Cited by 277Stroke Rehabilitation and RecoveryProsthetics and Rehabilitation RoboticsNeuroscience and Neural Engineering

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A review of portable FES-based neural orthoses for the correction of drop foot

Lyons, G.M., Sinkjaer, T., Burridge, J.H., Wilcox, D.J.·2002·IEEE Transactions on Neural Systems and Rehabilitation Engineering

DOI 10.1109/tnsre.2002.806832

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Abstract

This paper reviews the technological developments in neural orthoses for the correction of upper motor neurone drop foot since 1961, when the technique was first proposed by Liberson and his co-workers. Drop foot stimulator (DFS) developments are reviewed starting with hard-wired single-channel and multichannel surface functional electrical stimulation (FES) systems, followed by implanted drop foot stimulators, and then continuing with microprocessor-based surface and implanted drop foot stimulators. The review examines the role of artificial and "natural" sensors as replacements for the foot-switch as the primary control sensor in drop foot stimulators. DFS systems incorporating real-time control of FES and completely implanted DFS systems finish the review.

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Background
A Preliminary Study on Robot-Assisted Ankle Rehabilitation for the Treatment of Drop Foot
Zhang, M., Cao, J., Xie, S. Q., Zhu, G., Zeng, X., Huang, X., & Xu, Q. (2017) · Journal of Intelligent & Robotic Systems · doi:10.1007/s10846-017-0652-0 · Cited by 37
Real-Time Closed-Loop Functional Electrical Stimulation Control of Muscle Activation with Evoked Electromyography Feedback for Spinal Cord Injured Patients
Li, Z., Guiraud, D., Andreu, D., Gélis, A., Fattal, C., & Hayashibe, M. (2017) · International Journal of Neural Systems · doi:10.1142/s0129065717500630 · Cited by 37
Brain-controlled muscle stimulation for the restoration of motor function
Éthier, C., & Miller, L. E. (2014) · Neurobiology of Disease · doi:10.1016/j.nbd.2014.10.014 · Cited by 40
A Novel sEMG Triggered FES-Hybrid Robotic Lower Limb Rehabilitation System for Stroke Patients
Petersen, I. L., Nowakowska, W., Ulrich, C., & Struijk, L. N. S. A. (2020) · IEEE Transactions on Medical Robotics and Bionics · doi:10.1109/tmrb.2020.3019081 · Cited by 36
Appropriate Mother Wavelets for Continuous Gait Event Detection Based on Time-Frequency Analysis for Hemiplegic and Healthy Individuals
Ji, N., Zhou, H. D., Guo, K., Samuel, O. W., Huang, Z., Xu, L., & Li, G. (2019) · Sensors · doi:10.3390/s19163462 · Cited by 35
Electronic stimulators for surface neural prosthesis
Broderick, B. J., Breen, P. P., & OLaighin, G. M. (2008) · Journal of Automatic Control · doi:10.2298/jac0802025b · Cited by 35
“[3] and the restoration of upper and lower limb functions in”
Background
Changes in the electrical properties of the electrode–skin–underlying tissue composite during a week-long programme of neuromuscular electrical stimulation
Bîrlea, S. I., Breen, P. P., Corley, G. J., Bîrlea, N. M., Quondamatteo, F., & OLaighin, G. M. (2014) · Physiological Measurement · doi:10.1088/0967-3334/35/2/231 · Cited by 34
“Some of the functional applications of NMES include electrical stimulation assisted standing or walking (Lyons et al 2002b, Mushahwar et al 2007, Popović et al 2008), upper-limb motor restoration following stroke (Mangold et al 2009, Chan et al 2009, Chan et al 2006) and control of respiratory…”
Background
Feedback control of foot eversion in the adaptive peroneal stimulator
Seel, T., Laidig, D., Valtin, M., Werner, C., Raisch, J., & Schauer, T. (2014) · Mediterranean Conference on Control and Automation (MED) · doi:10.1109/med.2014.6961585 · Cited by 34
Adaptive Inverse Optimal Neuromuscular Electrical Stimulation
Wang, Q., Sharma, N., Johnson, M., Gregory, C. M., & Dixon, W. E. (2013) · IEEE Transactions on Cybernetics · doi:10.1109/tsmcb.2012.2228259 · Cited by 33
Restoration of ankle movements with the ActiGait implantable drop foot stimulator: a safe and reliable treatment option for permanent central leg palsy
Martin, K., Polanski, W. H., Schulz, A.-K., Jöbges, M., Hoff, H., Schackert, G., Pinzer, T., & Sobottka, S. B. (2015) · Journal of neurosurgery · doi:10.3171/2014.12.jns142110 · Cited by 33
Adaptive multichannel FES neuroprosthesis with learning control and automatic gait assessment
Müller, P., del‐Ama, A. J., Moreno, J. C., & Schauer, T. (2020) · Journal of NeuroEngineering and Rehabilitation · doi:10.1186/s12984-020-0640-7 · Cited by 31
Hemodynamic effects of habituation to a week-long program of neuromuscular electrical stimulation
Corley, G. J., Breen, P. P., Bîrlea, S. I., Serrador, J. M., Grace, P. A., & OLaighin, G. M. (2011) · Medical Engineering & Physics · doi:10.1016/j.medengphy.2011.08.005 · Cited by 31
Continuous gait cycle index estimation for electrical stimulation assisted foot drop correction
Coste, C., Jović, J., Pissard-Gibollet, R., & Froger, J. (2014) · Journal of NeuroEngineering and Rehabilitation · doi:10.1186/1743-0003-11-118 · Cited by 30
