1 4 . H O W T O U S E T H E W I R E L E S S P R O F E S S I O N A L O N S P E C I F I C
I N D I C AT I O N S
262
EN
WIRELESS PROFESSIONAL
14.11.1 dorsiflexion of the hemiplegic foot
One of the problems in hemiplegic patients is the greater or lesser degree of difficulty that they encounter
when raising the foot voluntarily, or even the total inability to do so.
For this reason, the foot drops when walking during heel strike.
Neuromuscular electrical stimulation (NMES) in the area of the flexor muscles of the foot (tibialis anterior,
extensors of the toe) allows for dorsiflexion to be achieved.
This NMES is functional (FES) if the dorsiflexion achieved is synchronised with the gait so as to stop the
foot from dropping when lifted from the ground.
The aim of FES is to teach the hemiplegic patient to walk again by creating a functional gait pattern that
the patient is then able to reproduce more easily.
However, this method of gait rehabilitation using FES is not suitable for all hemiplegic patients. Two types
of case must be considered:
1. If the stimulation of the muscles lifting the foot produces a spasm reflex in the muscles of the lower limb,
this technique should no longer be used (this phenomenon is rare in hemiplegics but more common in
paraplegics).
2. If the spasticity of the soleus muscle is considerable, to the point where satisfactory dorsiflexion cannot
be achieved, programmes for the treatment of spasticity in the lower limb must be used initially, before
resuming work on the gait with FES when spasticity of the triceps surae has been sufficiently reduced.
14.11.1.1 Protocol
The hemiplegic foot. USE CHANNEL 1 (other channels are inactive for this programme)
14.11.1.2 treatment frequency
Minimum of three sessions per week, the length of treatment varies greatly depending on progress.