Fes for foot drop

L300 Foot Drop System Frequently Asked Questions

Click on a question below to view the answers to frequently asked questions about the L300 Foot Drop System. If you have additional questions, please Contact Us.

FUNCTIONAL ELECTRICAL STIMULATION

Q. What is Functional Electrical Stimulation (FES)? A. FES is the use of low-level electrical stimulation to restore or improve function due to a neurological condition or injury. FES is designed to produce movements or functions that mimic natural voluntary movements to help you lead a more natural life. Q. How does FES create body movement? A. The brain sends electrical signals to your body through the nervous system. These signals tell the body how to move. When injury or disease interrupts normal communication between the brain and lower extremities, muscle weakness or paralysis may result. If a muscle and its nerve supply remain healthy, but communication from the brain cannot occur because of a problem with the central nervous system, FES may be used to replace the natural electrical signals from the brain, helping the weak or paralyzed limbs move again. With continued stimulation over time, the brain may even be able to recapture and relearn this movement without the stimulation. Q. What are the benefits of FES when applied to paralysis or paresis (partial loss of movement)? A. FES may improve voluntary movement in injured limbs. It may also reeducate your muscles, prevent muscle loss (often called atrophy), maintain or increase joint range of motion and increase local blood flow. Q. Who is a candidate for FES? A. If you are experiencing paralysis or paresis as a result of a Stroke, Multiple Sclerosis, Traumatic Brain Injury or Spinal Cord Injury, you may be a candidate. You should consult with your physician or clinician to find out if FES is the right treatment for you. A number of factors impact the overall benefit a person will receive from using FES, including the severity and nature of the paralysis, the length of time since the paralysis occurred and how frequently the system is used. Q. Does FES hurt? A. FES is not supposed to hurt. Most people describe FES as a tingling sensation. The initial step is for your therapist to find the appropriate level of stimulation needed, followed by a gradual buildup of intensity over time. Note: There are a number of issues affecting an individual’s tolerance of FES, including electrode size and position, the type of pulse that is administered, the muscle group stimulated, and the intensity of the stimulation. The large electrodes and customized fit of the L300 Foot Drop System help to minimize any uncomfortable sensation the stimulation may create. Q. When is it appropriate to start using FES? A. Before beginning any kind of rehabilitation therapy, it is essential to speak with your physician. In most cases, use of FES can be started almost immediately following your initial injury. Clinical studies show that early use of FES may provide optimal benefits of functional recovery. However, even those patients whose injuries occurred more than a year before starting rehabilitation demonstrated significant improvements.1 Q. How long will someone benefit from using FES? A. Your doctor and clinician can help you determine the length of time you will use FES.

L300 FOOT DROP SYSTEM

Q. What is the L300 Foot Drop System? A. The L300 Foot Drop System is a state-of-the-art Functional Electrical Stimulation (FES) system that uses mild stimulation of nerves and muscles to help people with foot drop regain a more natural walking pattern (gait). Q. How does the L300 Foot Drop System work? A. The L300 Foot Drop System has three main parts that use wireless communication to “talk” to each other. Watch the video to see how the L300 Foot Drop System works. Q. What sizes does the L300 come in? A. The L300 Foot Drop System comes in two sizes: regular and small (to fit calf circumferences approximately 12 inches or smaller). Q. What are the potential benefits of the L300 Foot Drop System? A. The L300 Foot Drop System is cleared for the following indications:

  • Provides ankle-foot dorsiflexion which may improve gait
  • Reeducates muscles1
  • Prevents muscle disuse atrophy (muscle loss)
  • Maintains or increases joint range of motion
  • Increases local blood flow

Q. Is the L300 Foot Drop System only for Stroke patients? A. No. It can be used for Multiple Sclerosis, Spinal Cord Injuries and Traumatic Brain Injury. Q. Do I need to have foot and ankle movement to use the L300 Foot Drop System? A. No. However, your physician will determine if the system is appropriate for you. Q. When can I start using the L300 Foot Drop System? A. Ideally, use begins during inpatient rehabilitation and continues at home. Q. How long could I benefit from the L300 Foot Drop System? A. The L300 Foot Drop System is designed to provide benefits over a lifetime of use, or as medically appropriate. Many factors may affect your outcome, including severity of impairment, age, time elapsed since the impairment, co-morbidities, pre-existing conditions, therapy compliance and overall cognition. Length of use also may depend on whether the goal is to manage impairment or improve function.

GETTING MY OWN L300 FOOT DROP SYSTEM

Q. How do I obtain the L300 Foot Drop System for home use? A. You will need to obtain a prescription for therapy and be evaluated by a Bioness-trained healthcare provider. If you are considered a candidate, the next step will be to complete the Patient Forms Packet, which consists of:

  • A letter of medical necessity and device prescription
  • A checklist for custom fitting
  • A release of patient and insurance information

Bioness works closely with you and your healthcare provider during the acquisition process. Q. Does the L300 Foot Drop System require a prescription? A. Yes. In order to acquire the device for home use, a prescription from your physician is required. Q. Is the L300 Foot Drop System covered by my insurance? A. Use of a Bioness system in the clinic setting is billed by your healthcare professional and often reimbursed if it is medically necessary. While we can’t guarantee insurance reimbursement when a Bioness system is purchased for home use, your health insurance plan may cover some or all of the cost of a Bioness system. Claims submitted for reimbursement of a Bioness system are often evaluated on a case-by-case basis. Q. Are there financing options for the L300 Foot Drop System? A. Bioness is committed to helping you explore a variety of payment options — from insurance to financing — so we can find a purchase plan that makes the system affordable. To discuss your payment options, to have a Bioness Representative contact you, or call us at 800-211-9136, option 2.

