The WalkAide System

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The WalkAide System

• The WalkAide is a new battery-operated, single
  channel electrical stimulator that can be used
  for functional electrical stimulation.

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The WalkAide System

• Design Criteria
• Self-contained
• Built-in sensors
• Single-handed donning and doffing
• Self-aligning
• Comfortable
• Low profile
• Lightweight

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The WalkAide System

• One unique feature of the WalkAide is that it
  uses a Tilt Sensor to control stimulation during
  walking, thus eliminating the need for additional
  wires from a heel sensor.
• Expands shoe wear options for patients.

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The WalkAide System

• WalkAnalyst is a sophisticated computer software
  program that optimizes individual gait data for
  the unique needs of each patient.
• Bluetooth technology allows wireless transmission
  between the WalkAnalyst software and the WalkAide
  stimulator.

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Functional Electrical Stimulation (FES)

• FES is applicable to central nervous system (CNS)
  
• and/or upper motor neuron (UMN) involvements
• INDICATIONS for WalkAide
• With CNS pathology, the nerve to muscle pathway
  is intact, voluntary messages cannot get out.
• CONTRAINDICATIONS for WalkAide
• With PNS pathology, either nerve or muscle insult
  prevents transmission of messages.

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Patient Populations

• Who is medically eligible?
• General patient profile
• Joints that can move throughout the range needed
  (i.e. only minor contractures)
• Good general health
• Acceptance of technology
• Skin sensation than can tolerate surface
  electrodes
• Emotionally stable and realistic optimistic and
  motivated
• Committed to follow-up appointments

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Patient Populations

• INDICATIONS
• Upper motor neuron lesions
• CVA or stroke
• Incomplete SCI (T6? T12?)
• Traumatic brain injury
• Cerebral palsy
• Multiple sclerosis
• Familial hereditary spastic paraplegia (FSP)

Incomplete SCI
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Patient Populations

• CONSIDERATIONS
• Limited walking potential
• Decreased sensation / proprioception
• Combined orthotic / FES treatments

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Patient Populations

• Other factors
• History of falls
• Severe cardiac disease or pacemaker
• History of seizures
• Pregnancy
• Existing skin irritation around electrode site
• Fixed PF contracture
• Morbid obesity (BMI gt 40)
• Dysesthetic pain
• Inappropriate response to stimulation
• Unable to safely operate

• CONTRAINDICATIONS
• Lower motor neuron involvements
• Poliomyelitis
• Sciatica
• Spinal stenosis
• Guillain-Barre
• Peripheral nerve injury
• Spinal disc injury

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Functional Electrical Stimulation (FES)

• With injury to the CNS, command center signals
  between the CNS and the PNS are disrupted.
• Electrical stimulation over the motor nerve sends
  information in two directions
• Distally to create a functional movement, and
• Proximally to enhance central walking patterns or
  programs.

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Therapeutic Electrical Stimulation (TES)

• Therapeutic objective of electrical stimulation
• Treat the entire neuromusculoskeletal system
• Increase strength and endurance
• Maintain range of motion
• Reduce / delay / reverse muscle atrophy
• Increase circulation
• Reduce the incidence of injury
• Maintain or increase bone density
• Muscle re-education and facilitation
• To re-establish or improve voluntary control
• Improve motor recovery
• Reduce hypertonicity
• Improve sensory awareness

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Therapeutic Electrical Stimulation (TES)

• Using the Exercise Mode
• Patient is seated in comfortable, relaxed
  position with WalkAide in place.
• Exercise Mode is triggered by pressing and
  holding the button.
• ON and OFF times are determined by the
  medical team.
• Sessions up to 30 minutes can be programmed.

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Evidenced-Based Benefits of FES / TES

• Reduce spasticity
• Carryover effect
• Reduced effort in walking
• Slow osteoporosis, bone mineral loss
• Reduce swelling, formation of blood clots (deep
  venous thrombosis)
• Improve cardiovascular health / endurance
• Increased walking speed
• Synergy decrease
• Improved proprioception

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Evidenced-Based Benefits of FES / TES

• Improved walking performance
• Improved voluntary control
• Increased forcefulness of voluntary contraction
• Increased rate of improvement during acute phase
  of rehabilitation
• Improved swing phase kinematics
• Improved symmetry
• Improved floor contact patterns
• User preference / satisfaction

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Summary

• Electrical stimulation is a rapidly advancing
  medical technology that should be undertaken ONLY
  under the continual guidance and supervision of
  trained health care professionals.
• FES holds great potential to improve the health,
  well-being and quality of life of many people.

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