CHECGAIT: A Functional Electrical Stimulation Clinical Pathway to Reduce Foot Drop during Walking in Adult Patients with Upper Motor Neuron Lesions

Author:

Areno Gilles12,Chantraine Frédéric13,Schreiber Céline1ORCID,Masson Xavier14,Classen Tanja12,Pereira José Alexandre Carvalho3,Dierick Frédéric15ORCID

Affiliation:

1. Laboratoire d’Analyse du Mouvement et de la Posture (LAMP), Centre National de Rééducation Fonctionnelle et de Réadaptation—Rehazenter, Rue André Vésale 1, 2674 Luxembourg, Luxembourg

2. Physiotherapy Department, Centre National de Rééducation Fonctionnelle et de Réadaptation—Rehazenter, Rue André Vésale 1, 2674 Luxembourg, Luxembourg

3. Medical Department, Centre National de Rééducation Fonctionnelle et de Réadaptation—Rehazenter, Rue André Vésale 1, 2674 Luxembourg, Luxembourg

4. Päiperléck, Op Tomm 19, 5485 Wormeldange, Luxembourg

5. Faculté des Sciences de la Motricité, UCLouvain, Place Pierre de Coubertin 1-2, 1348 Ottignies-Louvain-la-Neuve, Belgium

Abstract

Foot drop during the swing phase of gait and at initial foot contact is a current kinematic abnormality that can occur following an upper motor neuron (UMN) lesion. Functional electrical stimulation (FES) of the common peroneal nerve through an assistive device is often used in neuro-rehabilitation to help patients regain mobility. Although there are FES-specific guideline recommendations, it remains a challenge for clinicians to appropriately select patients eligible for the daily use of FES devices, as very few health insurance systems cover its cost in Europe. In Luxembourg, since 2018, successfully completing an FES clinical pathway called CHECGAIT is a prerequisite to receiving financial coverage for FES devices from the national health fund (Caisse Nationale de Santé—CNS). This study describes the structure and steps of CHECGAIT and reports our experience with a cohort of 100 patients enrolled over a three-year period. The clinical and gait outcomes of all patients were retrospectively quantified, and a specific analysis was performed to highlight differences between patients with and without an FES device prescription at the end of a CHECGAIT. Several significant gait differences were found between these groups. These results and CHECGAIT may help clinicians to better select patients who can most benefit from this technology in their daily lives. In addition, CHECGAIT could provide significant savings to public health systems by avoiding unnecessary deliveries of FES devices.

Publisher

MDPI AG

Subject

General Medicine

Reference26 articles.

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