FES Standing & WalkingFES Standing & Walking

Dan Faulkner & Dom DriverDan Faulkner & Dom Driver

Paraplegic Stand and WalkParaplegic Stand and Walk

Many methods for Many methods for standing/walking, standing/walking, including Frames, including Frames, Hydraulics, Hydraulics, Pneumatics, FES.Pneumatics, FES.

What is FES?What is FES?

Functional Electric Stimulation.Functional Electric Stimulation.

From the work of Faraday.From the work of Faraday.

A replacement for neuronal stimulation to A replacement for neuronal stimulation to a muscle group/fibre.a muscle group/fibre.

““The principle of FES is to replace the The principle of FES is to replace the nerve impulses to the muscles that are nerve impulses to the muscles that are interrupted by damage to the brain or interrupted by damage to the brain or spinal cord with small electrical signals” spinal cord with small electrical signals”

How does it work?How does it work?

Electrodes to Electrodes to stimulate muscle can stimulate muscle can be percutaneous or be percutaneous or subcutaneous.subcutaneous.

Percutaneous Percutaneous stimulation from stimulation from electrodes on the electrodes on the surface of the skinsurface of the skin

Subcutaneous – Subcutaneous – sacral anterior rootsacral anterior root

Who can use FES?Who can use FES?

SCI patients with lesions in mid to lower SCI patients with lesions in mid to lower thorasic regionthorasic region

Stroke related brain damageStroke related brain damage

Head Injuries leading to brain damageHead Injuries leading to brain damage

Patients with Neurological problems (MS, Patients with Neurological problems (MS, Cerebral Palsy, Spasticity)Cerebral Palsy, Spasticity)

Why use FES?Why use FES?

Allow people to stand or walk, and all the Allow people to stand or walk, and all the benefits that entails.benefits that entails.Clinical ReasonsClinical Reasons Increased Muscle massIncreased Muscle mass Pressure sore reliefPressure sore relief Improve blood supplyImprove blood supply Reduce osteoporosis.Reduce osteoporosis.

Psychological ReasonsPsychological Reasons Aesthetic improvementAesthetic improvement IndependenceIndependence Sense of AchievementSense of Achievement

FES StandingFES Standing

Quadreceps muscles allow standingQuadreceps muscles allow standing If stimulated strongly enough, allow extension If stimulated strongly enough, allow extension

of the knee upto the point where knees lock of the knee upto the point where knees lock into stable standing position.into stable standing position.

Gluteal muscles allow stability of hips.Gluteal muscles allow stability of hips.High knee velocities a problemHigh knee velocities a problem Extra wear on knee jointsExtra wear on knee joints

Sensors & closed loop control reduce this Sensors & closed loop control reduce this problem.problem.

FES standingFES standing

FES WalkingFES Walking

Combination stimulus to quads and Peroneal Combination stimulus to quads and Peroneal nerve in lower leg.nerve in lower leg.

Electrode DiagramElectrode Diagram

FES WalkingFES Walking