disorders and unstable ankle joints. Not only did it reduce the number of falls that they suffered, but they also had better ability to walk. However, the device didn’t seem to help patients catch their breath or recover energy after exerting themselves in training.
The device reduced the overall number of falls, even when the participants walked for longer than before or increased their activity level throughout the day. The FES support directly activates the nerve that lifts the toes and feet away from the floor, literally preventing people from tripping over their own feet
Researchers also found that this fall reduction and gait improvement directly related to faster walking and longer endurance. By week 8, participants could walk almost 40 meters farther during the 6-minute walk test than when they first started. Because of that, patients had improvements in their daily activities and overall independence.
Why you should consider FES in your stroke rehabilitation
The study was relatively small, and there wasn’t a control group, but the results are nothing to ignore. People were getting better with the FES, especially when it comes to walking and independence. If you’re experiencing issues with ankle function and balance, you should consider using FES as part of your rehabilitation. The device itself is very convenient because you can use it in addition to your standard therapy. However, it does cost a few thousand dollars, and many insurance policies won’t cover it. Talk to your doctor and physical therapist about FES and discuss whether or not it could benefit you.
The lead author of this study is Elisa Gervansoni, a physical therapist at the Gait and Balance Disorders Laboratory Department of Neurorehabilitation in Milano, Italy.