Design and Development of a Wireless Functional Electrical Stimulation and m-Health Application for Foot Drop Using an IoT-Based Architecture
Article Sidebar
Main Article Content
Abstract
To enhance accessibility in foot drop rehabilitation, this study presents the design and development of a wireless functional electrical stimulation system integrated with a mobile health (m-Health) application and an ESP32-based IoT (Internet of Things) platform. The system comprises a stimulation node and a sensor node that communicate via Bluetooth Low Energy (BLE) for heel-strike-triggered stimulation. The stimulation node delivers symmetrical biphasic pulses to the peroneal nerve with adjustable parameters. A cloud-based backend using MQTT supports real-time logging and device management, while the m-Health application enables mode selection, parameter tuning, and usage tracking. Key hardware includes a 70V boost converter, programmable current limiter, and H-bridge pulse generator. Evaluations show reliable pulse output (400.3 us width, 2.1 us rise/fall), low BLE latency (6.16 ms), and accurate analog-to-digital converter readings. Results confirm the system's feasibility as a compact, portable solution for home-based rehabilitation, addressing limitations of traditional wired systems.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
เนื้อหาข้อมูล
References
V. L. Feigin et al., “World Stroke Organization (WSO): Global stroke fact sheet 2022,” Int. J. Stroke, vol. 17, no. 1, pp. 18-29, Jan. 2022, https://doi.org/10.1177/17474930211065917
S. L. Nori and M. F. Stretanski, Foot Drop. Treasure Island, FL, USA: Stat Pearls Publ., 2025.
D. Totah, M. Menon, C. Jones-Hershinow, K. Barton, and D. H. Gates, “The impact of ankle-foot orthosis stiffness on gait: A systematic literature review,” Gait Posture, vol. 69, pp. 101-111, Jan. 2019.
P. Chayaratanasin, S. Vongpipatana, and W. Chira-Adisai, “Comparison of gait pattern during walking with and without functional electrical stimulation ‘Dearndee™’ in stroke patients with foot drop: A pilot study,” ASEAN J. Rehabil. Med., vol. 25, no. 2, pp. 65-72, Aug. 2015.
S. Kumnoonsup, M. Buntragulpoontawee, and A. Kovindha, "Effectiveness of functional electrical stimulator (FES-Dearndee™) on physiological cost index in subacute stroke patients with foot drop: A pilot study,” ASEAN J. Rehabil. Med., vol. 25, no. 3, pp. 95-102, Dec. 2015.
A. Behboodi, N. Zahradka, H. Wright, J. Alesi, and S. C. Lee, “Real-time detection of seven phases of gait in children with cerebral palsy using two gyroscopes,” Sensors, vol. 19, no. 11, p. 2517, Jun. 2019.
Y. R. Mao et al., “Spatiotemporal, kinematic and kinetic assessment of the effects of a foot drop stimulator for home-based rehabilitation of patients with chronic stroke: A randomized clinical trial,” J. Neuroeng. Rehabil., vol. 19, no. 1, p. 56, Dec. 2022, https://doi.org/10.1186/s12984-022-01036-0/
D. B. Popović, “Foot drop stimulator,” in Handbook of Biochips, M. Sawan, Ed. New York, NY, USA: Springer, 2022, pp. 1241-1255.
F. Alnajjar, R. Zaier, S. Khalid, and M. Gochoo, “Trends and technologies in rehabilitation of foot drop: A systematic review,” Expert Rev. Med. Devices, vol. 18, no. 1, pp. 31-46, Jan. 2021, https://doi.org/10.1080/17434440.2021.1857729
A. E. Carolus, M. Becker, J. Cuny, R. Smektala, K. Schmieder, and C. Brenke, “The interdisciplinary management of foot drop,” Dtsch. Arztebl. Int., vol. 116, no. 20, pp. 347-354, 2019.
J. Jitprasutwit, R. Chaiwattanatham, and Z. Lertmanorat, “Development and distribution of functional electrical stimulator for foot drop for Thais,” in Proc. 8th Biomed. Eng. Int. Conf. (BMEICON), 2015, pp. 1-4.
A. H. H. Mohamed, H. Tawfik, D. Al-Jumeily, and L. Norton, “MOHTAM: A technology acceptance model for mobile health applications,” in Proc. Developments E-Syst. Eng., 2011, pp. 13-18.
W. Peng, S. Kanthawala, S. Yuan, and S. A. Hussain, “A qualitative study of user perceptions of mobile health apps,” BMC Public Health, vol. 16, no. 1, p. 1158, Dec. 2016, https://doi.org/10.1186/s12889-016-3808-0
A. Kralj and T. Bajd, Functional Electrical Stimulation: Standing and Walking after Spinal Cord Injury. Abingdon, UK: Routledge, 2022, p. 208.
