• J Rehabil Med · Feb 2013

    The long-term cost-effectiveness of the use of Functional Electrical Stimulation for the correction of dropped foot due to upper motor neuron lesion.

    • Paul Taylor, Laura Humphreys, and Ian Swain.
    • The National Clinical FES Centre, Salisbury District Hospital, Salisbury, United Kingdom. p.taylor@salisburyfes.com
    • J Rehabil Med. 2013 Feb 1; 45 (2): 154-60.

    ObjectiveFunctional Electrical Stimulation (FES) for correction of dropped foot has been shown to increase mobility, reduce the incidence of falls and to improve quality of life. This study aimed to determine how long the intervention is of benefit, and the total cost of its provision.DesignRetrospective review of medical records.ParticipantsOne hundred and twenty-six people with spastic dropped foot (62 stroke, 39 multiple sclerosis, 7 spinal cord injury, 3 cerebral palsy, 15 others) who began treatment in the year 1999.MethodAll received common peroneal nerve stimulation, producing dorsiflexion and eversion time to the swing phase of gait using a heel switch. Device usage, 10 m walking speed and Functional Walking Category (FWC) were recorded.ResultsThe median time of FES use was 3.6 years (mean 4.9, standard deviation 4.1, 95% confidence interval 4.2-5.6) with 33 people still using FES after a mean of 11.1 years. People with stroke walked a mean of 45% faster overall, including a 24% training effect with 52% improving their FWC. People with multiple sclerosis did not receive a consistent training effect but walked 29% faster when FES was used with 40% increasing their FWC. The average treatment cost was £3,095 per patient resulting in a mean cost per Quality Adjusted Life Years of £15,406.ConclusionFES is a practical, long-term and cost-effective treatment for correction of dropped foot.

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