Reference:
1. Yan T, et al. 2005. Stroke. 36(1):80-85.

WalkAide®

Dynamic FES for Neuro Rehabilitation

The WalkAide® System is an advanced Functional Electrical (FES) Stimulation System for the treatment of Foot Drop caused by upper motor neuron injury such as:

• Multiple Sclerosis (MS)
• Stroke (CVA)
• Incomplete Spinal Cord Injury
• Cerebral Palsy (CP)
• Traumatic Brain Injury (TBI)

Utilizing a tilt sensor and accelerometer technology, the WalkAide stimulates the common peroneal nerve to lift the foot at the right time during the gait cycle, prompting a more natural, efficient, and safe walking pattern. WalkAide users have the freedom to walk with or without footwear, up and down the stairs, and all directions.

Effective from Acute to Post-Rehab Care

Using the WalkAide in all stages of neuro rehabilitation provides the therapist a valuable tool to promote optimal patient outcomes.

• Improve walking speed with less fatigue
• Improve gait quality
• Reduce atrophy
• Improve circulation, muscle condition, and bone density
• Promote Neuroplasticity

Options for Rehab Use

Tilt Mode
• Gait Training: Maximize patient handling while increasing sensorimotor input
• Swing: Enhance motor learning through repeated, forced use during open chain activities (swing)
• Random Practice: Improve gait on all surfaces and generalize to varying environments
• Biofeedback: Use audible feedback during stimulation to promote tibial translation

Hand Mode
• Pre-Gait Skills: Practice weight shifting to improve transition between extensor and flexor tone
• Blocked Practice: Use controlled stepping and swing initiation in early gait training
• Gait Training: Manage dorsiflexion for safe steps during ambulation
• Exercise and Gait: Vary durations of stimulation to assist, challenge and progress activities

Heel Mode
• Functional Activities: Cue forward weight shifting in sitting and assist with sit-to-stand transfers
• Pre-Gait Skills: Teach controlled weight shifting side-to-side and with stepping forward and back
• Early Gait Training: Walk in parallel bars or for short distances to improve motor control

Exercise Mode
• Bedside Therapy: Enhance movement, circulation, strength, etc.
• Rehab and Home Exercise: Build muscle strength and endurance, increase ROM, normalize tone, etc.
• Neuromuscular Re-education: Promote learning via sensory feedback from consistent, repetitive and functional movement

Background .– Functional electrical stimulation in stroke patients showed orthotic and therapeutic effects on foot-drop syndrome . Drawbacks of classical methods using footswitch are poor adaptability, muscle fatigability leading to poor foot-drop correction during the day and often wired connection. We are developing a new method to monitor in a continuous manner gait cycles phases with accelerometry, angular rate and magnetic field measurements in combination. Thanks to this approach, we can implement a pre-programmed stimulation pattern adapted to the recorded measures. The aim of this study is to assess validity of gait cycle measurement in stroke patients.

Methods .– Fifteen chronic stroke patients performed three trials in three different conditions: no stimulation, classic stimulation triggered by heel switch and stimulation triggered by gait event detection extracted from the continuous analysis of gait cycles. Data are compared to those given by electronic footprints assessment (Gaitrite®).

Results .– This method of continuous gait analysis is able to accurately detect heel-off and heel-on gait events and thus trigger fibular nerve stimulation when desired.

Discussion.– Only one measure has been done whereas evaluation after a training period and a new adaptation of parameters would have allowed the individualization of the procedure. However, performances are at least similar to the classic footswitch based stimulation.

Conclusion.– This study, validate this new approach. Future developments should permit to assess stimulation timing, adaptation of stimulation pattern to dorsiflexors force in case of fatigability, implement an algorithm able to detect changes in gait circumstances (turn back, obstacle clearance, stairs climbing/descending, etc.) in order to adapt stimulation parameters according to these circumstances.

Functional Electrical Stimulation (FES)

What is Functional Electrical Stimulation?

PhysioFunction are recognised as international experts in the use of Functional Electrical Stimulation (FES). FES Stimulates the nerves and activates weakened muscles to provide an aid to walking which assists with recovery and independent mobility.

We have a wide range of equipment that can help promote rehabilitation outcomes and function. The use of FES may assist in day to day activities which otherwise may not be possible.

Our physiotherapists have had great success in treating conditions such as:

  • Foot Drop – Avoid trips and falls using Functional Electrical Stimulation (FES) to lift your foot as you step. Bioness Go.
  • Poor or absent hand function – Assists the recovery of hand and arm function. SaeboFlex, SaeboReach, SaeboGlove, Bioness H200
  • Weak and paralysed muscles – Strengthen muscles or maintain muscle bulk in paralysed muscles with our affordable electrical stimulators
  • Tight muscles – Loosen tight muscles with our effective splinting solutions
How to sum up PhysioFunction? Great team giving independence back to people. Can’t thank them all enough. To be able to walk my children to school is priceless.

Justin Ashton, Northampton Client

To find out more about our services or how we can help you, please click contact PhysioFunction or call 0800 043 0327

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