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Effect of a Foot-Drop Stimulator and Ankle–Foot Orthosis on Walking Performance After Stroke
- Source :
- Neurorehabilitation and Neural Repair. 27:579-591
- Publication Year :
- 2013
- Publisher :
- SAGE Publications, 2013.
-
Abstract
- Background. Studies have demonstrated the efficacy of functional electrical stimulation in the management of foot drop after stroke. Objective. To compare changes in walking performance with the WalkAide (WA) foot-drop stimulator and a conventional ankle–foot orthosis (AFO). 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. 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. Conclusions. Both devices produce equivalent functional gains.
- Subjects :
- Adult
Male
medicine.medical_specialty
Foot drop
Time Factors
Injury control
Foot Orthoses
Poison control
Electric Stimulation Therapy
Walking
law.invention
Physical medicine and rehabilitation
Randomized controlled trial
Ankle/foot orthosis
law
Foot Joints
Humans
Functional electrical stimulation
Medicine
Stroke
Gait Disorders, Neurologic
Physical Therapy Modalities
Aged
Cross-Over Studies
business.industry
General Medicine
Middle Aged
medicine.disease
Preferred walking speed
Treatment Outcome
Physical therapy
Female
Ankle
medicine.symptom
business
Subjects
Details
- ISSN :
- 15526844 and 15459683
- Volume :
- 27
- Database :
- OpenAIRE
- Journal :
- Neurorehabilitation and Neural Repair
- Accession number :
- edsair.doi.dedup.....14c2dec77d3f225e8fde19c59508235d