faye pitt bsc(hons) msc senior orthotist trulife

Faye Pitt BSc(Hons) MSc

Senior OrthotistTrulife

The WalkAide is a battery-operated, single channel, functional electrical stimulation device used to address Foot Drop.

- Functional

- Therapeutic

Dorsiflexion of the ankle at the optimal time during the gait cycle to normalise walking.

One piece & self-aligning

Built-in sensors

One-hand donning/doffing

Universal R/L cuff

Electrode markers for placement

Light-weight & comfortable

Adaptations for visual & hearing impaired

• Facilitates sagittal plane swing

• Works with any initial foot position

• No heel strike needed

• Minimises skin irritation via balanced charge recovery circuitry

• Collects & analyses patient data via wireless Bluetooth technology

• Walking Mode and Exercise mode

Candidates

Upper Motor Neuron Lesions

CVA or stroke

Incomplete SCI

Traumatic brain injury

Cerebral palsy

Multiple sclerosis

Familial hereditary spastic paraplegia (FSP)

Considerations Contraindications

Severe sensory/proprioception deficit Lower Motor Neuron

History of skin sensitivity Pacemaker

Limited walking potential Pregnancy

Morbid obesity <35%> History of Seizure Disorder

Cognitive StatusThrombosis in

area of the device

Peripheral Nerve Damage

Surgical Trauma; lumbar or hipLumbar spinal

stenosisPoliomyelitis

Guillain-Barre Syndrome

Sciatica

• Well tolerated

• Prevent Deformity

• Delay or Prevent Surgery

Paediatrics

Cerebral Palsy: Left Hemiparesis

HOW ?

Peripheral Nerve Stimulation

An intact peroneal nerve pathway is

required.

Controlled amounts of electrical currents

are applied to the peroneal nerve in order to promote

functional dorsiflexion.

‘Tilt’ Sensor

Inclinometer

Tilt ON Threshold Tilt OFF Threshold

Measures angular

changes from vertical

Tilt Sensor Input

Posterior angle: ON Anterior angle: OFFSwing: ON

Measures changes in acceleration.

Measures time between the angular changes;

(The force exerted by restraints in an accelerating body).

Accelerometer

WALKAIDE SYSTEMProduct Development

WalkAide® System

Equipment

Patient Set-up• Pre-screening:

Ministim

Electrode Location

Patient Kit

Clinician Kit-Programming Tools

* WalkAnalyst Software

Heel Sensor Input

Unload: ON Load: OFFSwing: ON

Data Collection and Programming

Clinician InputWalkLink

System Data Collection

Normalise Gait– Initiation of swing– Duration of swing– Termination of swing

3.0 Version Upgrades– Rapid Programming– Walking Speed Calculation– Comparative Reporting

3.0

WalkAnalyst

Walking Speed: • Quantify changes over time• With and without device

Usage Log:• Hours per day• Stims per day

Printed Reports:• Back-up data• Prescriber Communication

Quantification of Outcomes

WHY ?

Maximize Recovery• Regain voluntary control, restore reflex responses

and complex functional movement

– Precise and timely feedback from the periphery allows for quality control of movement

– Task Oriented

– Biofeedback

– Repetition

– Sensory feedback

– Audible feedback

Augmentation

Research from the University of Alberta

“A Multicenter Trial of a Footdrop Stimulator Controlled by a Tilt Sensor”

Stein et al, Neurorehabilitation and Neural Repair 2006

• Increase in velocity with and without the WalkAide System (Carry-over effect) – 3 mo 16%– 6 mo 27%– 12 mo 51%

• PCI index decreased 25% – Voluntary drive and muscle strength

WalkAide® System Evidence:

MEP Mapping by TMS

• Normal subject (age 27)

Long-Term Effects of FES in a Head-Injured Patient (10+ years post-injury)

Before FES use After 6 months of FES use

Does Functional Electrical stimulation for Foot Drop Strengthen Corticospinal Connections? Everaert et al Neurorehab. Neural Repair 2010

regular use of a foot drop stimulator strengthens activation of motor cortical areas and their residual descending connections

Long-Term Therapeutic and Orthotic Effects of a Foot Drop Stimulator on Walking

Performance in Progressive and Nonprogressive Neurological Disorders – Stein et al,

Neurorehab. Neural Repair 2010

Both groups had an orthotic benefit from FES.

Therapeutic effect increased for 11 months on nonprogressive disor

up to 3 months in the progressive disorders.

Who do we work with?

• Trulife clinicians

• Private clinicians

• NHS units

Global Presence

23 Countries

Mobility and Independence.One Step at a Time.

Thank you for listening