Odstock Medical Limited – FES pioneer

Functional Electrical Stimulation (FES) uses small electrical impulses to stimulate muscles weakened by damage to the brain or spinal cord in adults and children.

The technique is used to assist walking, improve hand and arm function and assist other bodily functions.

Odstock Medical Limited (OML) is a major innovator of FES in the UK. Based at Salisbury District Hospital, the company provides clinical services, equipment and training.

OML is also researching into new applications of FES, for example, FES to reduce the some symptoms of Parkinson’s disease, improving the recovery after total hip replacement and the treatment of constipation in neurogenic bowel conditions.

Paul Taylor is co-founder and clinical director at OML.

A biomechanical engineer by background, Paul’s journey with OML began in 1986, with funding from the Department of Health to investigate electrical stimulation for the rehab of spinal cord injury.

“FES isn’t a new thing. The concept goes back to the early ‘60s but it failed to make it into service back then,” Paul says.

“I designed a new kit, worked out clinical methods for using it and provided courses for teaching other people how to use it.

“We made a device specifically for stroke patients that was shown to improve walking.

“More patients got referred, more devices were made and it soon became clear that more and more conditions could benefit from FES.”

Despite promising research and routine use of FES in the former Yugoslavia, globally, the technique was slow to take off.

Paul and his team were one of the first to bring the FES into the clinic in the UK, with the aim of making it a routine application for patients at Salisbury and further afield.

While early investigations explored FES for spinal cord injury, it soon became clear that people with stroke and MS could find significant benefit.

Paul explains:

“We originally investigated FES to provide standing for people with spinal cord injury.

“If the equipment stopped working, they would muddle through and get around to telling you at some point.

“But if the walking stimulator for drop foot stopped working, the patients would be banging the door, wanting it replaced as soon as possible because it made such a huge difference.”

“This certainly shows that patients experience improved quality of life and improved activities of daily living.

“And for some, it’s the difference between walking and not walking at all, so it does make a big difference.

“It’s not one-solution-fits-all. We have a suite of solutions to suit individual patients for their individual needs.

“Likewise, we can use FES to improve knee and hip movement.”

NICE guidance from 2009 established FES as routine NHS treatment for drop foot due to brain or spinal cord injury.

Also, national guidelines for how FES is implemented in clinical practice have recently been published by the Association of Charted Physiotherapist In Neurology.

To access NHS treatment, patients have to be referred by a GP, MS nurse or neurologist.

But whether NHS or privately-funded, FES has been shown to be a long-term cost-effective treatment.

Paul says:

“The latest independent study showed that FES is cost-effective in comparison to ankle foot orthoses (AFOs).

“Although the orthoses were cheaper, the adherence rate for FES was about double that of the AFO, and the improvements and quality of life benefits were greater overall.

“In fact, one of the patients from our original randomised controlled trial is still using their FES device 30 years later.”

OML’s technologies are now helping countless patients across stroke, brain injury, cerebral palsy, Parkinson’s disease and beyond, with new innovations currently under development.

Paul says:

“We’re developing a new stimulator device to give hand movement to people with tetraplegia. It’s called Tetra Grip.

“We are also waiting to hear if we’ll get further funding to develop a new generation of stimulator, designed to extend the range of disabilities that can be helped by FES.”

Despite significant evidence for FES, there are still areas of the country where it is not routinely funded by the NHS.

This year the MS society has launched a campaign to improve access to FES.

You can join their campaign at  https://www.mssociety.org.uk/care-and-support/professionals/evidence-professionals

Find out more about OML at odstockmedical.com