Focus of the Report: This report focuses on the use of functional electrical stimulation (FES) for treatment of dropped foot in patients who have multiple sclerosis (MS). The goals of this therapy are to improve gait, walking speed, quality of life, and overall functional mobility.

Technology Description: FES uses electrical pulses applied to the common peroneal nerve to try to recreate the muscle contractions and movements of normal voluntary gait (lifting the foot as it swings forward and placing it correctly on the ground). In skin-surface FES, electrodes placed over the nerve are connected to a stimulator unit, which provides control that can be facilitated by a foot switch or remote programming.

Controversy: Compared with an ankle-foot orthosis (AFO) for treatment of dropped foot in patients with MS, FES devices may not provide greater improvements in walking despite their greater complexity and expense.

Key Questions:

  • Does FES improve gait and quality of life in adult patients with MS who have dropped foot?

  • How does FES compare with clinical standards for treatment of foot drop in patients with MS?

  • Is FES treatment associated with any safety issues in patients who have MS?

  • Have definitive patient selection criteria been established for FES treatment of dropped foot in MS patients?

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