I currently use FES, however, due to the progressive nature of MS, I now find it difficult to place electrodes, foot switch etc. I’m now looking into Actigait. Any body out there with experience of this? Thank you for any help and tips in advance
No experience of a Actigait, but the Odstock FES is now available with a wireless foot switch and you can get the electrodes implanted (STIMuSTEP). Try contacting www.ostockmedical.com for more information.
Hi. l have been useing the FES now for about 3months l still have bother placeing the electrodes, sometimes l think it just feels like a tens and does not lift the foot and l still trip. l have not seen the Actigait but will look it up. The lady that fited it took a photo on my phone of the electrodes in place so that helps a little. Take care regards Jan.
LONG POST
Hi. I have ms related foot-drop and I’m in the unusual, possibly unique, position of having tried both Ottobock and Actigait. My physiotherapist supplies all sorts of FES equipment and let me try firstly the sort that is supplied on the NHS. Ghastly. It’s incredibly fiddly to fit the electrodes and there is a connector wire between the electrodes on the shin, the foot switch and the control equipment on the waist. The electodes managed to slip in the short trial period I gave it walking round the block. Instant rejection!
She gave me lots of info about both Ottobock and Actigait. There’s a big price differential. Ottobock is about £2.5k and with the support package Actigait is £18 – 20k. I decided to go for the cheaper option and got the equipment fitted just before Christmas 2012. It’s substantially better than the wired cheap version. The electrodes are fixed to suit your physiology at the time it is fitted. They attach to the inside of the knee cuff with Velcro and the placement was marked for me in pen so that replacement electrodes can be easily located. The cuff is not heavy but is quite bulky and noticeable, especially if you wear short skirts. It is, however, a lot less noticeable than the traily wires alternative. It is possible to wear the unit under tights of the 7 -15 denier variety but not practical under opaque ones. It would not fit under knee length boots or skinny trousers and has to be skin mounted so it limits the wardrobe options a bit.
The main disadvantage that I found was that I needed the strength turned right up in cold weather or when I was tired and the higher the strength, the more uncomfortable it is. People have referred in earlier posts to a TENS machine and the sensation is very similar. I found that my walking was much better with the Ottobock than without it but investigated the Actigait equipment further. The cost was a bit of a disincentive, but I eventually decided to go for it.
Actigait is a much more sophisticated bit of kit, which you would obviously expect for such a lot more money. The operative part involves electrodes which are implanted on the motor nerves mid leg. They are connected below the surface (don’t know how deeply) to a receiver which is implanted in the thigh muscle. An adhesive patch is applied on the skin surface of the thigh, above the receiver element and that allows an attachment to be fixed to the thigh which is connected by wire which passes under the clothes to the control unit which is mounted on, for instance a skirt waistband or a trouser belt. The control unit is about the size of a mid-size mobile phone. The other element of the kit is a foot switch which is held in place by a heel sock. I understand that there are plans to produce them in a neutral colour, but at the moment they are only available in black, which is a bit unsightly, although nothing like as eye catching as the Ottobock knee cuff. The attachment on the thigh is about 4 centimetres in diameter (I’m guessing) but very thin and would not hinder wearing skinny trousers. All in all, the kit is very unobtrusive. People that don’t know have told me that they assumed that the control unit is a mobile and have attributed the ankle sock to an ankle support, thinking that I’d had a sports injury.
Obviously, the implanting has to be done in hospital. I went for the procedure in April 2013 and was in for two nights. I then had limited mobility with my leg absolutely straight for a month or so. It wasn’t a painful procedure. I had to go back to have the stitches out and then again to have the equipment commissioned. And then I could use it. What an improvement! I’ve already mentioned the difference in size and noticeability of the kit, compared to the Ottobock. Even better is the fact that the impulse that is used to stimulate the foot to lift is applied by the electrode directly to the motor nerve which is
a) more accurate than surface mounted electrodes because the implanted version has been precisely positioned once and for all on the nerve itself. No more fiddling about to find the optimum positioning first thing in the morning or after a shower. And
b) Absolutely non painful. In fact there is no sensation of the stimulus at the application point at all. There is a sensation at the ankle and foot, because the body’s reaction is to tense the muscle. That is, after all, the whole point of the exercise. But it doesn’t hurt like the FES did.
Just before Christmas I managed to damage a wire and was without the Actigait for a while. It happened on a Friday night. Typical! Although I wasn’t expecting a response until the Monday, in fact, I got an almost instant reply. A temporary replacement was dispatched immediately and was received on the Tuesday which I don’t think could have been bettered. However, I was without my Actigait for 4 days and used the Ottobock which I had retained as a back up. It’s a curious thing. When something is replaced and it’s better it’s difficult to quantify by how much. But when it is replaced and it’s worse it is so so noticeable. My range, speed and gait were very obviously worse with the Ottobock than with the Actigait and I had a miserable few days until I got the replacement bits.
I don’t want to sound as if I’m knocking the Ottobock. The price differential means that it is not comparing like with like, as with Ford and Rolls Royce in the motoring world. Ottobock works very well and is a lot more user friendly than the versions with the wire connectors. I was pleased with it for the time that I used it and I hadn’t realised until I read Whammel’s post that they did an implanted version. Obviously, people’s conditions vary and what suits one is no use for someone else but the Actigait is, for me, much better than the other options that were available to me and totally worth what I’ve spent on it.
If you’ve bothered to read this far, I hope that the info is of some use. Happy to reply to requests for more info or private posts, but I’m a sporadic visitor and you may have to wait a while.
CORRECTION TO YESTERDAY’S POST
I have made a grave mistake in my post yesterday; the equipment I had was a Walkaide and not an Ottobock. Hope I haven’t misled anyone too much. And apologies to both Ottobock and Walkaide
Debbi
Thanks Debbi, I have extensor spasticity. The increase tone in my calf and quads prevent me from lifting my foot and bending my knee. would actigait work ? I currently use a SAFO AFO from Dorset Orthopaedic. Where did you get yours fitted. Moyna xxx
Thanks for the very informative post Debbie. There’s nothing like personal accounts. Thank you for taking the time to write about your experiences. BL
Thanks Debbie… that is very useful information! Pat xx
Moyna,
I’m a consumer and not an expert so I’m sorry I can’t answer your question. However, I know that the Actigait people keep an eye on this forum. Perhaps one of their experts will pick up your post and be able to give you some info either on this thread or by private post. I got it fitted at Blackheath Hospital in London.
Debbi