1. Faye Pitt BSc(Hons) MSc
Senior Orthotist
Trulife 1

2. The WalkAide is a battery-operated, single channel, functional electrical stimulation device used to address Foot Drop.
- Functional
- Therapeutic

3. Dorsiflexion of the ankle at the optimal time during the gait cycle to normalise walking.

4. One piece & self-aligning
Built-in sensors
One-hand donning/doffing
Universal R/L cuff
Electrode markers for placement
Light-weight & comfortable
Adaptations for visual & hearing impaired

8. Facilitates sagittal plane swing
Works with any initial foot position
No heel strike needed
Minimises skin irritation via balanced charge recovery circuitry
Collects & analyses patient data via wireless Bluetooth technology
Walking Mode and Exercise mode

10. Upper Motor Neuron Lesions
Candidates
Upper Motor Neuron Lesions
CVA or stroke
Incomplete SCI
Traumatic brain injury
Cerebral palsy
Multiple sclerosis
Familial hereditary spastic paraplegia (FSP)
Here is a list of patient populations who are indicated for consideration of the WalkAide system.
There are 750,000 new stroke patients each year and walking is a primary goal.
Spinal cord injuries must be thoroughly evaluated by the medical team. Injuries above T6 may risk autonomic dysreflexia and injuries below T12 involve peripheral nerve structures.
Each person must be individually evaluated in terms of their walking profile, reaction to electrical stimulation, functional movement produced, and ability to operate the WalkAide system. 10

11. Considerations Contraindications
Severe sensory/proprioception deficit
Lower Motor Neuron
History of skin sensitivity
Pacemaker
Limited walking potential
Pregnancy
Morbid obesity <35%>
History of Seizure Disorder
Cognitive Status
Thrombosis in area of the device
Peripheral Nerve Damage
Surgical Trauma; lumbar or hip
Lumbar spinal stenosis
Poliomyelitis
Guillain-Barre Syndrome
Sciatica

12. Paediatrics
Well tolerated
Prevent Deformity
Delay or Prevent Surgery

13. Cerebral Palsy: Left Hemiparesis

14. HOW ?

15. An intact peroneal nerve pathway is required.
4/21/2017
Peripheral Nerve Stimulation
An intact peroneal nerve pathway is required.
Controlled amounts of electrical currents are applied to the peroneal nerve in order to promote functional dorsiflexion.
Common peroneal nerve
Superficial peroneal nerve
Peroneus longus
Peroneus brevis
Plantar flexion
Eversion
Deep peroneal nerve
Tibialis anterior
Ext. digitorum longus
Ext. digitorum brevis
Ext. hallucis longus
Dorsiflexion
Inversion
WalkAide_ISPO-NL2008 15 15

16. Measures angular changes from vertical
Inclinometer
‘Tilt’ Sensor
Measures angular changes from vertical
Tilt ON Threshold
Tilt OFF Threshold

17. Tilt Sensor Input
Anterior angle: OFF
Posterior angle: ON
Swing: ON

18. Measures changes in acceleration.
Accelerometer
Measures changes in acceleration.
Measures time between the angular changes;
(The force exerted by restraints in an accelerating body).

19. WalkAide® System
Equipment
WALKAIDE SYSTEM
Product Development

20. Patient Set-up
Pre-screening: Ministim

21. Electrode Location

22. Patient Kit

23. Clinician Kit-Programming Tools
* WalkAnalyst Software

24. Heel Sensor Input
Unload: ON
Swing: ON
Load: OFF

25. Data Collection and Programming

26. Clinician Input
WalkLink

27. System Data Collection
4/21/2017
System Data Collection
WalkAide_ISPO-NL2008 27 27

28. 3.0 WalkAnalyst Normalise Gait 3.0 Version Upgrades
Initiation of swing
Duration of swing
Termination of swing
3.0 Version Upgrades
Rapid Programming
Walking Speed Calculation
Comparative Reporting

29. Quantification of Outcomes
Walking Speed:
Quantify changes over time
With and without device
Usage Log:
Hours per day
Stims per day
Printed Reports:
Back-up data
Prescriber Communication

30. Stimulus Adjustability
Total stimulation CHARGE is regulated by pulse duration, time in between and intensity
Patient Comfort
Quality of the stimulation
Preserves skin integrity and muscle endurance
Body is dynamic-changes 30

31. Parameter Adjustability
Pulse duration
Frequency
Ramp On/Ramp Off
Extra stimulations
Filter
Exercise settings
Traceability
Troubleshooting Diagnostic Codes 31

32. WHY ?

33. Augmentation Maximize Recovery
Regain voluntary control, restore reflex responses and complex functional movement
Precise and timely feedback from the periphery allows for quality control of movement
Task Oriented
Biofeedback
Repetition
Sensory feedback
Audible feedback
Augmentation

34. Research from the University of Alberta
“A Multicenter Trial of a Footdrop Stimulator Controlled by a Tilt Sensor”
Stein et al, Neurorehabilitation and Neural Repair 2006

35. WalkAide® System Evidence:
Increase in velocity with and without the WalkAide System (Carry-over effect)
3 mo 16%
6 mo 27%
12 mo 51%
PCI index decreased 25%
Voluntary drive and muscle strength

36. MEP Mapping by TMS Normal subject (age 27)
Motor Evoked Potential mapping by Transmagnetic stimulation. Record MEPs by stimulating the motor cortex. There is a best point for evoking EMG potential of tib anterior.

37. Long-Term Effects of FES in a Head-Injured Patient (10+ years post-injury)
After 6 months of FES use
Before FES use
43 yr old male. Head injury 19 years earlier. No reports of changes in walking speed before entering the trial.
Decided he didn’t need WA after 12 months. 2 years later returned feeling no progress was being made and PCI & velocity measures indicated this – so he returned to WA.
Shows potential for re-educating brain and compensation for brain damage.

38. Both groups had an orthotic benefit from FES.
Does Functional Electrical stimulation for Foot Drop Strengthen Corticospinal Connections? Everaert et al Neurorehab. Neural Repair regular use of a foot drop stimulator strengthens activation of motor cortical areas and their residual descending connections
Long-Term Therapeutic and Orthotic Effects of a Foot Drop Stimulator on Walking
Performance in Progressive and Nonprogressive Neurological Disorders – Stein et al,
Neurorehab. Neural Repair 2010
Both groups had an orthotic benefit from FES.
Therapeutic effect increased for 11 months on nonprogressive disor
up to 3 months in the progressive disorders.

39. Who do we work with?
Trulife clinicians
Private clinicians
NHS units

40. Global Presence
23 Countries

41. Mobility and Independence.
One Step at a Time.
Thank you for listening