New study to help people with Parkinson’s Disease regain their stride

Researchers are conducting the first-large scale trial of a device which could help people with Parkinson’s Disease to walk better.

Over 200 people with Parkinson’s at eight sites around the UK will test the use of a Functional Electrical Simulation (FES) device, which is already used by people with Multiple Sclerosis (MS) and those who’ve had a stroke to improve their walking ability.

The STEPS 2 trial is being led by Professor Paul Taylor at Salisbury District Hospital, working in partnership with the University of Southampton, University of Plymouth and the University of Exeter. It’s being funded by the National Institute for Health and Care Research (NIHR).

Parkinson’s Disease affects about 148,000 people in the UK, making it the second most prevalent neurodegenerative condition, after Alzheimer’s disease. It is also growing faster than any other neurological condition, with around 18,000 new diagnoses each year.

Difficulty walking

Most people don’t have to think too much about walking, it’s an automatic process of naturally lifting and landing each foot, step by step. However, for people with Parkinson’s disease, these automatic movements often diminish as the disease progresses. This can lead to slower, smaller, shuffling steps which increase the risk of falls.

Falls can have a devastating impact on patients, resulting in injuries, psychological distress and admissions to hospital, which in turn place added pressure on the NHS.

To help with these mobility issues, Functional Electrical Stimulation (FES) sends low-energy electrical pulses to contract muscles in the foot, helping to raise the toes during each step. A footswitch times these pulses to match the person’s gait.

Professor Paul Taylor co-founded Odstock Medical (OML), an NHS-owned company that manufactures FES devices. He is also a Consultant Clinical Scientist at Salisbury NHS Foundation Trust and is leading the STEPS 2 trial.

He said: “Nearly four in ten people with Parkinson’s Disease are recurrent fallers, experiencing an average of 21 falls a year. This can lead to a reduction in overall activity, fitness, health and social participation.

“Reduced muscle activity particularly affects the ability to dorsiflex (foot lift) the feet. Functional Electrical Stimulation is already recommended by NICE as an assistive device for people with dropped foot due to a stroke or MS, and we believe it could offer similar benefits to those with Parkinson’s Disease.”

David Muskett, 72, from Bournemouth, was diagnosed with Parkinson’s disease 10 years ago. He first took part in the trial at the beginning of June 2024 and has been using the FES device ever since. He says:

“Over the past two years walking has become increasingly difficult. The FES device has been an enormous help. It’s simple to set up, and I have been amazed at the difference it has made.

“Prior to using the device, walking was like wading through treacle. I have always been an active person, and having the FES device has made walking, golf and football a much more pleasurable experience. It has helped my balance, fitness and strengthened my legs.

“I play walking football with Dorset Parky Striders, which we formed in October last year. We all have Parkinson’s, but to see us all chasing a ball around the pitch you would never guess. There’s a tremendous camaraderie within the group, and it keeps us all fit.”

Promising early results

STEPS 2 follows a 2020 feasibility study (STEPS 1). In this smaller study, 64 people with Parkinson’s who had difficulty walking received FES in addition to standard care or standard care alone.

A significant number of those who’d received FES had increased walking speed and fewer falls. The results were echoed in interviews with the participants receiving FES, who reported improved walking ability, mobility and confidence.

Professor Maggie Donovan-Hall from the University of Southampton is a coinvestigator on both trials. She said: “Our feasibility study showed that people with Parkinson’s Disease receiving FES walked faster, took larger strides, and had fewer falls. Interestingly, these benefits persisted even after some participants stopped using the device, indicating that it had a ‘training effect’.

“Participants also reported important wider benefits to their overall wellbeing, independence and family life.”

The results indicated that the therapeutic effect could potentially be even greater for people with Parkinson’s Disease than for people who have had a stroke or have MS.

Prof Donovan-Hall added: “Improved average walking speed was observed after six weeks, maintained at 18 weeks, and was still present but slightly reduced at 22 weeks (four weeks after FES was withdrawn).”

Next steps

The STEPS 2 trial hopes to build on these promising results. Patients are already taking part at hospitals in Bristol, Birmingham, Leeds, Salisbury, Swansea, Derby, Betsi Cadwaladr (North Wales)  and Ipswich.

FES is available on the NHS as a low-cost treatment for people who have had a stroke and MS. If successful, the STEP 2 trial could see the devices made available to those with Parkinson’s Disease in the coming years.

The STEPS 2 trial is currently recruiting patients. To find out more visit: https://www.plymouth.ac.uk/research/penctu/steps-2

Learn more about OML at odstockmedical.com