13 msfocusmagazine.org For persons living with multiple sclerosis, walking and other everyday movements may become a significant problem, limiting independence in the home and community. Persons with MS who have difficulty with movement should see a physical therapist. A PT will examine you to determine your movement limitations, such as walking and balance, and will develop a treatment pro- gram to address any deficits. Therapists may prescribe electrical stimulation devices specifically for persons with MS. The purpose of these devices is not to replace exercise and mobility programs, but rather to supplement them in an effort to maximize function and promote greater independence. There are several different electrical stimulation devices currently available that can be used bypersonswith MS. It is important to realize that each device has specific uses dependingontheindividual’sprimarycomplaint, problem, and preference. These include movement-related problems, increased pain, and muscle stiffness,which maymake moving uncomfortable or very difficult. Functional Electrical Stimulation (FES) FESprovideselectriccurrents to certain muscles to allow for assisted movement during specific activities. It is most commonly utilized to treat a condition called “foot drop,” where the individual is unable to lift their ankle upwards, resulting in dragging and/or catching of the foot when walking. Foot drop is very common in MS and can lead to balance loss and falls. Besides treating foot drop, FES can also assist with thigh weakness, and to assist with arm or leg cycling. FES for foot and thigh When used for foot drop, FES works by stimulating the nerve that is responsible for lifting up the front of the foot during walking. The device can sense where the individual’s foot is during walking and provide electrical impulses to the nerve at the appropriate time to allow the foot to clear the ground when stepping. Compared to using a regular ankle brace that is frequently utilized for foot drop, FES has the advantage of creating a more symmetrical and normal walking pattern by activating the ankle muscles, rather than merely preventing the foot from dragging. In other words, the FES device allows your ankle to move, while a plastic brace does not. It also has the benefit of being able to be worn in a variety of shoes because of its minimalist design. FES can also assistwith thigh weakness. For those with weakness in the thigh and ankle, Bioness has an FES device for the thigh that works in conjunction with the foot drop component to help control the knee as well Move More Freely with Electrical Stimulation Devices By Michael Zervas, PT, DPT and Herb Karpatkin, PT, DSC, MSCS