Article

OBJECTIVE: To compare the effects on walking of functional electrical stimulation
(FES) and ankle foot orthoses for foot-drop 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.
- Pied tombant

Langue : ANGLAIS