Functional electrical stimulation and ankle foot orthoses provide equivalent therapeutic effects on foot drop: A meta-analysis providing direction for future research

Sarah Prenton, Kristen L. Hollands, Laurence P J Kenney, Pornsuree Onmanee

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Objective: To compare the randomized controlled trial evidence for therapeutic effects on walking of functional electrical stimulation and ankle foot orthoses for foot drop caused by central nervous system conditions. Data sources: MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, REHABDATA, PEDro, NIHR Centre for Reviews and Dissemination, Scopus and clinicaltrials.gov. Study selection: One reviewer screened titles/abstracts. Two independent reviewers then screened the full articles. Data extraction: One reviewer extracted data, another screened for accuracy. Risk of bias was assessed by 2 independent reviewers using the Cochrane Risk of Bias Tool. Data synthesis: Eight papers were eligible; 7 involving participants with stroke and 1 involving participants with cerebral palsy. Two papes reporting different measures from the same trial were grouped, resulting in 7 synthesized randomized controlled trials (n=464). Meta-analysis of walking speed at fnal assessment (p=0.46), for stroke participants (p=0.54) and after 4-6 weeks' use (p=0.49) showed equal improvement for both devices. Conclusion: Functional electrical stimulation and ankle foot orthoses have an equally positive therapeutic effect on walking speed in non-progressive central nervous system diagnoses. The current randomized controlled trial evidence base does not show whether this improvement translates into the user's own environment or reveal the mechanisms that achieve that change. Future studies should focus on measuring activity, muscle activity and gait kinematics. They should also report specifc device details, capture sustained therapeutic effects and involve a variety of central nervous system diagnoses.

LanguageEnglish
Pages129-139
Number of pages11
JournalJournal of Rehabilitation Medicine
Volume50
Issue number2
Early online date17 Nov 2017
DOIs
Publication statusPublished - Feb 2018

Fingerprint

Foot Orthoses
Therapeutic Uses
Ankle
Electric Stimulation
Meta-Analysis
Foot
Central Nervous System
Randomized Controlled Trials
Stroke
Equipment and Supplies
Information Storage and Retrieval
Cerebral Palsy
Gait
Biomechanical Phenomena
MEDLINE
Walking
Muscles
Direction compound
Walking Speed

Cite this

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title = "Functional electrical stimulation and ankle foot orthoses provide equivalent therapeutic effects on foot drop: A meta-analysis providing direction for future research",
abstract = "Objective: To compare the randomized controlled trial evidence for therapeutic effects on walking of functional electrical stimulation and ankle foot orthoses for foot drop caused by central nervous system conditions. Data sources: MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, REHABDATA, PEDro, NIHR Centre for Reviews and Dissemination, Scopus and clinicaltrials.gov. Study selection: One reviewer screened titles/abstracts. Two independent reviewers then screened the full articles. Data extraction: One reviewer extracted data, another screened for accuracy. Risk of bias was assessed by 2 independent reviewers using the Cochrane Risk of Bias Tool. Data synthesis: Eight papers were eligible; 7 involving participants with stroke and 1 involving participants with cerebral palsy. Two papes reporting different measures from the same trial were grouped, resulting in 7 synthesized randomized controlled trials (n=464). Meta-analysis of walking speed at fnal assessment (p=0.46), for stroke participants (p=0.54) and after 4-6 weeks' use (p=0.49) showed equal improvement for both devices. Conclusion: Functional electrical stimulation and ankle foot orthoses have an equally positive therapeutic effect on walking speed in non-progressive central nervous system diagnoses. The current randomized controlled trial evidence base does not show whether this improvement translates into the user's own environment or reveal the mechanisms that achieve that change. Future studies should focus on measuring activity, muscle activity and gait kinematics. They should also report specifc device details, capture sustained therapeutic effects and involve a variety of central nervous system diagnoses.",
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Functional electrical stimulation and ankle foot orthoses provide equivalent therapeutic effects on foot drop : A meta-analysis providing direction for future research. / Prenton, Sarah; Hollands, Kristen L.; Kenney, Laurence P J; Onmanee, Pornsuree.

In: Journal of Rehabilitation Medicine, Vol. 50, No. 2, 02.2018, p. 129-139.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Functional electrical stimulation and ankle foot orthoses provide equivalent therapeutic effects on foot drop

T2 - Journal of Rehabilitation Medicine

AU - Prenton, Sarah

AU - Hollands, Kristen L.

AU - Kenney, Laurence P J

AU - Onmanee, Pornsuree

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N2 - Objective: To compare the randomized controlled trial evidence for therapeutic effects on walking of functional electrical stimulation and ankle foot orthoses for foot drop caused by central nervous system conditions. Data sources: MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, REHABDATA, PEDro, NIHR Centre for Reviews and Dissemination, Scopus and clinicaltrials.gov. Study selection: One reviewer screened titles/abstracts. Two independent reviewers then screened the full articles. Data extraction: One reviewer extracted data, another screened for accuracy. Risk of bias was assessed by 2 independent reviewers using the Cochrane Risk of Bias Tool. Data synthesis: Eight papers were eligible; 7 involving participants with stroke and 1 involving participants with cerebral palsy. Two papes reporting different measures from the same trial were grouped, resulting in 7 synthesized randomized controlled trials (n=464). Meta-analysis of walking speed at fnal assessment (p=0.46), for stroke participants (p=0.54) and after 4-6 weeks' use (p=0.49) showed equal improvement for both devices. Conclusion: Functional electrical stimulation and ankle foot orthoses have an equally positive therapeutic effect on walking speed in non-progressive central nervous system diagnoses. The current randomized controlled trial evidence base does not show whether this improvement translates into the user's own environment or reveal the mechanisms that achieve that change. Future studies should focus on measuring activity, muscle activity and gait kinematics. They should also report specifc device details, capture sustained therapeutic effects and involve a variety of central nervous system diagnoses.

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