1. FES Standing & Walking Dan Faulkner & Dom Driver

2. Paraplegic Stand and Walk Many methods for standing/walking, including Frames, Hydraulics, Pneumatics, FES.

3. What is FES? Functional Electric Stimulation. From the work of Faraday. A replacement for neuronal stimulation to a muscle group/fibre. “The principle of FES is to replace the nerve impulses to the muscles that are interrupted by damage to the brain or spinal cord with small electrical signals”

4. How does it work? Electrodes to stimulate muscle can be percutaneous or subcutaneous. Percutaneous stimulation from electrodes on the surface of the skin Subcutaneous – sacral anterior root

5. Who can use FES? SCI patients with lesions in mid to lower thorasic region Stroke related brain damage Head Injuries leading to brain damage Patients with Neurological problems (MS, Cerebral Palsy, Spasticity)

6. Why use FES? Allow people to stand or walk, and all the benefits that entails. Clinical Reasons Increased Muscle mass Increased Muscle mass Pressure sore relief Pressure sore relief Improve blood supply Improve blood supply Reduce osteoporosis. Reduce osteoporosis. Psychological Reasons Aesthetic improvement Aesthetic improvement Independence Independence Sense of Achievement Sense of Achievement

7. FES Standing Quadreceps muscles allow standing If stimulated strongly enough, allow extension of the knee upto the point where knees lock into stable standing position. If stimulated strongly enough, allow extension of the knee upto the point where knees lock into stable standing position. Gluteal muscles allow stability of hips. High knee velocities a problem Extra wear on knee joints Extra wear on knee joints Sensors & closed loop control reduce this problem.

8. FES standing

9. FES Walking Combination stimulus to quads and Peroneal nerve in lower leg.

10. Electrode Diagram

11. FES Walking