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 randomized controlled comparisons exist. OBJECTIVE:
To compare changes in gait and quality of life (QoL) between FES and an AFO in
individuals with foot drop poststroke. METHODS: In a multicenter randomized
controlled trial (ClinicalTrials.gov #NCT01087957) with unblinded outcome
assessments, 495 Medicare-eligible individuals at least 6 months poststroke wore
FES or an AFO for 6 months. Primary endpoints: 10-Meter Walk Test (10MWT), a
composite of the Mobility, Activities of Daily Living/Instrumental Activities of
Daily Living, and Social Participation subscores on the Stroke Impact Scale
(SIS), and device-related serious adverse event rate. Secondary endpoints:
6-Minute Walk Test, GaitRite Functional Ambulation Profile (FAP), Modified Emory
Functional Ambulation Profile (mEFAP), Berg Balance Scale (BBS), Timed Up and Go,
individual SIS domains, and Stroke-Specific Quality of Life measures. Multiply
imputed intention-to-treat analyses were used with primary endpoints tested for
noninferiority and secondary endpoints tested for superiority. RESULTS: A total
of 399 subjects completed the study. FES proved noninferior to the AFO for all
primary endpoints. Both the FES and AFO groups improved significantly on the
10MWT. Within the FES group, significant improvements were found for SIS
composite score, total mFEAP score, individual Floor and Obstacle course time
scores of the mEFAP, FAP, and BBS, but again, no between-group differences were
found. CONCLUSIONS: Use of FES is equivalent to the AFO. Further studies should
examine whether FES enables better performance in tasks involving functional
mobility, activities of daily living, and balance.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS