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Donna W1, Mendola-Byatt J1, Spadoni K1
1Robert Gordon University, School of Health Sciences, Aberdeen, United Kingdom
Background: Foot drop is a common clinical feature of neurological pathology. Such an impairment can lead to gait compensations such as slow walking, increased energy expenditure, reduced foot clearance and falls. If untreated, foot drop can have a significant impact on an individuals' Quality of Life (QOL). Functional Electrical Stimulation (FES) is an intervention which is used to address the effects of foot drop. Research into FES suggests walking speed and energy expenditure improves following application in stroke and there are positive effects on gait and falls in those with multiple sclerosis. Economic evaluations also demonstrate FES is a cost effective intervention. Despite this, evidence suggests that FES for lower limb foot drop is not widely available. The use of FES in physiotherapy practice has been evaluated in Canada but to date there is no current published literature on physiotherapy practice for FES for lower limb foot drop in the UK.
Purpose: Aim: To investigate UK physiotherapy practice with regard to FES for lower limb foot drop.
Objectives:
Methods: A descriptive enquiry using a survey approach was undertaken to establish a snapshot of physiotherapy practice. Following ethical approval and subsequent pilot, the e-survey was distributed to physiotherapists in the UK. In order to access a large and relevant sample of physiotherapists, the survey was distributed to the national special interest group, the national physiotherapy network and via relevant social media platforms.
All data was exported to excel and cleansed. Statistical analysis was performed on closed questions. Thematic analysis was performed on open text comments.
Results: A total of 219 responses were achieved from the questionnaire spanning all areas of practice in the UK. 86% of respondents had not received pre-registration FES training but 61% had since taken a continuing education course. All respondents regularly worked with patients with foot drop, however 6% of physiotherapists used FES most of the time, while 24% of physiotherapists had never utilised FES for foot drop.
Only 38% of respondents had specific referral criteria for the prescription of FES. Barriers to the use of FES were noted as lack of training, funding and access to FES units, while good referral pathways and a designated FES service were seen to be facilitators.
Conclusion(s): The use and application of FES for foot drop varies widely in the UK despite the evidence base supporting its use. Common facilitators to the use of FES include effective dedicated service provision and infrastructure whilst barriers such as lack of training and funding for FES units may restrict their use in practice.
Implications: Continuing education as well as development of referral pathways and services may aid the further implementation of evidenced based FES intervention.
Keywords: FES, Physiotherapy, Foot drop
Funding acknowledgements: There was no funding associated with this study.
Purpose: Aim: To investigate UK physiotherapy practice with regard to FES for lower limb foot drop.
Objectives:
- To establish physiotherapists frequency and pattern of use of FES for lower limb foot drop
- To investigate physiotherapists understanding of the evidence for FES for lower limb foot drop.
- To establish physiotherapists perceived barriers and facilitators to FES use for lower limb foot drop.
- To establish if physiotherapists have criteria for referral and prescription for FES for lower limb foot drop.
Methods: A descriptive enquiry using a survey approach was undertaken to establish a snapshot of physiotherapy practice. Following ethical approval and subsequent pilot, the e-survey was distributed to physiotherapists in the UK. In order to access a large and relevant sample of physiotherapists, the survey was distributed to the national special interest group, the national physiotherapy network and via relevant social media platforms.
All data was exported to excel and cleansed. Statistical analysis was performed on closed questions. Thematic analysis was performed on open text comments.
Results: A total of 219 responses were achieved from the questionnaire spanning all areas of practice in the UK. 86% of respondents had not received pre-registration FES training but 61% had since taken a continuing education course. All respondents regularly worked with patients with foot drop, however 6% of physiotherapists used FES most of the time, while 24% of physiotherapists had never utilised FES for foot drop.
Only 38% of respondents had specific referral criteria for the prescription of FES. Barriers to the use of FES were noted as lack of training, funding and access to FES units, while good referral pathways and a designated FES service were seen to be facilitators.
Conclusion(s): The use and application of FES for foot drop varies widely in the UK despite the evidence base supporting its use. Common facilitators to the use of FES include effective dedicated service provision and infrastructure whilst barriers such as lack of training and funding for FES units may restrict their use in practice.
Implications: Continuing education as well as development of referral pathways and services may aid the further implementation of evidenced based FES intervention.
Keywords: FES, Physiotherapy, Foot drop
Funding acknowledgements: There was no funding associated with this study.
Topic: Neurology; Electrophysical & isothermal agents
Ethics approval required: Yes
Institution: Robert Gordon University
Ethics committee: School of Health Sciences Research Review Group
Ethics number: SHS/18/13
All authors, affiliations and abstracts have been published as submitted.
