Khattar Bhawna, Banerjee Alakananda, Reddi Rajsekhar, Dutta Anirban
Department of Physiotherapy and Rehabilitation, Max Super Speciality Hospital, Saket, New Delhi, India.
Case Rep Neurol Med. 2012;2012:830873. doi: 10.1155/2012/830873. Epub 2012 Aug 1.
Functional Electrical Stimulation (FES) facilitates ambulatory function after paralysis by electrically activating the muscles of the lower extremities. The Odstock Dropped Foot Stimulator (ODFS, Odstock, UK) called ODFS Pace, was used for heel-switch triggered FES-assisted walking. The ODFS is recommended as an intervention for neurologically impaired gait in the Royal College of Physicians (UK) Clinical Guidelines on Stroke. Based on the guidelines by the National Institute of Clinical Excellence (NICE, UK), we started first clinical study in India on ODFS Pace as an orthotic intervention for daily use. In this preliminary study, we also investigated improvement in volitional walking following 6 sessions (3 times per week, for 2 weeks) of 30 minutes of FES-assisted treadmill walking on 7 chronic (>6 months after stroke) stroke survivors. We found that short-duration, moderately intensive FES-assisted gait therapy improved volitional gait in 3 out of 7 stroke survivors suffering from foot drop. Even in absence of improvement in volitional walking, there were no adverse effects and the subjects found heel-switch triggered FES-assisted walking mostly "easy" (6 out of 7). Therefore FES is promising as an orthotic intervention for daily use; however, tailoring the intensity and/or frequency based on patient's ability may make it viable as a therapeutic intervention.
功能性电刺激（FES）通过电激活下肢肌肉来促进瘫痪后的行走功能。一种名为ODFS Pace的奥德斯托克垂足刺激器（英国奥德斯托克公司生产）被用于足跟开关触发的FES辅助行走。在英国皇家内科医师学院关于中风的临床指南中，ODFS被推荐作为对神经功能受损步态的一种干预措施。基于英国国家卫生与临床优化研究所（NICE）的指南，我们在印度开展了第一项关于ODFS Pace作为日常使用的矫形干预措施的临床研究。在这项初步研究中，我们还对7名慢性中风患者（中风后超过6个月）进行了6次（每周3次，共2周）每次30分钟的FES辅助跑步机行走训练，并调查了其自主行走能力的改善情况。我们发现，短时间、中等强度的FES辅助步态治疗使7名患有足下垂的中风幸存者中的3人自主步态得到改善。即使自主行走没有改善，也没有出现不良反应，并且受试者发现足跟开关触发的FES辅助行走大多“轻松”（7人中有6人）。因此，FES作为日常使用的矫形干预措施很有前景；然而，根据患者能力调整强度和/或频率可能使其成为一种可行的治疗干预措施。
