Neuromodulation : journal of the International Neuromodulation Society
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Sacral nerve root stimulation (SNRS) is known to be effective in the treatment of pelvic motor dysfunction(1-4). Bladder and urethral motor disorders commonly treated include urinary urge incontinence, voiding/detrusor dysfunction, and urgency/frequency syndromes. To date, neurostimulation specific to bladder and urethral dysfunction has applied a unilateral, trans-sacral approach. (Interstim, Medtronic, Minneapolis, MN) Despite some success, this method has been associated with technical failures in maintaining electrode position(5,6). As an alternative, this case report describes the selective epidural application of a cephalocaudal ("retrograde") lead insertion method in a patient with severe detrusor dysfunction and urinary urge incontinence(7).
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This article presents an overview of the research and clinical experience of the use of Functional Electrical Stimulation (FES) for the treatment of drop-foot in hemiplegia. The article reviews the evidence from the literature over the past 10 years to answer the question posed in the title. ⋯ Quality of research is criticized and the need for rigorous clinical studies, technological development, and collaboration between clinicians and engineers is argued. The drop foot stimulator does improve walking in hemiplegia, but factors such as patient and clinician education, reliability of equipment, and selection of patients, are important.