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FastFES Project |
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Fast FES Team Members |
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Information for POTENTIAL PARTICIPANTS
 What is FES? What is the FastFES project? Who can Participate? What is the testing like? Is there a cost to Participate? Directions to UD Physical Therapy |
 The Fast-FES Team |
| To see the WHYY news broadcast story on the Fast-FES Project, click here. |
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FES stands for Functional Electrical Stimulation which is a type of treatment that involves activating muscles with mild electrical pulses with a small portable stimulator during activity. Normally, the brain sends signals to muscles to contract and produce movement. When signals from the brain to the muscles are impaired, such as after a stroke, FES can be used to activate the muscles to produce movements that improve function. In addition, FES may also help individuals learn how to activate their muscles on their own.
The FastFES project is a research study in the Department of Physical Therapy, funded by the National Institutes of Health, to study the effect of FES and Fast Walking on daily function and quality of life in people with hemiparesis after stroke. The study involves the development of a treadmill walking program that is customized for each participant to improve walking patterns, increase walking speed and reduce the energy cost of overground walking.
The FES that is applied to the muscles is based on novel and innovative stimulation methods developed by Dr. Stuart Binder-Macleod, a physical therapist and internationally known researcher in muscle physiology and electrical stimulation, in the Muscle Performance Laboratory. Dr. Binder-Macleod teamed up with Dr. Darcy Reisman, a physical therapist and researcher at UD who is an expert in motor control and locomotion in people with hemiparesis, to develop this ground breaking study to investigate a treatment intervention that may improve walking function better than current rehabilitation techniques. The multidisiplinary team is rounded out by experts in exercise science (Dr. Bill Farquhar), engineering (Dr. Ramu Perumal and Dr. Jill Higginson), locomotion and electromyography (Dr. Katherine Rudolph), and Physical Therapy (Dr. Margie Roos).
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| Typical Walking Training Session on Treadmill |
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To participate you must:
be 18-80 years of age, and in general good health
have experienced only one stroke, affecting one side of the body
be able to understand spoken instruction and communicate with the investigators
be able to walk without the assistance of another person but may use a leg brace or an assistive device (cane etc.)
give consent for the investigators to contact your physician to request medical clearance for you to participate
What will I need to do if I become a subject?
There are three stages to the FastFES study. If eligible, you can participate in all 3 stages if you wish to do so. For most sessions, you will need to wear a loose fitting T-shirt, loose fitting shorts and athletic shoes.
Stage 1: Clinical Testing with Strength Testing, Treadmill Walking and Energy Efficient Testing
During clinical testing, researchers will measure:
- Sensation in your impaired leg
- Your ability to tell movement of your impaired leg when your eyes are closed
- The motion that you have in the joints in your legs
- Your strength and coordination when you move your legs in different combinations while lying down, in sitting and in standing
- Your ability to walk at different speeds on the ground
- Your balance during everyday tasks
During strength testing, researchers will measure your muscles' responses to stimulation as you are seated on a force measurement device. The muscles in the front of your leg and in your calf will be stimulated using a pair of adhesive pads placed on your skin (see pictures at right and below). The level of stimulation, though it may cause a "prickly" sensation on your skin and will make your muscle feel like it is being squeezed, should not be painful. Each stimulation will last no more than 1 second. You will be asked to relax your muscles during most of the testing. However, for a portion of the testing, you will be requested to contract your muscle during the stimulation so that the researchers can evaluate the force response of your muscle.
During treadmill walking, researchers will place elastic bands around your thighs and calves to which small, reflective balls will be attached. Balls will be taped to your sneakers and on you upper back, shoulder, wrist, pelvis, hip, knee and ankle joints with adhesive tape. Eight video cameras will record the movements of these balls and be able to tell us how you move when you walk on the treadmill. A safety harness will be attached to you to prevent any loss of balance as you walk at different speeds from slow to fast. You will also be able to hold onto a handrail on the treadmill.
During the energy efficient training, the amount of oxygen you will use will be measured during treadmill walking speeds that you choose during the previous session. You will wear a nose clip and breathe through a mouthpiece so that the air you breathe out can be sampled for oxygen content.
Stage 2: Treadmill Walking with FES
During this stage, you will do similar tasks as those described in treadmill walking above. The differences are that you will walk on the treadmill at different speeds while receiving electrical stimulation to the muscles on the front of your leg and your calf (see pictures at left and above). Stimulation to the front of the leg will help to lift your toes as you swing your paralyzed leg during walking. Stimulation to the calf muscle will help you to push down on the treadmill belt during walking. These electrical stimulations will last no more than 1 second and should not be painful. This stage allows the researchers to determine the best stimulation parameters for Stage 3.
Stage 3: Training with FES
The training phase of this study will help us develop procedures that may allow stroke survivors to walk more efficiently and become less tired. In this phase, you will undergo training on the treadmill and over ground with and without electric stimulation 3 times per week for a total of approximately 36 training sessions. Every 4 weeks, you will undergo the evaluation sessions again as mentioned during Stage 1 which allow us to document your progress. When you have finished all the training sessions, we will ask you to come back in 3 months to undergo the evaluations again to see how you have been walking since you finished the study.
Is there a cost to Participate?
There is no cost to participate in this study. Subjects will be paid an honorarium of $30 for participation in each evaluation session.
Who can I contact for more information?
For more information about the FastFES study please contact:
Leigh Shrewsbury, Stroke Studies Coordinator 302-831-4616 or UDPTresearch@udel.edu
INformation for Medical Professionals