“Abbreviations FES: Functional electrical stimulation; DFS: Droop foot stimulator; GCI: Gate cycle index; Std: Standard deviation.”
BackgroundInfluential
Novel multi-pad functional electrical stimulation in stroke patients: A single-blind randomized study
Dujović, S. D., Malesevic, J. M., Malešević, N., Vidakovic, A. S., Bijelić, G., Keller, T., & Konstantinović, L. M. (2017) · Neurorehabilitation · doi:10.3233/nre-172153 · Cited by 30
“(Lyons, Sinkjær, Burridge, & Wilcox, 2002).”
A programmable and portable NMES device for drop foot correction and blood flow assist applications
Breen, P. P., Corley, G. J., O'Keeffe, D. T., Conway, R., & OLaighin, G. M. (2008) · Medical Engineering & Physics · doi:10.1016/j.medengphy.2008.05.003 · Cited by 30
“An extensive review of portable FES-based neural orthoses for the correction of drop foot up until 2002 was conducted by Lyons et al. [ 2 ].”
Background
A Practical Gait Feedback Method Based on Wearable Inertial Sensors for a Drop Foot Assistance Device
Meng, L., Martínez-Hernández, U., Childs, C. R., Dehghani-Sanij, A. A., & Buis, A. W. P. (2019) · IEEE Sensors Journal · doi:10.1109/jsen.2019.2938764 · Cited by 29
“Most devices for drop foot correction depend on simple and fixed pattern control where gait events switch on/off the external assistance, making these robots susceptible to failure during the assistance to human [7].”
Background
State of the Art in Gait Analysis Using Wearable Sensors for Healthcare Applications
Zhang, B., Jiang, S., Wei, D., Marschollek, M., & Zhang, W. (2012) · IEEE/ACIS International Conference on Computer and Information Science (ICIS) · doi:10.1109/icis.2012.100 · Cited by 28
A Dual-Modal Approach Using Electromyography and Sonomyography Improves Prediction of Dynamic Ankle Movement: A Case Study
Zhang, Q., Iyer, A., Sun, Z., Kim, K., & Sharma, N. (2021) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2021.3106900 · Cited by 28
Nonlinear model predictive control of joint ankle by electrical stimulation for drop foot correction
Benoussaad, M., Mombaur, K., & Coste, C. (2013) · IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS) · doi:10.1109/iros.2013.6696470 · Cited by 28
The ICVSIE: A General Purpose Integral Equation Method for Bio-Electromagnetic Analysis
Gomez, L. J., Yücel, A. C., & Michielssen, E. (2017) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2017.2704540 · Cited by 27
“Finally, the ICVSIE and VIE are used to simulate NMES, a procedure widely used to induce artificial muscle contractions during physical therapy [43]–[45].”
Method
Muscle Synergy-Based Functional Electrical Stimulation Reduces Muscular Fatigue in Post-Stroke Patients: A Systematic Comparison
Bala, S., Vishnu, V. Y., & Joshi, D. (2023) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2023.3290293 · Cited by 27
“acteristics under clinical settings [9], [10].”
Accelerometers and Force Sensing Resistors for Optimal Control of Walking of a Hemiplegic
Dosen, S. S., & Popović, D. B. (2008) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2008.919715 · Cited by 27
“The cost function Rn was nonlinear with respect to the controls and it had to be minimized subject to constraints involving both the state variables (e.g., physiological joint constraints) and control inputs (e.g., ui∈[0, 1 ]).”
BackgroundMethodInfluential
Dynamic optimization of stimulation frequency to reduce isometric muscle fatigue using a modified Hill‐Huxley model
Doll, B. D., Kirsch, N. A., Bao, X., Dicianno, B. E., & Sharma, N. (2017) · Muscle & Nerve · doi:10.1002/mus.25777 · Cited by 26
“FES allows individuals with mobility impairments to perform functional tasks, such as standing and walking(2) or grasping,(3,4) and it is also used to correct physical impairments, such as loss of arm control(5) and drop foot.(6) FES recruits motor units in a nonselective, spatially fixed, and temporally synchronous p…”
Background
A system for the delivery of programmable, adaptive stimulation intensity envelopes for drop foot correction applications
Breen, P. P., O'Keeffe, D. T., Conway, R., & Lyons, G. M. (2005) · Medical Engineering & Physics · doi:10.1016/j.medengphy.2005.04.008 · Cited by 26
“Electronics technology has evolved a great deal since 1961, as have the methods used to combat drop-foot [2].”
MethodSelf-citation
Enhancing functional electrical stimulation for emerging rehabilitation robotics in the framework of hyper project
Brunetti, F., Garay, A. Y. B., Moreno, J. C., & Pons, J. L. (2011) · International Conference on Rehabilitation Robotics · doi:10.1109/icorr.2011.5975370 · Cited by 26
“Unlike CVA, almost the 50% of SCI population is between the ages of 16 and 30, causing an even deeper impact in social structure and important economical burdens, [14].”
BackgroundInfluential
Ultrasound Echogenicity as an Indicator of Muscle Fatigue during Functional Electrical Stimulation
Zhang, Q., Iyer, A., Lambeth, K., Kim, K., & Sharma, N. (2022) · Sensors · doi:10.3390/s22010335 · Cited by 25
Spatiotemporal and Kinematic Effect of Peroneal Nerve Stimulation Versus an Ankle‐Foot Orthosis in Patients With Multiple Sclerosis: A Case Series
