Article

Studies have demonstrated the efficacy of functional electrical
stimulation in the management of foot drop after stroke. OBJECTIVE: To compare
changes in walking performance with the WalkAide (WA) foot-drop stimulator and a
conventional ankle-foot orthosis (AFO). METHODS: Individuals with stroke within
the previous 12 months and residual foot drop were enrolled in a multicenter,
randomized controlled, crossover trial. Subjects were assigned to 1 of 3 parallel
arms for 12 weeks (6 weeks/device): arm 1 (WA-AFO), n = 38; arm 2 (AFO-WA), n =
31; arm 3 (AFO-AFO), n = 24. Primary outcomes were walking speed and
Physiological Cost Index for the Figure-of-8 walking test. Secondary measures
included 10-m walking speed and perceived safety during this test, general
mobility, and device preference for arms 1 and 2 for continued use. Walking tests
were performed with (On) and without a device (Off) at 0, 3, 6, 9, and 12 weeks.
RESULTS: Both WA and AFO had significant orthotic
(On-Off difference),
therapeutic (change over time when Off), and combined (change over time On vs
baseline Off) effects on walking speed. An AFO also had a significant orthotic
effect on Physiological Cost Index. The WA had a higher,
but not significantly
different therapeutic effect on speed than an AFO, whereas an AFO had a greater
orthotic effect than the WA (significant at 12 weeks). Combined effects on speed
after 6 weeks did not differ between devices. Users felt as safe with the WA as
with an AFO, but significantly more users preferred the WA. CONCLUSIONS: Both
devices produce equivalent functional gains.
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Langue : ANGLAIS