Peroneal Stimulation for Foot Drop After Stroke: A Systematic Review
Kari Dunning1, Michael W O'Dell, Patricia Kluding
1From the Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, Ohio (KD); Division of Rehabilitation Medicine, Weill Cornell Medical College, New York, New York (MWO); Department of Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, Kansas City, Kansas (PK); and Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, Maryland, and Bioness Inc, Valencia, California (KM).
Single-channel foot drop stimulation and ankle foot orthoses are equally effective for improving gait speed in stroke survivors. Foot drop stimulation also reduced the Physiologic Cost Index and was preferred by participants.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Foot drop is a common impairment following stroke, affecting mobility and independence.
- Ankle foot orthoses (AFOs) and functional electrical stimulation (FES) are common interventions to address foot drop.
- Evidence comparing the efficacy and patient preference of these interventions is crucial for clinical decision-making.
Purpose of the Study:
- To systematically review the effects of daily single-channel foot drop stimulation (FDS) compared to other interventions, primarily AFOs, in individuals with stroke.
- To evaluate the impact of FDS on various functional outcomes, including gait speed, balance, and quality of life.
Main Methods:
- A systematic review of randomized controlled trials (RCTs) was conducted.
- Searches were performed on electronic databases up to May 2014.
- Six RCTs involving 820 participants were included in the analysis.
Main Results:
- Both FDS and AFOs demonstrated effectiveness in increasing gait speed, with comparable results.
- Timed Up and Go (TUG) and Six-Minute Walk Test (6MWT) consistently improved with both interventions.
- FDS showed greater efficacy in reducing the Physiologic Cost Index (PCI) and was associated with higher participant preference compared to AFOs.
Conclusions:
- Single-channel FDS and AFOs are equivalent in improving gait speed in stroke patients.
- FDS may offer additional benefits in reducing physiological cost and enhancing patient preference.
- Physical therapy can augment the benefits of both FDS and AFOs.
