Firstly we should cover who will benefit from Functional Electrical Stimulation (FES). It is commonly used for a dropped foot or an affected arm, normally this happens after a stroke, brain injury or in conditions such as Multiple Sclerosis. For the purposes of this review we will be looking at its use for foot drop and we will be exploring the most common FES system by Odstock medical.
ODFS Pace
How does it work?
- The system works by providing electrical stimulation directly to the muscle belly, causing it to contract and lift your foot. This is the same with all FES systems.
- It has a switch in the heel of your shoe that will detect your heel lifting and start the stimulation.
- Your clinician can adjust the location of the switch according to your walking pattern.
- Once your heel hits the floor again the stimulation switches off – it ramps down slowly to avoid your foot slapping on the floor.
How do I set it up?
- You will need a physiotherapist with extra training in this area in order to adjust the settings for your walking pattern.
- Once this is completed you can attach the electrodes directly to your skin.
- These attach to the unit through wires.
- Your foot switch is then taped into the heel of your shoe, although you can also buy special insoles to accommodate it.
- The switch comes in a wired or wireless option.
- You can then clip the unit onto your waistband.
What are the pros and cons?
| Component | Pros | Cons |
| Sticky gel electrodes | Good connectivity | Last around 2 weeks only |
| Can buy a “cuff” to place electrodes in to make it easier to fit. | Need to be put in the same place each time – can be hard to achieve. | |
| Attaching the connector to the wire can be hard single handed | ||
| Control unit | Small and discreet | Small screen can be hard to see, especially if visually impaired. |
| Stop/start function easy to use | Difficult to access menus. | |
| Not particularly user friendly, especially if single handed. | ||
| Not easy to wear if you are wearing something without pockets/waistband. | ||
| Foot switch | Good sensitivity when fitted correctly. | Needs fitting to each shoe and transferring when changing footwear. |
| Wireless option much better. | Wires can get in the way. | |
| No learning capability, works on how it is set up as opposed to adapting to your walking pattern over time (other models can do this). |
Final thoughts
The ODFS Pace is a good entry model FES system and is something you can often get funded through the NHS once assessed at an FES clinic (ask your GP). However it does have several drawbacks when compared to other (more expensive) manufacturers, namely it is not particularly user friendly in terms of the visibility of the menu, the use of the buttons and the application of the electrodes can be difficult when wanting to achieve the right movement.
The electrodes also only last a few weeks and we often find users do not replace them enough. Additionally all the wiring that goes with it and the control unit mean it is not particularly discrete or adaptable to different clothing choices.
Having said that if you are looking for an affordable way to explore using FES for the first time and are only walking moderate distances indoors/outdoors I think it is a good starter option. You can also gain funding for it via your GP after having an assessment at your local FES clinic.
If you are using FES every day and for higher level activities such as long walks or running then I would suggest exploring some of the more expensive and advanced options such as the Bioness LG300.
For more information on FES contact your local Neuro Physiotherapist.
