Functional electrical stimulation compared with ankle-foot orthosis in subacute post stroke patients with foot drop: A pilot study
Naama Karniel, Eitan Raveh, Isabella Schwartz, Sigal Portnoy
Abstract
Naama Karniel, Eitan Raveh, Isabella Schwartz, Sigal Portnoy
Abstract
Background: The conventional treatment for foot drop includes an ankle-foot orthosis (AFO) or functional electrical stimulation (FES).Goal: To compare gait parameters in patients following a subacute post stroke with foot drop treated with AFO or FES.Method: Twenty one subacute patients with stroke with foot drop were fitted with FES (N = 10) or AFO (N = 11). Evaluations were performed at baseline, following 4 weeks and 12 weeks. Spatiotemporal gait parameters and symmetry, dynamic electromyography, 10-m walk test, 6-min walk test, timed up and go, functional ambulation classification, and perception of improvement in walking were measured. The gait analysis measures were collected without the assistive devices while the functional measures were collected with them.Results: Both groups showed improvement in all of the outcome measures, with no between-groups differences. The swing duration’s and step length’s symmetry indicated better gait symmetry in the FES group after 12 weeks (p = 0.037, effect size = −0.538 and p = 0.028 effect size = −0.568, respectively). The FES group perceived significant improvement in gait after 4 weeks, while subjects in the AFO group reported to perceive improvement only after 12 weeks.Conclusions: Our findings suggest that FES is at least as effective as traditional AFO and may be more so.
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Background: The conventional treatment for foot drop includes an ankle-foot orthosis (AFO) or functional electrical stimulation (FES).Goal: To compare gait parameters in patients following a subacute post stroke with foot drop treated with AFO or FES.Method: Twenty one subacute patients with stroke with foot drop were fitted with FES (N = 10) or AFO (N = 11). Evaluations were performed at baseline, following 4 weeks and 12 weeks. Spatiotemporal gait parameters and symmetry, dynamic electromyography, 10-m walk test, 6-min walk test, timed up and go, functional ambulation classification, and perception of improvement in walking were measured. The gait analysis measures were collected without the assistive devices while the functional measures were collected with them.Results: Both groups showed improvement in all of the outcome measures, with no between-groups differences. The swing duration’s and step length’s symmetry indicated better gait symmetry in the FES group after 12 weeks (p = 0.037, effect size = −0.538 and p = 0.028 effect size = −0.568, respectively). The FES group perceived significant improvement in gait after 4 weeks, while subjects in the AFO group reported to perceive improvement only after 12 weeks.Conclusions: Our findings suggest that FES is at least as effective as traditional AFO and may be more so.
Key concepts: Foot drop, Functional electrical stimulation, Physical medicine and rehabilitation, Gait, Ankle, Medicine, Physical therapy, Gait analysis