Sheffler, L. R., Bailey, S. N., & Chae, J. (2009) · PM&R · doi:10.1016/j.pmrj.2009.04.002 · Cited by 25
“Functional electrical stimulation in the form of peroneal nerve stimulation (PNS) [7] may e a promising alternative to the use of an AFO in the MS patient population.”
Background
Automatic Control of a Drop‐Foot Stimulator Based on Angle Measurement Using Bioimpedance
Nahrstaedt, H., Schauer, T., Shalaby, R., Hesse, S., & Raisch, J. (2008) · Artificial Organs · doi:10.1111/j.1525-1594.2008.00617.x · Cited by 25
Improvement in Functional Ambulation as a Therapeutic Effect of Peroneal Nerve Stimulation in Hemiplegia: Two Case Reports
Sheffler, L. R., Hennessey, M. T., Naples, G. G., & Chae, J. (2007) · Neurorehabilitation and neural repair · doi:10.1177/1545968306297869 · Cited by 25
A decision support system for electrode shaping in multi-pad FES foot drop correction
Malesevic, J. M., Dujović, S. D., Savić, A. M., Konstantinović, L. M., Vidakovic, A. S., Bijelić, G., Malešević, N., & Keller, T. (2017) · Journal of NeuroEngineering and Rehabilitation · doi:10.1186/s12984-017-0275-5 · Cited by 25
“, the dorsiflexion (DF) of the ankle (for a review, see references [8, 9]).”
Background
Withdrawal reflex responses evoked by repetitive painful stimulation delivered on the sole of the foot during late stance: site, phase, and frequency modulation
Spaich, E. G., Emborg, J., Collet, T., Arendt‐Nielsen, L., & Andersen, O. K. (2009) · Experimental Brain Research · doi:10.1007/s00221-009-1705-9 · Cited by 24
Functional electrical stimulation of gluteus medius reduces the medial joint reaction force of the knee during level walking
Rane, L., & Bull, A. M. J. (2016) · Arthritis Research & Therapy · doi:10.1186/s13075-016-1155-2 · Cited by 24
“Here, treatments that aim to increase activation, and thus power, must bypass the damaged central nervous system, and one way in which this can be achieved is by direct activation of muscle and nerve with electrical current, a technique that has widespread clinical use under the term functional electrical stimulation…”
Background
Neuroprosthetics in amputee and brain injury rehabilitation
Eapen, B. C., Murphy, D. P., & Cifu, D. X. (2016) · Experimental Neurology · doi:10.1016/j.expneurol.2016.08.004 · Cited by 25
“Later that year, a prosthetic device was developed to address foot drop in hemiplegics due to motor loss but it was not until themid-1990's the clinical trials proved functional electrical stimulation (FES) of motor nerves and muscles showed efficacy(Lyons et al., 2002).”
Background
Gait phase detection from sciatic nerve recordings in functional electrical stimulation systems for foot drop correction
Chu, J., Song, K., Han, S., Lee, S. H., Kang, J. Y., Hwang, D., Suh, J. F., Choi, K., & Youn, I. (2013) · Physiological Measurement · doi:10.1088/0967-3334/34/5/541 · Cited by 23
Clinical Application of Peroneal Nerve Stimulator System Using Percutaneous Intramuscular Electrodes for Correction of Foot Drop in Hemiplegic Patients
Shimada, Y., Matsunaga, T., Misawa, A., Ando, S., Itoi, E., & Konishi, N. (2006) · Neuromodulation Technology at the Neural Interface · doi:10.1111/j.1525-1403.2006.00074.x · Cited by 23
“(14) reviewed technological developments in neural orthoses for correction of foot drop since 1961, when the technique was first proposed by Liberson et al.”
Method
Adaptive Neuro-Fuzzy Sliding Mode Control of Multi-Joint Movement Using Intraspinal Microstimulation
Asadi, A., & Erfanian, A. (2012) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2012.2197828 · Cited by 23
Assessment of a two-channel implantable peroneal nerve stimulator post-stroke
Kottink, A. I. R. (2009) · doi:10.3990/1.9789036529594 · Cited by 22
Development of practical functional electrical stimulation cycling systems based on an electromyography study of the Cybathlon 2016
Arnin, J., Yamsa-ard, T., Triponyuwasin, P., & Wongsawat, Y. (2017) · European Journal of Translational Myology · doi:10.4081/ejtm.2017.7111 · Cited by 21
Iterative Adjustment of Stimulation Timing and Intensity During FES-Assisted Treadmill Walking for Patients After Stroke
Jiang, C., Zheng, M., Li, Y., Wang, X., Li, L., & Song, R. (2020) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2020.2986295 · Cited by 21
“using open-loop controller, which is a feed forward controller with preset parameters and without feedback information from sensors [19], [20].”
Method
Volitional EMG Estimation Method during Functional Electrical Stimulation by Dual-Channel Surface EMGs
Jung, J.-Y., Lee, D.-W., Son, Y. K., Kim, B. S., & Shin, H. C. (2021) · Sensors · doi:10.3390/s21238015 · Cited by 21
“, hand mobility rehabilitation for stroke patients [1], dorsiflexion rehabilitation for foot drop patients [2], and rehabilitation for spinal cord injury patients [3–5].”
Background
Robot-assisted ankle rehabilitation for the treatment of drop foot: A case study
Zhu, G., Zeng, X., Zhang, M., Xie, S. Q., Meng, W., Huang, X., & Xu, Q. (2016) · IEEE/ASME International Conference on Mechatronic and Embedded Systems and Applications · doi:10.1109/mesa.2016.7587130 · Cited by 20

