Device puts stroke patient back in step

The electrical stimulation is going into his right leg, but James McManus' eyes light up when he talks about the new device.

"It gives you hope in a dark hour," said the 61-year-old Waynesboro man.

He is talking about the Ness L300 electrical stimulation system in use at Walton Rehabilitation Hospital.

The wireless device, which is attached to the common peroneal nerve in the leg and includes electrodes and sensors in the shoe, was among four similar systems recently purchased with $28,000 raised by Walton Foundation for Independence.

The system is easier to use than standard electrodes and gives therapist more flexibility, said physical therapist Erica Walling.

A study of 24 patients in Israel published earlier this year in the American Journal of Physical Medicine &Rehabilitation found that patients who used the device for eight weeks increased the steadiness of their gait by 45 percent and increased their walking speed by 34 percent.

"It's pretty exciting," said Walton CEO Dennis Skelley. "It shows such an improvement in outcomes, especially in the area of foot drop," a partial paralysis common to strokes where patients have difficulty lifting the foot and toes.

In the case of Mr. McManus, it has helped him get back on his feet after an April 13 stroke. He woke up that morning and had difficulty putting his feet into his pants. Eventually he got them on and felt well enough to eat breakfast but found he had difficulty swallowing.

It was while he was being checked out at University Hospital that the bigger stroke hit and his right side went numb.

"Everything worked for the best that I was already in the hospital," Mr. McManus said.

After some therapy at University, he was transferred to Walton and began working with the Ness system on both his foot drop and getting some use back in his right hand with a companion stimulation system.

Four weeks later, the difference is evident as he walks haltingly without the machine and straighter and more confidently with it.

The stimulator has a sensor to turn it on and off as the foot lands and is raised to help the patient lift the foot and turn it off when stimulation wouldn't help.

"It promotes the natural gait cycle," said Ms. Walling, the physical therapist who is working with Mr. McManus.

The device would appear to be a better alternative to some braces that don't promote normal movement as well, said Dr. Eric K. Robertson, an assistant professor of physical therapy at the Medical College of Georgia.

"This really is a benefit because you can send that patient out the door and have a relatively normal gait and a safe gait, too," he said. "The problem with foot drop is that you can catch your foot on things."

Perhaps just as important is the psychological lift it gives the patient to be able to move as they used to, Mrs. McManus said.

"It gives them a positive outlook," she said.

Almost too positive. Mr. McManus said he has seen a big difference in four weeks of working with it.

"And in eight weeks, she told me I could run," he said, turning to Ms. Walling, who could only smile and laugh.

Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.