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To assess the clinical effectiveness of the Odstock dropped foot stimulator by analysis of its effect on physiological cost index (PCI) and speed of walking. This functional electrical stimulation (FES) device stimulates the common peroneal nerve during the swing phase of gait.A retrospective study of patients who had used the device for 4 1/2 months.One hundred fifty-one patients with a dropped foot resulting from an upper motor neuron lesion.A medical physics and biomedical engineering department of a district general hospital specializing in the clinical application of FES and a neurophysiotherapy department at a separate hospital.Changes in walking speed and effort of walking, as measured by PCI over a 10-meter course.There was a 92.7% compliance with treatment. Stroke patients showed a mean increase in walking speed of 27% (p.01) and reduction in PCI of 31% (p.01) with stimulation, and changes of 14% (p.01) and 19% (p.01), respectively, while not using the stimulator. Multiple sclerosis patients gained similar orthotic benefit but no "carry-over."The measured differences in walking with and without stimulation were statistically significant in the stroke and multiple sclerosis groups. In this study use of the stimulator improved walking. Those with stroke demonstrated a short-term "carry-over" effect.

Objective: To determine the perceived benefit, pattern and problems of use of the Odstock Dropped Foot Stimulator (ODFS) and the users' opinion of the service provided. Design: Questionnaire sent in a single mailshot to current and past users of the ODFS. Returns were sent anonymously. Setting: Outpatient-based clinical service. Subjects: One hundred and sixty-eight current and 123 past users with diagnoses of stroke (CVA), multiple sclerosis (MS), incomplete spinal cord injury (SCI), traumatic brain injury (TBI) and cerebral palsy (CP). Intervention: Functional electrical stimulation (FES) to correct dropped foot in subjects with an upper motor neuron lesion, using the ODFS. Main outcome measures: Purpose-designed questionnaire. Results:• Return rate 64% current users (mean duration of use 19.5 months) and 43% past users (mean duration of use 10.7 months). • Principal reason cited for using equipment was a reduction in the effort of walking. • Principal reasons identified for discontinuing were an improvement in mobility, electrode positioning difficulties and deteriorating mobility. • There were some problems with reliability of equipment. • Level of service provided was thought to be good. Conclusion: The ODFS was perceived by the users to be of considerable benefit. A comprehensive clinical follow-up service is essential to achieve the maximum continuing benefit from FES-based orthoses.

The Odstock dropped foot stimulator (ODFS) is a foot switch controlled single channel neuromuscular stimulator for correction of dropped foot. Following a randomized controlled trial, the ODFS was recommended for use in the United Kingdom's National Health Service and a clinical service established. The patient performance was assessed by measurement of walking speed over 10 m, physiological cost index (PCI), and by questionnaire. After 4.5 months stroke patients (n = 111) showed a mean increase in walking speed of 27% and reduction in PCI of 31% with stimulation and changes of 14% and 19%, respectively, unassisted. Multiple sclerosis patients (n = 21) gained similar orthotic benefit but no carry over. The principal reason cited for using the equipment was that it reduced the effort of walking. The principal reasons identified for discontinuing were an improvement in mobility, electrode positioning difficulties, and deteriorating mobility. A comprehensive clinical follow-up service is essential to achieve the maximum continuing benefit from FES based orthosis.

The authors' involvement in functional electrical stimulation (FES) began 13 years ago when they began investigation into the development of a standing system for complete paraplegics. This work was funded by the Medical Devices Agency of the Department of Health. During the course of this work the authors perceived that there were a number of incomplete paraplegics whose mobility could be improved by the provision of simple FES systems to dorsiflex the foot. At that time there did not appear to be a reliable, commercially available device in the UK. The subsequent grant further developed the stimulator, the Odstock Drop Foot Stimulator (ODFS) and established treatment protocols to improve walking function for patients with a variety of different neurological conditions such as CVA, MS and cerebral palsy as well as incomplete SCI. After the completion of the randomised controlled trial the authors obtain the approval of the South and West Development and Evaluation Committee in early 1996 which has made funding easier in certain areas. This trial showed that in the treatment group walking speed was increased by 21%, the effort involved in walking measured by the Physiological Cost index, PCI, was reduced by 25 %, that reduction in spasticity was more sustained and that patients anxiety and depression levels were reduced. All of these findings were statistically significant. The service has now been running for 5 years. The authors take referrals from both G.P.'s and Consultants and then apply to the patient's local Health Authority or to the G.P. if they are a member of a fund holding practice. (2 pages)