Article

Evidence supports peroneal nerve functional electrical stimulation
(FES) as an effective alternative to ankle foot orthoses (AFO) for treatment of
foot drop poststroke, but few long-term, randomized controlled comparisons exist.
OBJECTIVE: Compare changes in gait quality and function between FES and AFOs in
individuals with foot drop poststroke over a 12-month period. METHODS: Follow-up
analysis of an unblinded randomized controlled trial (ClinicalTrials.gov
#NCT01087957) conducted at 30 rehabilitation centers comparing FES to AFOs over 6
months. Subjects continued to wear their randomized device for another 6 months
to final 12-month assessments. Subjects used study devices for all home and
community ambulation. Multiply imputed intention-to-treat analyses were utilized;
primary endpoints were tested for noninferiority and secondary endpoints for
superiority. Primary endpoints: 10 Meter Walk Test (10MWT) and device-related
serious adverse event rate. Secondary endpoints: 6-Minute Walk Test (6MWT),
GaitRite Functional Ambulation Profile, and Modified Emory Functional Ambulation
Profile (mEFAP). RESULTS: A total of 495 subjects were randomized, and 384
completed the 12-month follow-up. FES proved noninferior to AFOs for all primary
endpoints. Both FES and AFO groups showed statistically and clinically
significant improvement for 10MWT compared with initial measurement. No
statistically significant between-group differences were found for primary or
secondary endpoints. The FES group demonstrated statistically significant
improvements for 6MWT and mEFAP Stair-time subscore. CONCLUSIONS: At 12 months,
both FES and AFOs continue to demonstrate equivalent gains in gait speed. Results
suggest that long-term FES use may lead to additional improvements in walking
endurance and functional ambulation; further research is needed to confirm these
findings.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS