Journal
ANNALS OF PHYSICAL AND REHABILITATION MEDICINE
Volume 64, Issue 1, Pages -Publisher
ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER
DOI: 10.1016/j.rehab.2020.03.012
Keywords
Stroke rehabilitation; Lower extremity; Electric stimulation; Neurologic gait disorders
Categories
Funding
- Brazilian agency CAPES (Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior)
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FES has limited impact on gait speed for patients with foot drop, but shows better improvement when combined with supervised exercises. It is effective in enhancing ankle dorsiflexion, balance, and functional mobility, although with some uncertainties in the results due to high heterogeneity.
Background: Functional electrical stimulation (FES) applied to the paretic peroneal nerve has positive clinical effects on foot drop secondary to stroke. Objective: To evaluate the effectiveness of FES applied to the paretic peroneal nerve on gait speed, active ankle dorsiflexion mobility, balance, and functional mobility. Methods: Electronic databases were searched for articles published from inception to January 2020. We included randomized controlled trials or crossover trials focused on determining the effects of FES combined or not with other therapies in individuals with foot drop after stroke. Characteristics of studies, participants, comparison groups, interventions, and outcomes were extracted. Statistical heterogeneity was assessed with the I2 statistic. Results: We included 14 studies providing data for 1115 participants. FES did not enhance gait speed as compared with conventional treatments (i.e., supervised/unsupervised exercises and regular activities at home). FES combined with supervised exercises (i.e., physiotherapy) was better than supervised exercises alone for improving gait speed. We found no effect of FES combined with unsupervised exercises and inconclusive effects when FES was combined with regular activities at home. When FES was compared with conventional treatments, it improved ankle dorsiflexion, balance and functional mobility, albeit with high heterogeneity for these last 2 outcomes. Conclusions: This meta-analysis revealed low quality of evidence for positive effects of FES on gait speed when combined with physiotherapy. FES can improve ankle dorsiflexion, balance, and functional mobility. However, considering the low quality of evidence and the high heterogeneity, these results must be interpreted carefully. (C) 2020 Elsevier Masson SAS. All rights reserved.
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