J. S. Park, S. H. Lee, W. G. Yoo, and M. Y. Chang, “Immediate effect of a wearable foot drop stimulator to prevent foot drop on the gait ability of patients with hemiplegia after stroke,” Assist. Technol., vol. 33, no. 6, pp. 313-317, Nov. 2021, https://doi.org/10.1080/10400435.2019.1634658
G. Hsu, F. Farahani, and L. C. Parra, “Cutaneous sensation of electrical stimulation waveforms,” Brain Stimul., vol. 14, no. 3, pp. 693-702, 2021.
C. Marquez-Chin and M. R. Popovic, “Functional electrical stimulation therapy for restoration of motor function after spinal cord injury and stroke: A review,” Biomed. Eng. Online, vol. 19, no. 1, p. 34, Dec. 2020, https://doi.org/10.1186/s12938-020-00773-4
A. S. Gorgey, H. J. Poarch, D. D. Dolbow, T. Castillo, and D. R. Gater, “Effect of adjusting pulse durations of functional electrical stimulation cycling on energy expenditure and fatigue after spinal cord injury,” J. Rehabil. Res. Dev., vol. 51, no. 9, pp. 1455-1468, Aug. 2014.
Espressif Systems, “ESP32 Bluetooth Architecture,” Espressif, 2025. [Online]. Available: https://www.espressif.com/sites/default/files/documentation/esp32_bluetooth_architecture_ en.pdf. [Accessed: May 19, 2025].
D. Hercog, T. Lerher, M. Truntič, and O. Težak, “Design and implementation of ESP32-based IoT devices,” Sensors, vol. 23, no. 15, p. 6739, Jul. 2023.
S. D. Bhattacharya and M. Manjunatha, “Functional electrical stimulation on improving foot drop gait in poststroke rehabilitation: A review of its technology and clinical efficacy,” Crit. Rev. Biomed. Eng., vol. 41, no. 2, Jan. 2013.
P. L. Melo, M. T. Silva, J. M. Martins, and D. J. Newman, “Technical developments of functional electrical stimulation to correct drop foot: sensing, actuation and control strategies,” Clin Biomech, vol. 30, no. 2, pp. 101-113, 2015.
T. Watanabe, S. Endo, and R. Morita, “Development of a prototype of portable FES rehabilitation system for relearning of gait for hemiplegic subjects,” Healthc. Technol. Lett., vol. 3, no. 4, pp. 284-289, Dec. 2016, https://doi.org/10.1049/ht1.2016.0045
P. Aqueveque et al., “A novel capacitive step sensor to trigger stimulation on functional electrical stimulators devices for drop foot,” IEEE Trans. Neural Syst. Rehabil. Eng., vol. 28, no. 12, pp. 3083-3088, Jan. 2020.
G. York and S. Chakrabarty, “A survey on foot drop and functional electrical stimulation,” Int. J. Intell. Robot. Appl., vol. 3, no. 1, pp. 4-10, Mar. 2019, https://doi.org/10.1007/$41315-019-00088-1
K. Kipli, M. N. Ulia, L. Roslan, A. Jamali, and N. Soin, “Functional Electrical Stimulation (FES) study for foot drop rehabilitation using Arduino Nano Atmega328p,” in Proc. 4th Int. Conf. Innov. Biomed. Eng. Life Sci. (IFMBE P), vol. 107, 2024, pp. 242-249, https://doi.org/10.1007/978-3-031-56438-3_24
T. F. De Almeida, L. H. B. Borges, and A. F. O. de A. Dantas, “Development of an IoT electrostimulator with closed-loop control,” Sensors, vol. 22, no. 9, p. 3551, 2022.
N. Gangadharan, S. Balasubramanian, G. Tharion, J. John, T. Senthilvelkumar, and S. Devasahayam, “An intelligent system for automatic footdrop correction in stroke patients using FES: A pilot study,” Int. J. Sci. Eng. Res., vol. 10, no. 4, pp. 1102-1110, Apr. 2019.
O. A. Chiriac, F. C. Adochiei, N.-I. Trocan, and M. I. Nistor, “Design and implementation of a cost-effective, functional electrical stimulation device for foot drop rehabilitation,” Rev. Roum. Sci. Tech. Electrotech. Energ., vol. 70, no. 1, pp. 151-156, 2025.
