Functional electrical stimulation versus ankle foot orthoses for foot-drop: A meta-analysis of orthotic effects

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

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Objective: To compare the effects on walking of functional electrical stimulation (FES) and ankle foot orthoses for footdrop of central neurological origin, assessed in terms of unassisted walking behaviours compared with assisted walking following a period of use (combined-orthotic effects). Data sources: MEDLINE, AMED, CINAHL, Cochrane Central Register of Controlled Trials, Scopus, REHABDATA, PEDro, NIHR Centre for Reviews and Dissemination and clinicaltrials.gov, plus reference list, journal, author and citation searches. Study selection: English language comparative randomized controlled trials (RCTs). Data synthesis: Seven RCTs were eligible for inclusion. Two of these reported different results from the same trial and another 2 reported results from different follow-up periods and were therefore combined, resulting in 5 synthesized trials with 815 stroke participants. Meta-analyses of data from the final assessment in each study and 3 overlapping time-points showed comparable improvements in walking speed over 10 m (p = 0.04-0.79), functional exercise capacity (p = 0.10-0.31), timed up-and-go (p = 0.812 and p = 0.539) and perceived mobility (p = 0.80) for both interventions. Conclusion: Data suggest that, in contrast to assumptions that predict FES superiority, ankle foot orthoses have equally positive combined-orthotic effects as FES on key walking measures for foot-drop caused by stroke. However, further long-term, high-quality RCTs are required. These should focus on measuring the mechanisms-of-action; whether there is translation of improvements in impairment to function, plus detailed reporting of the devices used across diagnoses. Only then can robust clinical recommendations be made.

LanguageEnglish
Pages646-656
Number of pages11
JournalJournal of Rehabilitation Medicine
Volume48
Issue number8
DOIs
Publication statusPublished - 1 Sep 2016

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Foot Orthoses
Ankle
Electric Stimulation
Walking
Meta-Analysis
Foot
Randomized Controlled Trials
Stroke
Information Storage and Retrieval
MEDLINE
Language
Equipment and Supplies

Cite this

Prenton, Sarah ; Hollands, Kristen L. ; Kenney, Laurence P J. / Functional electrical stimulation versus ankle foot orthoses for foot-drop : A meta-analysis of orthotic effects. In: Journal of Rehabilitation Medicine. 2016 ; Vol. 48, No. 8. pp. 646-656.
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abstract = "Objective: To compare the effects on walking of functional electrical stimulation (FES) and ankle foot orthoses for footdrop of central neurological origin, assessed in terms of unassisted walking behaviours compared with assisted walking following a period of use (combined-orthotic effects). Data sources: MEDLINE, AMED, CINAHL, Cochrane Central Register of Controlled Trials, Scopus, REHABDATA, PEDro, NIHR Centre for Reviews and Dissemination and clinicaltrials.gov, plus reference list, journal, author and citation searches. Study selection: English language comparative randomized controlled trials (RCTs). Data synthesis: Seven RCTs were eligible for inclusion. Two of these reported different results from the same trial and another 2 reported results from different follow-up periods and were therefore combined, resulting in 5 synthesized trials with 815 stroke participants. Meta-analyses of data from the final assessment in each study and 3 overlapping time-points showed comparable improvements in walking speed over 10 m (p = 0.04-0.79), functional exercise capacity (p = 0.10-0.31), timed up-and-go (p = 0.812 and p = 0.539) and perceived mobility (p = 0.80) for both interventions. Conclusion: Data suggest that, in contrast to assumptions that predict FES superiority, ankle foot orthoses have equally positive combined-orthotic effects as FES on key walking measures for foot-drop caused by stroke. However, further long-term, high-quality RCTs are required. These should focus on measuring the mechanisms-of-action; whether there is translation of improvements in impairment to function, plus detailed reporting of the devices used across diagnoses. Only then can robust clinical recommendations be made.",
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Functional electrical stimulation versus ankle foot orthoses for foot-drop : A meta-analysis of orthotic effects. / Prenton, Sarah; Hollands, Kristen L.; Kenney, Laurence P J.

In: Journal of Rehabilitation Medicine, Vol. 48, No. 8, 01.09.2016, p. 646-656.

Research output: Contribution to journalReview article

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T1 - Functional electrical stimulation versus ankle foot orthoses for foot-drop

T2 - Journal of Rehabilitation Medicine

AU - Prenton, Sarah

AU - Hollands, Kristen L.

AU - Kenney, Laurence P J

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N2 - Objective: To compare the effects on walking of functional electrical stimulation (FES) and ankle foot orthoses for footdrop of central neurological origin, assessed in terms of unassisted walking behaviours compared with assisted walking following a period of use (combined-orthotic effects). Data sources: MEDLINE, AMED, CINAHL, Cochrane Central Register of Controlled Trials, Scopus, REHABDATA, PEDro, NIHR Centre for Reviews and Dissemination and clinicaltrials.gov, plus reference list, journal, author and citation searches. Study selection: English language comparative randomized controlled trials (RCTs). Data synthesis: Seven RCTs were eligible for inclusion. Two of these reported different results from the same trial and another 2 reported results from different follow-up periods and were therefore combined, resulting in 5 synthesized trials with 815 stroke participants. Meta-analyses of data from the final assessment in each study and 3 overlapping time-points showed comparable improvements in walking speed over 10 m (p = 0.04-0.79), functional exercise capacity (p = 0.10-0.31), timed up-and-go (p = 0.812 and p = 0.539) and perceived mobility (p = 0.80) for both interventions. Conclusion: Data suggest that, in contrast to assumptions that predict FES superiority, ankle foot orthoses have equally positive combined-orthotic effects as FES on key walking measures for foot-drop caused by stroke. However, further long-term, high-quality RCTs are required. These should focus on measuring the mechanisms-of-action; whether there is translation of improvements in impairment to function, plus detailed reporting of the devices used across diagnoses. Only then can robust clinical recommendations be made.

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M3 - Review article

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JO - Journal of Rehabilitation Medicine

JF - Journal of Rehabilitation Medicine

SN - 1650-1977

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