FES As a Way to Improve Mobility of People with MS

Foot drop is when disruption to the nerve pathways between the legs and brain means that the front of the foot cannot be lifted to the correct angle when walking.

It can be a common symptom of MS – and it's certainly one of mine.

I've been using walking sticks for a long time, alongside various orthotic supports and an increasing reliance on a wheelchair.

But the last time I had a few tests with my MS Nurse, she began talking to me about Functional Electrical Stimulation (or FES) as a way to improve my walking and to reduce the number of stumbles (and falls) I can have.

How does it work?

FES involves sending a small electrical charge to a nerve which controls the muscle which normally lifts the front of the foot. At the right moment in your gait - when your foot is about to lift up to be swung forwards - the FES device stimulates the nerve and the muscle lifts the foot.

Because FES stimulates the existing nerves in the leg, it is important that the nerve fibers between the spinal cord and the muscles are not damaged. So to be suitable for the treatment, you need to be able to walk, even if only for a few meters with a stick or crutch.

My appointment

My appointment took around 90 minutes. I walked up and down the room a few times, with two nurses watching (and filming!) me. After a bit of chat, it was time to try fitting the device.

The control pack and battery for the device resembles a pager and fits onto your clothes or in a pocket/bag. Two wires come from it and attach to two electrodes. For foot drop these are placed on the leg just below the knee (where the nerve which controls the foot-lifting muscle is situated).

Setting up the device

Then we had some fun (!) setting up the device. We had to spend a little time fine-tuning the charge and the position of the electrodes. When it was on my bone and directly on the nerve it was so intense and the movements so dramatic that I was worried my foot might snap off! And it was undeniably bizarre to see my foot wildly lurching back and to the left of its own accord.

The sweet spot

Eventually we hit the sweet spot and the right amount of charge. I then did a few more walking tests, and almost immediately both legs were working better. My right leg wasn't having to do so much of the heavy lifting and my left leg was working properly for the first time in years (SPOILER ALERT: due to this, my left leg was exhausted after a little bit of walking).

Apparently it isn't always the case, but in my experience, a sensor was placed in my shoe, which activated the device when my foot lifted off the floor. Some more modern devices don't use this type of switch, meaning that the FES device can be used with bare feet or sandals.

A combination of FES and exercise

And FES doesn't work on its own – research has shown that while FES is effective in improving walking, enabling greater distances to be achieved, exercise can also make a significant difference to walking. So a combination of FES plus exercise might prove to be a more effective means of improving mobility.

Early today I received a call arranging fitting of my own device in a couple of weeks. I'm really excited and hopeful that this will help my walking to improve!

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