Article

OBJECTIVE: To examine the evidence for a training effect on the lower limb of
functional electrical stimulation. PATIENTS: A total of 133
patients >6 months post-stroke. METHODS: Training and orthotic effects were
determined from walking speed over 10 m, associated minimal and substantial
clinically important differences (i.e. >0.05 and >0.10 m/s),
and Functional
Ambulation Category (FAC), ranging from household walking to independent walking
in the community. RESULTS:
An overall significant (p < 0.01) training effect was
found that was not a clinically important difference (0.02 m/s); however,
"community" FAC (>/= 0.8 m/s) and "most limited community walkers" FAC (0.4-0.58
m/s), but not "household walkers" (< 0.4 m/s), benefitted from a clinically
important difference. A highly significant (p< 0.001), substantial clinically
important orthotic effect (0.10 m/s) was found. In terms of overall improvement
of one or more FACs, 23% achieved this due to a training effect, compared with
43% due to an orthotic effect. CONCLUSION: The findings suggest that functional
electrical stimulation provides a training effect in those who are less impaired.
Further work, which optimizes the use of the device for restoration of function,
rather than as an orthotic device, will provide greater clarity on the
effectiveness of functional electrical stimulation for eliciting a training effect.

Langue : ANGLAIS