Effect of peroneal electrical stimulation versus an ankle-foot orthosis on obstacle avoidance ability in people with stroke-related foot drop.
The use of Functional Electrical Stimulation (FES) is growing as a treatment for people with drop foot due to stroke. Taking participants who previously used ankle-foot-orthosis (AFO) and where able to walk unaided for more than 10 minutes, this study looked at the effect of FES in obstacle avoidance.
Stimulation units with two electrodes placed on the common peroneal nerve and the anterior tibial muscle, were fitted. A foot switch was placed under the heel, ensuring “switch on” when the affected leg was in swing phase. Participants walked on a treadmill and an obstacle was released to fall in front of the affected side. The trial was repeated using AFOs.
A significantly higher avoidance success rate was seen with FES, with a large amount of variability in the improvement from one participant to another, indicating FES is beneficial only in some cases. It is also interesting to acknowledge that, although responding well to FES, one participant was forced to drop out due to a skin irritation caused by the surface electrodes.
The writers noted that lower leg strength and participants with a low Motricity Index score showed greater benefit and the observed gains in obstacle avoidance ability appear to be clinically relevant. > From: Van Swigchem et al., Phys Ther 92 (2012) 398-406. All rights reserved to the American Physical Therapy Association.
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