The use of Function Electrical Stimulation (FES) in neurological rehabilitation.

The most common application for FES is the correction of dropped foot. Stimulation is applied to the outside of the leg using self-adhesive electrodes causing the muscle to contract and the foot to lift.

Functional Electrical Stimulation, or FES, is a method of externally controlling muscles when signals from the brain can no longer control movement. This can happen after a spinal cord injury, stroke orneurological disease such as Multiple Sclerosis. FES improves the quality of life for patients with neurological disabilities across the globe.

Wireless footswitch

Wireless footswitch

BU engineering research has been crucial in developing these intelligent systems with Odstock Medical Ltd (OML) – the first NHS commercial company in England. Following early research and development by Professor Swain in the 1990s, which showed FES had significant advantages over traditional physiotherapy, BU has worked with OML over the years providing a rapid prototyping facility via the product design service and through PhD students working on development of the system through body area wireless networks research.

FES systems can radically change people’s lives. They increase a person’s functional ability, thereby improving quality of life. The patient’s newfound ability to participate more actively in society reduces their isolation and dependence on others.

Wireless footswitch

Wireless footswitch

FES sales have increased since 2008 with OML’s turnover nearly doubling  and well over 10,000 stimulators have now been sold. Stimulators are also exported to 18 overseas countries, including developing countries like India. The use of FES for dropped foot obtained National Institute for Health and Care Excellence (NICE) approval in 2009 while the Royal College of Physicians have positively commented on FES in their 2012 Stroke Guidelines.

OML’s aspirational aims for the future are to make FES a routine treatment in the NHS, throughout the UK and to develop overseas markets. The company plans to improve the existing equipment by conducting further research and devising new techniques such as the wireless system, which can cascade through OML’s network of clinical centres. The target is that in 5 years a new range of OML’s FES devices, supported by BU’s academic expertise, will lead the world in providing innovative solutions and further improved quality of life for people with neurological disabilities.

Publications

  • Burridge JH, Hagan SA, Wood DE, Swain ID. “The effects of common peroneal nerve stimulation on the effort and speed of walking – a randomised controlled trial with chronic hemiplegic patients”. Clinical Rehabilitation, 11: 201‑210, 1997.
  • Burridge JH, Hagan SA, Wood DE, Swain ID. “The effect of common peroneal nerve stimulation on quadriceps spasticity in hemiplegia”. Physiotherapy, 83(2): 82‑89, 1997.
  • Academic Biomedical Engineering Research Group Workshop 2000-2005, ISBN: 1-85899-132-3, 1-85899-156-0, 1-85899-178-1, 1-85899-1730, 1-85899-2060.
  • Swain ID and Taylor PN. Proceedings of the 9th IFESS Meeting, Bournemouth UK, 2004 ISBN 1-85899-191-9.
  • Taylor PN, Esnouf JE, Hobby JA. “The functional impact of the Freehand system on tetraplegic hand function”. Clinical results. Spinal Cord, 40: 560-566, 2002.
  • Kenney L, Bultstra G, Buschman R, Taylor PN, Mann G, Hermens H. “An implantable two channel drop foot stimulator: initial clinical results”. Artif.Organs 2002;26:267-70.