![pad system pattern pad system pattern](http://www.padsystem.com/en/pattern/made_to_measure_en.png)
Multi-pad electrodes comprise many relatively small stimulation pads. One of the options for overcoming these issues is the use of multi-pad surface electrodes. Currently available commercial systems stimulate dorsiflexion only they do not compensate for eversion (EV) or inversion (IV) and do not support push-off due to the complexity of proper electrode positioning. The most common challenges in foot drop FES applications are determining motor points, i.e., adequately positioning the electrodes, setting stimulation parameters that produce comfortable foot lift without unnatural foot eversion or inversion, and increased muscle fatigue from electrically induced contraction.
![pad system pattern pad system pattern](https://lh3.googleusercontent.com/-OqJ07Ja5_Xc/VismYgRwQ7I/AAAAAAAAIIE/7oG9fFF-1wo/s800-Ic42/pad2.jpg)
Moreover, producing plantar flexion (PF) with FES during the pre-swing phase of the gait results in better knee flexion, which also facilitates the swing phase. FES-based therapeutic and assistive devices for foot drop correction typically stimulate the common peroneal nerve in the swing phase of the gait to ensure foot lifting, i.e., the dorsiflexion (DF) of the ankle (for a review, see references ). FES principles can be employed for the therapeutic treatment of foot drop and/or in the form of an active assistive orthotic device for daily use and the long-term replacement of the impaired motor function. It is a technique that relies on the production of short bursts of electrical pulses to induce contraction by eliciting an action potential in the motor neurons that innervate a muscle. įunctional electrical stimulation (FES) is an active approach for treating foot drop. These distortions of the gait pattern lead to a decrease in the gait velocity and walking endurance, longer stance and double support gait phases, an increased energy cost, instability and a tendency to trip and fall. To avoid foot dragging during the swing phase of the gait, patients with foot drop adopt abnormal gait patterns characterized by hip hitching, circumduction and toe catch. It is commonly caused by stroke, multiple sclerosis and spinal cord trauma. This study was registered at the Current Controlled Trials website with ID NCT02729636 on March 29, 2016.įoot drop is the inability or difficulty to voluntarily lift the foot due to weak or absent ankle dorsiflexors. The results support the use of multi-pad electrode technology in combination with automatic electrode shaping algorithms for the rehabilitation of foot drop. The proposed DSS in combination with a custom multi-pad electrode design covering the branches of peroneal and tibial nerves proved to be an effective tool for producing both the dorsiflexion and plantar flexion of a paretic foot. The range of motion achieved with FES was significantly greater than the corresponding active range of motion ( p < 0.05) during the first three weeks of therapy.
![pad system pattern pad system pattern](https://www.researchgate.net/profile/J-J-Sinou/publication/311305565/figure/fig1/AS:1086514658316288@1636056689020/Pad-disc-brake-system-a-Viewing-of-the-220-contact-points-red-b-Finite-element_Q640.jpg)
The position and number of pads included showed pronounced inter-patient and inter-session variability however, zones for inducing dorsiflexion and plantar flexion within the multi-pad electrode were clearly separated. The results suggest that the DSS output was highly effective in creating optimized FES patterns. The range of paretic foot motion was used as a quality indicator for the chosen patterns. The efficacy of the DSS in providing satisfactory pad-current amplitude choices for shaping the stimulation electrode was evaluated by trained clinicians. The DSS ranked combinations of pads and current amplitudes based on a novel measurement of the quality of the induced movement and classified them based on the movement direction (dorsiflexion, plantar flexion, eversion and inversion) of the paretic foot. The DSS output suggested stimulation pads and parameters based on muscle twitch responses to short stimulus trains. The system was tested in ten stroke survivors (3–96 months post stroke) with foot drop over 20 daily sessions. The DSS is part of a system for drop foot treatment that comprises a custom-designed multi-pad electrode, an electrical stimulator, and an inertial measurement unit. We described and tested a novel decision support system (DSS) to facilitate the process of multi-pad stimulation electrode shaping. Transcutaneous multi-pad electrodes can increase the selectivity of stimulation however, shaping the stimulation electrode becomes increasingly complex with an increasing number of possible stimulation sites. Functional electrical stimulation (FES) can be applied as an assistive and therapeutic aid in the rehabilitation of foot drop.