Article

Walking ability of people with foot drop in the chronic phase after
stroke is better with functional electrical stimulation (FES) of the peroneal
nerve than without an orthotic device. However, the literature is not conclusive
on whether peroneal FES also is better than an ankle-foot orthosis (AFO) in this
regard. This study aimed to identify potential benefits of peroneal
FES over an AFO with respect to the ability to negotiate a sudden obstacle.
The study design was a within-subject comparison between FES and AFO
using repeated measures. METHODS: Twenty-four community-dwelling people with
stroke (mean age=52.6 years, SD=12.7) who regularly used a polypropylene AFO were
fitted with a transcutaneous FES device. The participants' obstacle avoidance
ability was tested after 2 and 8 weeks. They had to avoid 30 obstacles that were
suddenly dropped on a treadmill in front of the affected leg while walking with
either FES or an AFO. The obstacle avoidance success rates were determined.
RESULTS: Success rates were higher with FES than with an AFO, especially after
adjustment for individual leg muscle strength. Participants with relatively low
muscle strength (Motricity Index score <64) were most likely to benefit from FES
regarding obstacle avoidance ability. LIMITATION: Further work is needed to
determine whether the results may be generalized to other groups of people with
stroke. CONCLUSIONS: Peroneal FES seems to be superior to an AFO with regard to
obstacle avoidance ability in community-dwelling people with stroke. The observed
gains in obstacle avoidance ability appear to be clinically most relevant in the
people with relatively low leg muscle strength.

Langue : ANGLAIS