Correction of Footdrop Due to Multiple Sclerosis Using the STIMuSTEP Implanted Dropped Foot Stimulator

Paul N. Taylor , PhD; Ingrid A. Wilkinson Hart , PhD; Mansoor S. Khan ,FRCS(Plast); Diana E.M. Slade-Sharman , FRCS(Plast)

From the Department of Clinical Science and Engineering (PNT, IAWH) and the Department of Plastic Surgery (MSK, DEMS-S), Salisbury District Hospital, Salisbury, Wiltshire, UK.

Correspondence: Paul N. Taylor, PhD, Salisbury District Hospital, Salisbury, Wiltshire SP2 8BJ, United Kingdom; e-mail: p.taylor@salisburyfes.com.

Note: Supplementary material for this article is available on IJMSC Online at ijmsc.org.

Background: Footdrop is a significant problem in multiple sclerosis, reducing the safety and efficiency of walking. Functional electrical stimulation (FES) can produce dorsiflexion, correcting footdrop. The purpose of this retrospective analysis of clinical study data was to compare the effect of external and implanted FES devices for the correction of footdrop.

Methods: External FES was used for a minimum of 6 months before implantation. Walking performance was assessed using 10-m walking speed, 3-minute walking distance, the Physiological Cost Index, and health- and device-related quality of life and device-use questionnaires. Assessments were made before implantation and a mean (SD) of 128 (24) days after surgery, with additional walking speed measurements at 3 years.

Results: Twenty-three people with multiple sclerosis received the STIMuSTEP implant. Both devices enabled statistically significant increases in walking speed and walking distance, with a strong trend toward a reduced Physiological Cost Index, indicating that walking required less effort (P = .07). Both devices improved device-related quality of life. Walking speed gain with FES was maintained at 3 years. Three implants failed after falls, and there was one case of neuropraxia. The implant was used more days per week and was quicker to put on each day than the external FES device.

Conclusions: The STIMuSTEP implanted dropped foot stimulator is an effective long-term intervention for the correction of footdrop.