A comparison of the orthotic effect of the Odstock Dropped Foot Stimulator and the Walkaide functional electrical stimulation systems on energy cost and speed of walking in Multiple Sclerosis

Abstract Purpose: Functional electrical stimulation (FES), an assistive device used for foot drop, has been found to improve the speed and energy cost of walking in people with multiple sclerosis (pwMS). This study aims to compare the immediate orthotic effect on walking of two different devices; the Odstock Dropped Foot Stimulator (ODFS) and Walkaide (WA). Method: Twenty pwMS (10 female, 10 male, mean age 50.4 ± 7.3 years) currently using ODFS were recruited. Participants walked for 5 min around an elliptical 9.5 m course at their preferred walking speed; once with ODFS, once with WA and once without FES on the same day of testing. Gait speed, distance and energy cost were measured. Results: There was a statistically significant increase in walking speed for the ODFS (p = 0.043) and a near to significant increase for the WA (p = 0.06) in comparison to without FES. There were no differences between the ODFS and WA in terms of either walking speed (p = 0.596) or energy cost (p = 0.205). Conclusions: This is the first pilot study to compare the effects of two different FES devices on walking. Further research recruiting a larger cohort of FES naive participants is needed. Implications for Rehabilitation Functional electrical stimulation (FES) used for foot drop in multiple sclerosis (MS) is effective in improving the speed of walking. The Odstock Dropped Foot Stimulator and the Walkaide have similar orthotic effects on the speed and energy cost of walking in people with MS. Further research is urgently needed to compare FES devices, recruiting treatment of naive participants for a fully powered RCT.

[1]  A. McFadyen,et al.  The effect of functional electrical stimulation on the physiological cost of gait in people with multiple sclerosis , 2008, Multiple sclerosis.

[2]  John Whyte,et al.  Applying Evidence Standards to Rehabilitation Research , 2006, American journal of physical medicine & rehabilitation.

[3]  Frances Lynn,et al.  Timed 25-Foot Walk , 2013, Neurology.

[4]  Marcus J Fuhrer,et al.  Assessing the efficacy, effectiveness, and cost-effectiveness of assistive technology interventions for enhancing mobility , 2007, Disability and rehabilitation. Assistive technology.

[5]  J. Norton,et al.  Clinical use of the Odstock dropped foot stimulator: its effect on the speed and effort of walking. , 1999, Archives of physical medicine and rehabilitation.

[6]  B. Phillips,et al.  Gait and balance impairment in early multiple sclerosis in the absence of clinical disability , 2006, Multiple sclerosis.

[7]  Richard B. Stein,et al.  A Multicenter Trial of a Footdrop Stimulator Controlled by a Tilt Sensor , 2006, Neurorehabilitation and neural repair.

[8]  S. Weigand,et al.  Change in MS-related disability in a population-based cohort , 2004, Neurology.

[9]  V de Groot,et al.  Community walking can be assessed using a 10-metre timed walk test , 2011, Multiple sclerosis.

[10]  G. Mann,et al.  Impact on activities of daily living using a functional electrical stimulation device to improve dropped foot in people with multiple sclerosis, measured by the Canadian Occupational Performance Measure , 2010, Multiple sclerosis.

[11]  L. Rochester,et al.  Community ambulation after stroke: how important and obtainable is it and what measures appear predictive? , 2004, Archives of physical medicine and rehabilitation.

[12]  H. Weiner,et al.  Intensive immunosuppression in progressive multiple sclerosis. A randomized, three-arm study of high-dose intravenous cyclophosphamide, plasma exchange, and ACTH. , 1983, The New England journal of medicine.

[13]  R. Motl,et al.  Energy Cost of Walking and Its Association With Gait Parameters, Daily Activity, and Fatigue in Persons With Mild Multiple Sclerosis , 2012, Neurorehabilitation and neural repair.

[14]  P. Taylor,et al.  Experience of clinical use of the Odstock dropped foot stimulator. , 1997, Artificial organs.

[15]  Maarten J. IJzerman,et al.  The orthotic effect of functional electrical stimulation on the improvement of walking in stroke patients with a dropped foot: a systematic review. , 2004, Artificial organs.

[16]  P. Sandercock,et al.  Framework for design and evaluation of complex interventions to improve health , 2000, BMJ : British Medical Journal.

[17]  J. Holmes,et al.  What drives quality of life in multiple sclerosis? , 2004, QJM : monthly journal of the Association of Physicians.

[18]  R. Stein,et al.  Long-Term Therapeutic and Orthotic Effects of a Foot Drop Stimulator on Walking Performance in Progressive and Nonprogressive Neurological Disorders , 2010, Neurorehabilitation and neural repair.

[19]  A. Danielsson,et al.  Energy expenditure in stroke subjects walking with a carbon composite ankle foot orthosis. , 2004, Journal of rehabilitation medicine.

[20]  P. Taylor,et al.  A randomized trial to investigate the effects of functional electrical stimulation and therapeutic exercise on walking performance for people with multiple sclerosis , 2009, Multiple sclerosis.