Enhancing Mobility in Persons with Footdrop in Multiple Sclerosis through Functional Electrical Stimulation

• Published in: Multiple sclerosis and related disorders 2023-05, Vol.73, p.104651, Article 104651
• Main Authors: Fang, James, Kumar, Danya Pradeep, Celnikier, Elie, Snyder, Makenna, Potts, Emilia, Sosnoff, Jacob
• Format: Article
• Language: English
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2023.104651

Footdrop is a significant problem in individuals living with multiple sclerosis (MS), leading to falls and reduced quality of life. Functional electrical stimulation (FES) is a common treatment for footdrop. Technological advances are leading to the development of the next generation of FES devices, such as the non-invasive EvoWalk (Evolution Devices, Inc). Prior to widespread use the accuracy of the device's gait detection needs to be validated. To validate EvoWalk's gait analysis accuracy based on ground truths from a pressure-based walkway gait analysis system and examine the improvement in gait with FES in pwMS. Individuals living with MS, unilateral footdrop and capable of walking 10m with or without an assistive device were eligible. Participants performed a series of walking and stair-climbing tasks while wearing the EvoWalk device with and without FES stimulation active on the affected leg. Data was simultaneously recorded on the EvoWalk device, and the Zeno pressure-based walkway gait analysis system. Data from two pwMS with unilateral footdrop and one healthy control was analyzed. Compared to the pressure-based walkway system, EvoWalk yielded an average heel-strike and toe-off onset detection differences of 32.7ms (SE=15.3, 95% CI = [2.72,62.7]) and 59.1ms (SE=36.4, 95% CI = [0,130.4]), respectively. Also, in one pwMS, swing-time improved by 11.83% when the stimulation was active. Due to technical issues, we were unable to compare the stimulation results for the other pwMS and stimulation was inactive for the control participant. The wearable FES device tested here was accurate in detecting gait events and has some benefit to gait parameters. Further research concerning the device is warranted.