Lessons from Vienna: stakeholder perceptions of functional electrical stimulation technology and a conceptual model for practice

Abstract

Aim: Functional electrical stimulation (FES) is a technology that can be used on paralyzed muscles to allow them to move. It has been used in populations with muscle paralysis or weakness for exercise, such as spinal cord injury (SCI) and multiple sclerosis. In order to improve technology, it is vital to understand from a qualitative perspective, issues surrounding device development and implementation.

Materials and Methods: In 2016, a study was conducted at the Medical University of Vienna that sought to unravel perspectives of FES exercise from the perspective of clinicians, engineers and researchers. Semi-structured, qualitative interviews were conducted on a sample of participants from the conference (n = 22). Interviews were transcribed verbatim, and text data were analysed.

Results: Following this analysis, a conceptual model of FES application in the home environment was derived. We show that the likelihood of continuing FES over time may be influenced by expectations and initial education, as perceived by stakeholders.

Conclusion: This model provides a tool by which researchers or clinicians may implement FES in the home environment and may assist in the increased uptake of FES exercise at home for people who may reap benefits from its use.

Implications for Rehabilitation

• Functional electrical stimulation (FES) is a technology that enables individuals with paralysis, such as Spinal Cord Injury or Multiple Sclerosis, to exercise.

• Motivation and support networks, along with adequate initial education, are essential should patients be able to successfully use FES for exercise.

• There are unique issues associated with performing FES in the home, and compliance may be influenced by how patients perceive FES with regard to providing benefits, and what their initial expectations are.

• Communication and education are essential for all parties involved in the provision of FES treatment, to ensure successful treatment with FES at home.

Keywords:

• Neuromodulation
• spinal cord injury
• multiple sclerosis
• home
• translation
• exercise
• rehabilitation engineering
• qualitative

Acknowledgements

The authors would like to thank Ms. Melitta Pichler for her assistance in organizing interviews at the Medical University of Vienna. In addition, Guy Wilson for suggesting the idea of looking at laboratory/clinic compared with home. Further, they would like to thank OttoBock for assistance in subject recruitment during the Vienna interviews.

Disclosure statement

No potential conflict of interest was reported by the authors.