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The new e-step – FES technology from DM Orthotics

DM Orthotics is launching an exciting new product aimed at Dropfoot patients which incorporates FES technology with their own Lycra orthoses. The DMO Medical e-step is a hybrid neuromuscular stimulation unit which is incorporated into the highly successful DMO Dorsiflex Sock. It combines stimulation with ankle support and proprioception to provide a more natural walking pattern.

DM Orthotics Managing Director, Martin Matthews, approached Southapton University’s Rod Lane to collaborate on the project. Rod has been a specialist in FES for a number of years and has been credited with the development of a number of neuromuscular stimulation devices which restore functional movement following the effects of stroke.

The aim to was to create a market leading device which would not only improve people’s walking patterns but also give them added stability.

Martin comments,
“I have wanted to incorporate FES technology into some of our products for quite some time – but it was the case of being able to develop an innovative solution that would address the specific problems other products on the market were unable to. Research suggested that although many stimulators were able to provide an improvement to the gait of people with Dropfoot, they set the foot in an un-natural position in order to improve stability in their foot.”

The FES stimulator has a number of other advances developed by Rod, which set it apart from the competition. It has a wireless footswitch and motion sensor which utilise Bluetooth technology to detect; unloading at the end of stance as well as heel strike at the end of swing; shank movement and angle to determine the beginning and end of swing.

Rod Lane speaks on other advantages to incorporating the stimulator with the sock.
“There are a number of problems associated with the use of FES alone for the treatment of Dropfoot. These include; daily accurate electrode positioning, hygiene and skin irritation, and the effects of inappropriate foot positioning. The solution that we have developed addresses each of these issues.

By combining the stimulator with the sock we are able to improve a number of things for the user. FES stimulators are a great way to improve walking pattern for people with symptoms such as those associated with Dropfoot, but they lack ankle stability which reduces the potential for a more natural heel strike. Often stimulators are set up to produce foot eversion as well as dorsiflexion to ensure stability at heel strike. This is the opposite to normal gait, where the foot lands slightly inverted, rolling into eversion during stance, ahead of the next swing. Landing on an everted foot can produce abnormal loading on the inside of the knee joint as well as abnormal gait pattern. By using dynamic elastomeric splinting to stabilise the ankle, the FES can be targeted to produce dorsiflexion with a small amount of eversion to promote a more natural gait pattern.”

Rod explains,
“The Flexi-trode technology enables us to place the electrode pads permanently in precisely the right position for the user without having to reset them each time it is worn. This has huge advantages in ensuring the unit is set up for optimum use every time it is used and also addresses compliance issues associated with skin irritation and hygiene.”

The e-step sock has undergone a number of clinical tests which have shown positive results. Subjects were asked to undergo two tests to assess changes in walking speed and stride length to measure the change in effort required to walk using the e-step versus not using it. In each case improvements were seen in both walking speed and stride length with one subject seeing a reduction in the effort to walk of 51.6%.

Martin Matthews concludes,
“We are really passionate about this innovation and the potential it has to offer people who have Dropfoot and similar conditions. I really think we have developed something that will enhance people’s ability to be more active, improve their confidence and help them lead more independent lives. We have some other ideas in the pipeline that work off this principle – it’s an exciting time for us.”

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