A to Z of MS Functional electrical stimulation (FES)

In multiple sclerosis, scarring on the central nervous system prevents or interrupts messages passing to or from the brain. This can cause muscle stiffness (spasticity), weakness and poor coordination in limbs. People with MS can experience problems such as foot drop or instability and weakness at the hip and knee. These factors contribute to reduced mobility and increased fatigue as more energy is expended in moving about.

Functional electrical stimulation (FES) applies electrical stimulation to unresponsive or weak muscles and forces functional movement. To be suitable for the treatment, the individual needs to be able to walk, even if only a few metres with a stick or crutch. By wearing a foot switch triggered stimulator, the person with MS - with corrected dropped foot - can maintain use of walking muscles for longer.

In January 2009, the NICE (National Institute for Health and Clinical Excellence) issued guidance that FES can be offered routinely as a treatment option for people with foot drop caused by damage to the brain or spinal cord if the doctor feels it is appropriate.

The use of FES is growing, with an increasing number of centres offering the treatment. An assessment by a physiotherapist trained in the use of FES is required to ensure that the treatment will be suitable for the individual. The physiotherapist will also make sure that the pads are placed properly and that the equipment is being used most effectively.

Odstock Medical Limited, the NHS company that was formed by the department of Salisbury District Hospital that developed the treatment, has a map of UK centres on their website at www.odstockmedical.com.

Reference

Barrett CL, et al.
A randomized trial to investigate the effects of functional electrical stimulation and therapeutic exercise on walking performance for people with multiple sclerosis.
Multiple Sclerosis 2009;15(4):493-504.
abstract

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