Y. Cao et al., “Development of a wearable ultrasound-FES integrated rehabilitation and motor-functional reconstruction system for post-stroke patients,” Biomed. Signal Process. Control, vol. 100, p. 106846, Feb. 2025.
Bioness, “L300 Go System for foot drop,” BionessMedical, 2025. [Online]. Available: https://bionessmedical.com/1300/ [Accessed: Jan. 19, 2025].
BioMetrics Prosthetic and Orthotic CT, “WalkAide® System for foot drop,” BioMetrics, 2025. [Online]. Available: https://biometricsct.com/custom-orthopedic-care/walkaide/ [Accessed: May 19, 2025].
XFT, “Foot Drop System (XFT-2001D),” China, 2025. [Online]. Available: https://www.xft-china.com/foot-drop-system [Accessed: Jan. 19, 2025].
X. I. E. Chunhu and C. Liu, “Functional electrical stimulation therapeutic apparatus for foot drop,” China, CN Patent 113965021 B, Aug. 9, 2022.
T. Keller, N. Malesevic, and G. Bijelic, “System and method for functional electrical stimulation,” U.S. Patent 10,772,544, Sep. 15, 2020.
M. T. Anton, H. M. Greenberger, E. Andreopoulos, and R. L. Pande, “Evaluation of a commercial mobile health app for depression and anxiety (Able to Digital+): Retrospective cohort study,” JMIR Form. Res., vol. 5, no. 9, p. e27570, Sep. 2021.
S. Rianmora and S. Seng, "Keep It Cool' smart bag by Internet of Things (IoT) for better living with alternative design," Int. Sci. J. Eng. Technol. (ISJET), vol. 5, no. 2, pp. 38-54, Dec. 2021.
K. Wongwut, C. Chaisermvong, and D. Angamnuaysiri, “The development of smart farming system for sea lettuce cultured process,” Int. Sci. J. Eng. Technol. (ISJET), vol. 8, no. 2, pp. 47-53, Dec. 2024.
M5Stack, “M5Stack Basic Development Kit,” M5Stack documentation, 2025. [Online]. Available: https://docs.m5stack.com/en/core/basic [Accessed: May 19, 2025].
ON Semiconductor, “2N5401: PNP silicon transistor, datasheet, Rev. 2.1,” Onsemi, 2025. [Online]. Available: https://www.onsemi.com/pdf/datasheet/2n5401-d.pdf [Accessed: Feb. 19, 2025].
H. Nisar, A. R. Malik, M. Asawal, and H. M. Cheema, “An electrical stimulation based therapeutic wearable for pressure ulcer prevention,” in Proc. IEEE EMBS Conf. Biomed. Eng. Sci. (IECBES), 2016, pp. 411-414.
Diodes Inc., "ZXSC410: Voltage mode boost controller." Diodes, 2025. [Online]. Available: https://www.diodes.com/part/view/ZXSC410 [Accessed: Feb. 19, 2025].
ON Semiconductor, "2N5401: PNP silicon transistor, datasheet, Rev. 2.1," On Semiconductor, 2025. [Online]. Available: https://www.onsemi.com/pdf/datasheet/2n5401-d.pdf [Accessed: Feb. 19, 2025].
ON Semiconductor, "2N5551: NPN silicon transistor, datasheet, Rev. 6," On Semiconductor, 2025. [Online]. Available: https://www.onsemi.com/download/data-sheet/pdf/2n5551t-d.pdf [Accessed: May 19, 2025].
Nexperia, "BAS516: High-speed switching diode, datasheet," Nexperia, 2025. [Online]. Available: https://www.nexperia.com/product/BAS516 [Accessed: May 19, 2025].
M5Stack, "M5StickC Plus Development Kit,' M5Stack documentation," M5Stack, 2025. [Online]. Available: https://docs.m5stack.com/en/core/m5stickc_plus [Accessed: May 19, 2025].
S. Aali, F. Rezazadeh, G. Badicu, and W. R. Grosz, “Effect of heel-first strike gait on knee and ankle mechanics," Medicina, vol. 57, no. 7, p. 657, Jun. 2021.
P. Keil and A. Jossen, "Charging protocols for lithium-ion batteries and their impact on cycle life an experimental study with different 18650 high-power cells," J. Energy Storage, vol. 6, pp. 125-141, May. 2016.
G. J. Páez Fajardo et al., "Synergistic degradation mechanism in single crystal Ni-rich NMC//graphite cells," ACS Energy Lett., vol. 8, no. 12, pp. 5025-5031, Dec. 2023, https://doi.org/10.1021/acsenergylett.3c01596
