FastFES Project
	Fast FES Team Members Stuart Binder-Macleod, PT, PhD -Director Darcy Reisman, PT, PhD - Co-Director
	William Farquhar, PhD, Investigator Jill Higginson, PhD, Investigator Ramu Perumal, PhD, Investigator Katherine Rudolph, PT, PhD, Investigator Margie Roos, PT, DPT, NCS, Research PT	Trisha Kesar, PT, MS, PhD Leigh Shrewsbury, Stroke Studies                              Coordinator
	Resources for FastFES Team	Contact us for more information

Information for POTENTIAL PARTICIPANTS

What is FES? What is the FastFES project? The FastFES team Who can Participate? What is the testing like? Is there a cost to Participate? Directions to UD Physical Therapy

The Fast-FES Team

What is FES?

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.

What is the FastFES project?

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 treadmill training on daily function and quality of life in people with hemiparesis after stroke. Currently, people who have had a stroke are randomly placed in 1 of 3 treadmill training groups.  While on the treadmill, the first group walks at a comfortable pace, the second group walks at a faster pace, and the third group walks at a faster pace with electrical stimulation to ankle muscles.  We are interested in seeing which group is able to show greater improvements in walking patterns, walking speed and reducing the energy cost of over ground walking.

All participants of the FastFES project will walk on a treadmill 3 times per week for 12 weeks under the supervision of a Research Physical Therapist. 

Comfortable Pace Walking Group:  Individuals in this group will walk on treadmill (with a safety harness) at a pace which is similar to the walking pace they use every day when moving around the house. 

Faster Pace Walking Group:  Individuals in this group will walk on the treadmill (with a safety harness) at a faster pace that is determined during a practice session. 

FastFES Walking Group:  Individuals in this group will walk at a faster pace on the treadmill with Functional Electrical Stimulation (FES) to the muscles in the lower leg that control ankle movement.  FES 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 Research Team

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. Jill Higginson), locomotion (Dr Trisha Kesar), locomotion and electromyography (Dr. Katherine Rudolph), self-efficacy (Dr. Ingrid Pretzer-Aboff) and Physical Therapy (Drs. Margie Roos & Tamara Wright).

Who can Participate?

To participate you must:

be 30-80 years of age, and in reasonably 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
be able to walk without a brace on your leg
be able to walk for 5 minutes continuously
be able to come for treadmill training 3 times per week for a 12 week period of time
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?

For most sessions, you will need to wear a loose fitting T-shirt, loose fitting shorts and athletic shoes.

Participate in PRE-TRAINING EVALUATIONS

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 while walking

During this session, you can wear comfortable clothes and athletic shoes.  If you typically wear a brace in your shoe, you may want to bring a pair of shoes that are comfortable to walk in when you are not wearing your brace.
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 this session, you can wear comfortable clothes and athletic shoes.

During MOTION ANALYSIS, researchers will

• Record your body movements as you walk on the treadmill

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.    During this session, you will need to wear a loose fitting T-shirt, loose fitting shorts and athletic shoes.

During ENERGY EFFICIENCY TESTING, researchers will

• Measure the amount of oxygen you use while you walk on the treadmill at the different speeds from slow to fast.

While walking on the treadmill, you will wear a nose clip and breathe through a mouthpiece so that the air you breathe out can be sampled for oxygen content. During this session, you can wear comfortable clothes and athletic shoes.

When you have completed your Pre-Training Evaluations, we will provide you with a $100.00 honorarium.

Participate in TRAINING SESSIONS

• Each subject will receive treadmill training 3 times per week for 12 weeks.  The training will be completed with the assistance of a licensed Physical Therapist
• Prior to beginning walking on the treadmill, each subject will perform gentle leg stretches
• During the treadmill walking session, your heart rate and blood pressure will be monitored
• You will walk with a harness around your chest for safety.
• The total amount of time you will be walking is 36 minutes.  30 minutes of treadmill walking followed by 6 minutes of walking over ground

Participate in POST-TRAINING EVALUATIONS

These evaluations are the same as those mentioned in the Pre-Training Evaluations with the addition of an interview session.  During the interview, a researcher will ask you about your opinion about participating in the treadmill training study. When you have completed your Post-Training Evaluations, we will provide you with a $100.00 honorarium.

Participate in FOLLOW-UP EVALUATIONS

These evaluations are the same as those mentioned in the Pre-Training Evaluations. When you have completed your Follow-Up Evaluations, we will provide you with a $100.00 honorarium.

Is there a cost to Participate?

There is no cost to participate in the FastFES Project.  A physical therapist will work with you throughout your participation in the project to help you with your goal to improve your walking.

Who can I contact for more information?

For more information about the FastFES study please contact:
Leigh Shrewsbury, Stroke Studies Coordinator 302-831-4615 or UDPTresearch@udel.edu

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