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Functional electrical stimulation versus ankle foot orthoses for foot-drop: a meta-analysis of orthotic effects

Prenton, Sarah, Hollands, Kristen L. and Kenney, Laurence P. (2016) Functional electrical stimulation versus ankle foot orthoses for foot-drop: a meta-analysis of orthotic effects. Journal of Rehabilitation Medicine, 48 (8). pp. 646-656. ISSN 1650-1977 (In Press)

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Objective: To compare the effects on walking of Functional Electrical Stimulation (FES) and Ankle Foot Orthoses (AFO) for foot-drop of central neurological origin, assessed in terms of unassisted walking behaviours compared with assisted walking following a period of use (combined-orthotic effects).
Data Sources: MEDLINE, AMED, CINAHL, Cochrane Central Register of Controlled Trials, Scopus, REHABDATA, PEDro, NIHR Centre for Reviews and Dissemination and plus reference list, journal, author and citation searches.
Study Selection: English language comparative Randomised Controlled Trials (RCTs).
Data Synthesis: Seven RCTs were eligible for inclusion. Two of these reported different results from the same trial and another two reported results from different follow up periods so were combined; resulting in five synthesised trials with 815 stroke participants. Meta-analyses of data from the final assessment in each study and three overlapping time-points showed comparable improvements in walking speed over ten metres (p=0.04-0.95), functional exercise capacity (p=0.10-0.31), timed up-and-go (p=0.812 and p=0.539) and perceived mobility (p=0.80) for both interventions.
Conclusion: Data suggest that, in contrast to assumptions that predict FES superiority, AFOs have equally positive combined-orthotic effects as FES on key walking measures for foot-drop caused by stroke. However, further long-term, high-quality RCTs are required. These should focus on measuring the mechanisms-of-action; whether there is translation of improvements in impairment to function, plus detailed reporting of the devices used across diagnoses. Only then can robust clinical recommendations be made.

Item Type: Article
Subjects: R Medicine > R Medicine (General)
R Medicine > RT Nursing
Schools: School of Human and Health Sciences
Related URLs:
Depositing User: Sara Taylor
Date Deposited: 19 Jul 2016 14:19
Last Modified: 21 Oct 2016 18:07


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