title: The long-term cost-effectiveness of the use of Functional Electrical Stimulation for the correction of dropped foot due to upper motor neuron lesion.
abstract: OBJECTIVE
  Functional Electrical Stimulation (FES) for correction of dropped foot has been shown to increase mobility, reduce the incidence of falls and to improve quality of life. This study aimed to determine how long the intervention is of benefit, and the total cost of its provision.
  
  
  METHODS
  Retrospective review of medical records.
  
  
  METHODS
  One hundred and twenty-six people with spastic dropped foot (62 stroke, 39 multiple sclerosis, 7 spinal cord injury, 3 cerebral palsy, 15 others) who began treatment in the year 1999.
  
  
  METHODS
  All received common peroneal nerve stimulation, producing dorsiflexion and eversion time to the swing phase of gait using a heel switch. Device usage, 10 m walking speed and Functional Walking Category (FWC) were recorded.
  
  
  RESULTS
  The median time of FES use was 3.6 years (mean 4.9, standard deviation 4.1, 95% confidence interval 4.2-5.6) with 33 people still using FES after a mean of 11.1 years. People with stroke walked a mean of 45% faster overall, including a 24% training effect with 52% improving their FWC. People with multiple sclerosis did not receive a consistent training effect but walked 29% faster when FES was used with 40% increasing their FWC. The average treatment cost was £3,095 per patient resulting in a mean cost per Quality Adjusted Life Years of £15,406.
  
  
  CONCLUSIONS
  FES is a practical, long-term and cost-effective treatment for correction of dropped foot.
authors.affiliation: The National Clinical FES Centre, Salisbury District Hospital, Salisbury, United Kingdom. p.taylor@salisburyfes.com
authors.forename: Paul
authors.initials: P
authors.lastname: Taylor
authors.forename: Laura
authors.initials: L
authors.lastname: Humphreys
authors.forename: Ian
authors.initials: I
authors.lastname: Swain
mesh_terms: D000328:Adult; D000368:Aged; D002547:Cerebral Palsy / Q000150:complications / Q000534:rehabilitation / Q000628:therapy; D003362:Cost-Benefit Analysis; D004558:Electric Stimulation; D004599:Electric Stimulation Therapy / Q000191:economics; D005081:Exercise Therapy; D005260:Female; D005528:Foot; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation / Q000628:therapy*; D006365:Heel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000534:rehabilitation / Q000628:therapy; D010543:Peroneal Nerve / Q000473:pathology*; D020427:Peroneal Neuropathies / Q000209:etiology / Q000534:rehabilitation / Q000628:therapy*; D013119:Spinal Cord Injuries / Q000150:complications / Q000534:rehabilitation / Q000628:therapy; D020521:Stroke / Q000150:complications / Q000628:therapy; D000071939:Stroke Rehabilitation; D016138:Walking