Functional Electrical Stimulation for Foot Drop

Functional electrical stimulation (FES) is a treatment for foot drop that aims to improve walking. FES was first developed in America in the 1960's. In the UK, it was adopted in the mid 1980's and has been used since, commonly in people with foot drop. 

How FES Works?

FES uses electrical impulses to stimulate nerves and muscles, helping to lift the foot during walking. The FES works by applying small electrical charges to a muscle that has become weak or paralysed, due to damage in the brain or spinal cord. Neurological conditions such as MS and stroke often cause foot drop. 

During the swing phase of gait, the foot must lift up and clear the ground to enable walking. In cases of foot drop, the foot is unable to lift up and the toes drag on the ground. The FES is timed to occur during the swing phase, when the foot needs to dorsiflex and clear the ground, so as to avoid trips and falls. The electrical impulses stimulate the peroneal nerve, which causes the muscles to contract and lift the foot. The stimulation stops when the foot strikes the ground again. It can take some time to adjust the timings specifically for each person's individual walking pattern. Some FES devices have a heel sensor to help with timing.

Components of an FES Device

The FES device consists of a small control box (usually the size of a pack of cards) with a battery and electrodes. For foot drop the FES is usually worn on the lower leg, to deliver targeted electrical stimulation to the peroneal nerve. This nerve innervates the muscles that lift the foot.

Electrodes are placed specifically on the skin of the lower leg.  FES devices should only be fitted by trained professionals. It is a safe treatment, but it can sometimes cause discomfort and so the stimulation levels may need adjusted.

Home Use and Self-Management

FES should be used alongside other management strategies such as exercise and physiotherapy. A trained heath professional can teach you how to use the FES yourself at home. At the beginning, this may be time consuming until you learn how to place the electrodes on the correct area. As your muscles strengthen, you may need follow up sessions to have the level of stimulation adjusted.  

FES is not a cure for foot drop. It can be an effective treatment for foot drop but it is not successful for everyone.  It can cause a feeling of 'pins and needles' or a buzzing sensation. Very occasionally the electrodes can cause irritation to people's skin.  The experts at the health design collective are experienced in the applications of FES and have researched the effectiveness of FES in people with foot drop.

FES should be used alongside other types of therapy to optimise clinical outcomes. For more information on the Health Design Collective and to become involved in their research to develop products to help people with foot drop, please see the contact page.