Effect of a foot-drop stimulator and ankle-foot orthosis on walking performance after stroke: a multicenter randomized controlled trial.

MedStar author(s):
Citation: Neurorehabilitation & Neural Repair. 27(7):579-91, 2013 Sep.PMID: 23558080Institution: MedStar National Rehabilitation NetworkForm of publication: Journal ArticleMedline article type(s): Clinical Trial | Journal Article | Multicenter Study | Randomized Controlled Trial | Research Support, Non-U.S. Gov'tSubject headings: *Ankle/ir [Innervation] | *Electric Stimulation Therapy | *Foot Orthoses | *Gait Disorders, Neurologic/et [Etiology] | *Gait Disorders, Neurologic/th [Therapy] | *Stroke/co [Complications] | Adult | Aged | Cross-Over Studies | Female | Foot Joints/ir [Innervation] | Humans | Male | Middle Aged | Physical Therapy Modalities | Stroke/th [Therapy] | Time Factors | Treatment Outcome | WalkingLocal holdings: Available online from MWHC library: 2006 - 2009, Available in print through MWHC library: 1999 - March 2006ISSN:
  • 1545-9683
Name of journal: Neurorehabilitation and neural repairAbstract: BACKGROUND: Studies have demonstrated the efficacy of functional electrical stimulation in the management of foot drop after stroke.CONCLUSIONS: Both devices produce equivalent functional gains.METHODS: Individuals with stroke within the previous 12 months and residual foot drop were enrolled in a multicenter, randomized controlled, crossover trial. Subjects were assigned to 1 of 3 parallel arms for 12 weeks (6 weeks/device): arm 1 (WA-AFO), n = 38; arm 2 (AFO-WA), n = 31; arm 3 (AFO-AFO), n = 24. Primary outcomes were walking speed and Physiological Cost Index for the Figure-of-8 walking test. Secondary measures included 10-m walking speed and perceived safety during this test, general mobility, and device preference for arms 1 and 2 for continued use. Walking tests were performed with (On) and without a device (Off) at 0, 3, 6, 9, and 12 weeks.OBJECTIVE: To compare changes in walking performance with the WalkAide (WA) foot-drop stimulator and a conventional ankle-foot orthosis (AFO).RESULTS: Both WA and AFO had significant orthotic (On-Off difference), therapeutic (change over time when Off), and combined (change over time On vs baseline Off) effects on walking speed. An AFO also had a significant orthotic effect on Physiological Cost Index. The WA had a higher, but not significantly different therapeutic effect on speed than an AFO, whereas an AFO had a greater orthotic effect than the WA (significant at 12 weeks). Combined effects on speed after 6 weeks did not differ between devices. Users felt as safe with the WA as with an AFO, but significantly more users preferred the WA.All authors: Abrams GM, Dromerick AW, Everaert DG, Francisco GE, Hafner BJ, Huskey TN, Kufta CV, Munin MC, Nolan KJ, Stein RBDigital Object Identifier: Date added to catalog: 2014-04-03
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article Available 23558080

Available online from MWHC library: 2006 - 2009, Available in print through MWHC library: 1999 - March 2006

BACKGROUND: Studies have demonstrated the efficacy of functional electrical stimulation in the management of foot drop after stroke.

CONCLUSIONS: Both devices produce equivalent functional gains.

METHODS: Individuals with stroke within the previous 12 months and residual foot drop were enrolled in a multicenter, randomized controlled, crossover trial. Subjects were assigned to 1 of 3 parallel arms for 12 weeks (6 weeks/device): arm 1 (WA-AFO), n = 38; arm 2 (AFO-WA), n = 31; arm 3 (AFO-AFO), n = 24. Primary outcomes were walking speed and Physiological Cost Index for the Figure-of-8 walking test. Secondary measures included 10-m walking speed and perceived safety during this test, general mobility, and device preference for arms 1 and 2 for continued use. Walking tests were performed with (On) and without a device (Off) at 0, 3, 6, 9, and 12 weeks.

OBJECTIVE: To compare changes in walking performance with the WalkAide (WA) foot-drop stimulator and a conventional ankle-foot orthosis (AFO).

RESULTS: Both WA and AFO had significant orthotic (On-Off difference), therapeutic (change over time when Off), and combined (change over time On vs baseline Off) effects on walking speed. An AFO also had a significant orthotic effect on Physiological Cost Index. The WA had a higher, but not significantly different therapeutic effect on speed than an AFO, whereas an AFO had a greater orthotic effect than the WA (significant at 12 weeks). Combined effects on speed after 6 weeks did not differ between devices. Users felt as safe with the WA as with an AFO, but significantly more users preferred the WA.

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