Helping children with dropped foot to walk more easily

Dropped foot can be caused by cerebral palsy, multiple sclerosis, stoke or injury and makes walking difficult. Action funding has helped to refine a technology called functional electrical stimulation, developing it into an effective, wearable device that is now benefiting both children and adults in the UK.

Children with dropped foot are unable to properly lift one or both feet. They struggle to move their ankle and toes upwards, which causes the front part of the foot to drop down, or drag.

This can make walking difficult, slow and tiring, with an increased risk of trips and falls. It can severely limit mobility and affect a child’s confidence, independence and quality of life.

Conditions such as cerebral palsy, multiple sclerosis, stroke and some inherited neurological diseases can cause dropped foot. It can also be caused by brain or spinal cord injury.

HOW WE'VE HELPED

From the mid-1990s, Action funding of £182,000 over seven years allowed researchers, led by Professor Ian Swain, to adapt and develop a technology called functional electrical stimulation (FES).

FES had previously been used in laboratories and hospitals since the 1960s but the systems were too bulky and complex for use outside of these settings. Professor Swain and his team, based at Salisbury District Hospital, in Odstock, and the Universities of Surrey and Southampton, aimed to bring its benefits to many more people.

FES uses specially timed electrical stimulation of certain muscles to help lift the foot when walking. Usually signals, or small electrical pulses, travel along our nerve cells and tell our muscles when to contract, allowing us to move. But if these signals are disrupted, movement becomes difficult or impossible. FES involves wearing a special device that uses low energy electrical pulses to mimic the natural signals sent along the nerves.

The first Action grant allowed the researchers to improve and test a device they had already developed, known as the Odstock Dropped Foot Stimulator. Their new solution, tested on stroke patients, allowed two muscles to be stimulated at once instead of just one. This was shown to have much greater benefit, with improvements in walking continuing even when the device was not in use – something that hadn’t happened before.

Further funding allowed more improvements to be made and since then the researchers have continued to work on this technology. The Odstock Dropped Foot Stimulator (ODFS®) is now sold worldwide and is estimated to have benefited 15,000 people in the UK alone.

While the device was first developed for adults, the team in Salisbury now run a dedicated children’s clinic. This is managed by one of the original researchers on the Action-funded work, Dr Duncan Wood, and has treated children affected by cerebral palsy, stroke and head injury.

Children with dropped foot who use FES are able to walk faster, with less effort and fewer trips. But the most important benefits are associated with quality of life. Dr Wood reports young patients saying things like: “I can keep up with my friends” or “my walking looks more normal when I’m in town.”