Article

OBJECTIVE: To compare the randomized controlled trial evidence for therapeutic
effects on walking of functional electrical stimulation and ankle foot orthoses
for foot drop caused by central nervous system conditions.
DATA SOURCES: MEDLINE,
CINAHL, Cochrane Central Register of Controlled Trials, REHABDATA, PEDro, NIHR
Centre for Reviews and Dissemination, Scopus and clinicaltrials.gov. STUDY
SELECTION: One reviewer screened titles/abstracts.
Two independent reviewers then
screened the full articles.
DATA EXTRACTION: One reviewer extracted data, another
screened for accuracy. Risk of bias was assessed by 2 independent reviewers using
the Cochrane Risk of Bias Tool. DATA SYNTHESIS: Eight papers were eligible; 7
involving participants with stroke and 1 involving participants with cerebral
palsy. Two papes reporting different measures from the same trial were grouped,
resulting in 7 synthesized randomized controlled trials (n= 464). Meta-analysis
of walking speed at final assessment (p = 0.46), for stroke participants (p =
0.54) and after 4-6 weeks' use (p = 0.49) showed equal improvement for both
devices. CONCLUSION: Functional electrical stimulation and ankle foot orthoses
have an equally positive therapeutic effect on walking speed in non-progressive
central nervous system diagnoses. The current randomized controlled trial
evidence base does not show whether this improvement translates into the user's
own environment or reveal the mechanisms that achieve that change. Future studies
should focus on measuring activity, muscle activity and gait kinematics. They
should also report specific device details, capture sustained therapeutic effects
and involve a variety of central nervous system diagnoses.

Langue : ANGLAIS