Clinical spotlight - functional electrical stimulation
GLOBAL ROLE: FES lead Christine Singleton
Supporting people to live as independently as possible is key to an effective clinical approach to rehabilitation. And West Midlands Rehabilitation Centre has a proud track record of harnessing the full potential of a dedicated multidisciplinary team of professionals with innovative use of technology.
As lead for the functional electrical stimulation (FES) service, consultant physiotherapist Christine Singleton has helped thousands of people gain mobility and muscle function through electrical stimulation to activate muscles, restoring confidence and independence.
As one of the key architects of developing innovative use of FES in rehabilitation and maintenance of function where a person has muscle weakness or tightness, Christine has recently been elected president of the International FES Society (IFESS) UK and Ireland Chapter - prestigious recognition of leadership and expertise on a global scale.
It's a journey now spanning more than four decades. After qualifying, Christine worked as a physiotherapist at Dudley Road Hospital (now Sandwell and West Birmingham Hospitals' City Health Campus) for just a few years before taking a career break following the birth of twins.
Six years later, she responded to an appeal for neuro-physiotherapists after the Gulf War of 1990-91; and returned to the acute hospital.
“There was an urgent national call-out because it was anticipated it could be a chemical war, with the use of gas causing a lot of cases of nerve damage,” recalls Christine.
“I agreed to go back to work, but on a school term-time only contract - and that meant patients wouldn't see me for up to six weeks during school holidays and, understandably, that meant they would regress.
“I had tried a lot of things to bridge that gap of several weeks between physio appointments - orthotics, education resources - but when the 'lightbulb moment' came in 1994, there was an element of good fortune about it because it was a patient who mentioned her nephew's work in Salisbury exploring the potential of functional electrical stimulation. Thus began my journey in the world of FES!”
In partnership with colleagues in what was to become the National Clinical FES Centre, in Salisbury - also in the vanguard of exploring the potential of this new therapy - Christine developed a FES service at Dudley Road, sharing research data and exploring the potential of different equipment and usages. Soon, with growing interest in the possibilities, she was invited to set up a new specialist service at West Midlands Rehabilitation Centre, in 2002.
“They were excited by the potential and asked me to head up a new service,” said Christine.
“This made FES available to more people because the rehab centre serves the whole West Midlands region.
“And, crucially, you are giving patients equipment that they can use on their own at home. So no gaps between therapy and, whereas I had a caseload of about 21 patients at any one time as a neuro-physiotherapist, now I had 360!
“I'm a great advocate of FES because I'm passionate about what it can do for people. It doesn't work for everyone, it does depend on the diagnosis. But what keeps us fuelled is the life-changing results - we know we make a huge difference to our patients that is life-changing and we have the testimonials to show that.
Alongside her work as with the IFESS, Christine continues to explore and expand the potential of FES, with involvement in three ongoing research projects exploring its potential for, respectively, amputees, people with Parkinson's Disease and, her most recent area of exploration for a therapeutic use, constipation.
And having built and developed her team at WMRC over three decades, Christine is stepping back from her management responsibilities, giving colleagues the chance to develop. But she plans to remain involved in treating patients.
“The UK has been a leader in the development of FES, thanks to the work I became involved in at an early stage, along with colleagues in Salisbury.
“Now, the opportunities are much broader - there's an international alliance of clinicians, developers, engineers, commercial partners and patients in countries all over the world.
“But other countries are struggling to move from development and research to scaling patient services up.
“I want to create a movement that no-one can take away - I've done it with the service here in the West Midlands; now I want to give it that level of stability and recognition nationally and help other practitioners internationally learn from us.
“So I see this new role as an opportunity to strengthen the UK and Ireland's reputation - an opportunity to pull together clinicians, manufacturers, researchers, universities and patients from across the UK and Ireland to speak with one voice and spread the word about the life-changing potential of FES.”
If you are interested in FES for your patients, use FES - particularly in the UK and Ireland - or want to join IFESS UK and Ireland Chapter, please email IFESSUKI@ifess.org or christinesingleton@nhs.net to find out more.