faye pitt bsc(hons) msc senior orthotist trulife
TRANSCRIPT
Faye Pitt BSc(Hons) MSc
Senior OrthotistTrulife
The WalkAide is a battery-operated, single channel, functional electrical stimulation device used to address Foot Drop.
- Functional
- Therapeutic
Dorsiflexion of the ankle at the optimal time during the gait cycle to normalise walking.
One piece & self-aligning
Built-in sensors
One-hand donning/doffing
Universal R/L cuff
Electrode markers for placement
Light-weight & comfortable
Adaptations for visual & hearing impaired
• Facilitates sagittal plane swing
• Works with any initial foot position
• No heel strike needed
• Minimises skin irritation via balanced charge recovery circuitry
• Collects & analyses patient data via wireless Bluetooth technology
• Walking Mode and Exercise mode
Candidates
Upper Motor Neuron Lesions
CVA or stroke
Incomplete SCI
Traumatic brain injury
Cerebral palsy
Multiple sclerosis
Familial hereditary spastic paraplegia (FSP)
Considerations Contraindications
Severe sensory/proprioception deficit Lower Motor Neuron
History of skin sensitivity Pacemaker
Limited walking potential Pregnancy
Morbid obesity <35%> History of Seizure Disorder
Cognitive StatusThrombosis in
area of the device
Peripheral Nerve Damage
Surgical Trauma; lumbar or hipLumbar spinal
stenosisPoliomyelitis
Guillain-Barre Syndrome
Sciatica
• Well tolerated
• Prevent Deformity
• Delay or Prevent Surgery
Paediatrics
Cerebral Palsy: Left Hemiparesis
HOW ?
Peripheral Nerve Stimulation
An intact peroneal nerve pathway is
required.
Controlled amounts of electrical currents
are applied to the peroneal nerve in order to promote
functional dorsiflexion.
‘Tilt’ Sensor
Inclinometer
Tilt ON Threshold Tilt OFF Threshold
Measures angular
changes from vertical
Tilt Sensor Input
Posterior angle: ON Anterior angle: OFFSwing: ON
Measures changes in acceleration.
Measures time between the angular changes;
(The force exerted by restraints in an accelerating body).
Accelerometer
WALKAIDE SYSTEMProduct Development
WalkAide® System
Equipment
Patient Set-up• Pre-screening:
Ministim
Electrode Location
Patient Kit
Clinician Kit-Programming Tools
* WalkAnalyst Software
Heel Sensor Input
Unload: ON Load: OFFSwing: ON
Data Collection and Programming
Clinician InputWalkLink
System Data Collection
Normalise Gait– Initiation of swing– Duration of swing– Termination of swing
3.0 Version Upgrades– Rapid Programming– Walking Speed Calculation– Comparative Reporting
3.0
WalkAnalyst
Walking Speed: • Quantify changes over time• With and without device
Usage Log:• Hours per day• Stims per day
Printed Reports:• Back-up data• Prescriber Communication
Quantification of Outcomes
WHY ?
Maximize Recovery• Regain voluntary control, restore reflex responses
and complex functional movement
– Precise and timely feedback from the periphery allows for quality control of movement
– Task Oriented
– Biofeedback
– Repetition
– Sensory feedback
– Audible feedback
Augmentation
Research from the University of Alberta
“A Multicenter Trial of a Footdrop Stimulator Controlled by a Tilt Sensor”
Stein et al, Neurorehabilitation and Neural Repair 2006
• Increase in velocity with and without the WalkAide System (Carry-over effect) – 3 mo 16%– 6 mo 27%– 12 mo 51%
• PCI index decreased 25% – Voluntary drive and muscle strength
WalkAide® System Evidence:
MEP Mapping by TMS
• Normal subject (age 27)
Long-Term Effects of FES in a Head-Injured Patient (10+ years post-injury)
Before FES use After 6 months of FES use
Does Functional Electrical stimulation for Foot Drop Strengthen Corticospinal Connections? Everaert et al Neurorehab. Neural Repair 2010
regular use of a foot drop stimulator strengthens activation of motor cortical areas and their residual descending connections
Long-Term Therapeutic and Orthotic Effects of a Foot Drop Stimulator on Walking
Performance in Progressive and Nonprogressive Neurological Disorders – Stein et al,
Neurorehab. Neural Repair 2010
Both groups had an orthotic benefit from FES.
Therapeutic effect increased for 11 months on nonprogressive disor
up to 3 months in the progressive disorders.
Who do we work with?
• Trulife clinicians
• Private clinicians
• NHS units
Global Presence
23 Countries
Mobility and Independence.One Step at a Time.
Thank you for listening