Authors: Lyons, G. M., Sinkjaer, T., Burridge, J. H., & Wilcox, D. J.
Affiliations: University of Limerick (IE)
University of Southampton (GB)
Ollscoil na Gaillimhe – University of Galway (IE)
ORCID: Burridge, J.H.
Venue: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Published: 2002-12
Volume: 10
Issue: 4
Pages: 260-279
ISSN: 1534-4320 (ISSN-L)
1558-0210
DOI: 10.1109/tnsre.2002.806832
OpenAlex: W2165067332
Cited by: 277
References: 48
Citations by year: 2026: 1 · 2025: 4 · 2024: 8 · 2023: 8 · 2022: 10 · 2021: 10 · 2020: 14 · 2019: 9 · 2018: 10 · 2017: 20 · 2016: 17 · 2015: 20 · 2014: 16 · 2013: 19 · 2012: 13
FWCI: 5.82
Type: journal article
Language: en
Open access: closed
Licence: ieeexplore.ieee.org/Xplorehelp/downloads/license-information/IEEE.html (vor)
Locations: IEEE Transactions on Neural Systems and Rehabilitation Engineering (publishedVersion)
PubMed (publishedVersion)
VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
Topics: Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
Physical Sciences › Engineering › Biomedical Engineering › Prosthetics and Rehabilitation Robotics
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
Keywords: foot drop, functional electrical stimulation, upper motor neuron lesion, surface stimulation
MeSH terms: Electrodes, Implanted, Electric Stimulation Therapy, Equipment Design, Foot, Humans, Microelectrodes, Miniaturization, Orthotic Devices, Peroneal Nerve, Therapy, Computer-Assisted, Transducers, Muscle, Skeletal, Gait Disorders, Neurologic

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A review of portable FES-based neural orthoses for the correction of drop foot

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