Article

This study investigates the direct comparison of energy cost,
efficiency, and effort between an ankle-foot orthosis (AFO) and a functional
electrical stimulation (FES) device for foot drop in ambulatory patients with
multiple sclerosis. DESIGN: Twenty adults (32-74 years old; 55% female) with a
diagnosis of multiple sclerosis resulting in foot drop participated in a crossover, counterbalanced preliminary study. Each participant was tested on
different days, with each session consisting of a separate walk trial per
prosthetic device. Heart rate, oxygen consumption, speed, distance, and
self-reported exertion were measured independently for each device walk trial.
Repeated-measures analysis of variance with device and visit number as
within-participants independent variables were run for the primary outcome
variables of perceived exertion, energy, and metabolic efficiency. RESULTS: A
significant main effect of device was found for perceived exertion (P = 0.01),
with participants reporting decreased exertion levels (Borg Scale) when using the
FES compared with the AFO (mean difference, 1.63; 95% confidence interval,
0.49-2.76). Energy and efficiency did not significantly differ by device.
CONCLUSION: Results suggest that further investigation of the potential
advantages of FES devices over traditional AFO is warranted. TO CLAIM CME
CREDITS: Complete the self-assessment activity and evaluation online at
http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this
article, the reader should be able to: (1) describe the potential differences
between an AFO and FES for the treatment of foot drop in patients with multiple
sclerosis, (2) understand the mechanisms and prevalence of foot drop in patients
with multiple sclerosis, and (3) recognize the potential benefit of improved
perceived exertion found when using FES for the treatment of foot drop in
patients with multiple sclerosis. LEVEL: Advanced ACCREDITATION:
The Association
of Academic Physiatrists is accredited by the Accreditation Council for
Continuing Medical Education to provide continuing medical education for
physicians.The Association of Academic Physiatrists designates this activity for
a maximum of 1.5 AMA PRA Category 1 Credit(s). Physicians should only claim
credit commensurate with the extent of their participation in the activity.

Langue : ANGLAIS