Ankle-foot orthoses and continuous functional electrical stimulation improve walking speed after stroke: a systematic review and meta-analyses of randomized controlled trials

Nascimento, Lucas Rodrigues; Silva, Layla Alvarenga da; Barcellos, João Victor Matos Araújo; Teixeira-Salmela, Luci Fuscaldi

doi:10.1016/j.physio.2020.08.002

Cited by 11 publications

(30 citation statements)

References 35 publications

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“…In the next step, 37 potentially relevant studies were then identified and evaluated by the two reviewers independently based on the full text. Finally, 14 studies 4 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 were selected by the research team to enter the study (Figure 1 ). In the final step, 23 studies were excluded, along with the reasons for exclusion, which are listed in Supporting Information: Table 2 .…”

Section: Resultsmentioning

confidence: 99%

The quality of systematic reviews/meta‐analyses assessing the effects of ankle–foot orthosis on clinical outcomes in stroke patients: A methodological systematic review

Shahabi

Mojgani

Lankarani

et al. 2023

Health Science Reports

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Background and Aims Given the importance of systematic reviews (SRs) for practitioners, researchers, and policymakers, it is essential to assess them to ensure robust methodology and reliable results before applying them. The purpose of this methodological study was to assess the methodological and reporting quality of recently published SRs and/or meta‐analyses (MAs) evaluating the effects of ankle–foot orthoses (AFOs) on clinical outcomes in stroke survivors. Methods PubMed, Scopus, Web of Science, Embase, ProQuest, CENTRAL, REHABDATA, and PEDro were searched. The research team applied A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR‐2) tool and Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) checklist for evaluating the reporting and methodological quality, respectively, and the ROBIS tool was used to evaluate the risk of bias (RoB) in the included reviews. The quality of the evidence was also judged using the (Grades of Recommendation, Assessment, Development and Evaluation) GRADE method. Results In final, 14 SRs/MAs met inclusion criteria. Evaluation of methodological quality using the AMSTAR‐2 tool demonstrated that the overall quality of included reviews was mostly “critically low” or “low,” except for two studies that were “high.” In addition, the findings showed that the mean score of the reporting quality of the included reviews based on the PRISMA criteria was 24.9, down from 42. In accordance with the overall evaluation applying the ROBIS tool, 14.3% of the review studies were evaluated as high RoB, 64.3% were evaluated as unclear RoB, and 21.4% were evaluated as low RoB. Regarding the level of evidence quality, the GRADE results indicated that the evidence quality of the included reviews was unsatisfactory. Conclusion This study showed that although the reporting quality of recently published SR/MAs evaluating the clinical effects of AFOs in stroke survivors was moderate, the methodological quality of almost all reviews was suboptimal. Therefore, reviewers must consider a number of criteria in designing, conducting, and reporting their studies to move toward transparent and conclusive results.

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Section: Resultsmentioning

confidence: 99%

The quality of systematic reviews/meta‐analyses assessing the effects of ankle–foot orthosis on clinical outcomes in stroke patients: A methodological systematic review

Shahabi

Mojgani

Lankarani

et al. 2023

Health Science Reports

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“… 107 It consists of a structure with different presentations in which plantar sensors are connected to superficial electrodes that promote the contraction of the tibial and dorsiflexor muscles, preventing foot drop during the swing phase of gait. 107 A meta-analysis 108 concluded that there was evidence that AFO and FES can increase gait speed, mobility, dynamic balance, quality of life, endurance, and muscle activation poststroke. Another meta-analysis 109 of low-quality evidence showed that FES applied to the paretic peroneal nerve, when combined with physiotherapy, can improve ankle dorsiflexion, balance, and functional mobility.…”

Section: Mobilitymentioning

confidence: 99%

Brazilian practice guidelines for stroke rehabilitation: Part II

et al. 2022

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The Brazilian Practice Guidelines for Stroke Rehabilitation – Part II, developed by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, in Portuguese), focuses on specific rehabilitation techniques to aid recovery from impairment and disability after stroke. As in Part I, Part II is also based on recently available evidence from randomized controlled trials, systematic reviews, meta-analyses, and other guidelines. Part II covers disorders of communication, dysphagia, postural control and balance, ataxias, spasticity, upper limb rehabilitation, gait, cognition, unilateral spatial neglect, sensory impairments, home rehabilitation, medication adherence, palliative care, cerebrovascular events related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the future of stroke rehabilitation, and stroke websites to support patients and caregivers. Our goal is to provide health professionals with more recent knowledge and recommendations for better rehabilitation care after stroke.

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“…This increase in walking speed can be considered to be related to regular walking activity and exercises. [17][18][19][20][21][22][23][24] In the current study, VGA showed significant improvements in ankle rotations and initial contact of the foot between the baseline and 4-week measurements. In parallel with this, a significant synchronisation with the normal side of the stance was observed.…”

Section: Parametersmentioning

confidence: 80%

“…Baseline n (%), mean (SD) of a conventional treatment group and a FES group, significant improvements been reported in both groups. [13][14][15][16][17][18][19] However, these studies often included patients in the chronic phase. Chronic patients develop balance with an incorrect postural pattern by providing appropriate balance modification to the disability pretreatment.…”

Section: Parametersmentioning

confidence: 99%

The Efficiency of Functional Electrical Stimulation and Balance-Weighted Rehabilitation Therapy in Stroke Patients with Foot-Drop: A Pilot Study

Güzel¹,

Umay²,

Öztürk³

et al. 2022

J PMR Sci

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This study aimed to evaluate the effects of FES and balance-weighted rehabilitation therapy in addition to conventional rehabilitation in stroke patients with foot-drop on motor function, ambulation, posture, balance, physical disability, gait quality and activities of daily living. Material and Methods: This study included 35 stroke patients with foot-drop. The patients were evaluated in respect of motor function, activities of daily living posture, balance and risk of falling. Brunnstrom stages of motor recovery was administered to assess motor function. The functional disability was assessed by Functional Independence Measure. Functional Ambulation Category was used to assess the patients' gait performance. Berg Balance Scale was used in functional balance and risk of falling. Posture was assessed using the Trunk Control Test. Video-assisted visual gait analysis (VGA) over a distance of 10 m was also applied to patients. The two gait phases of swing and stance were analysed. Walking speed (m/sn) and walking rhythm (step/min) were determined. All patients received conventional rehabilitation, FES and balance-weighted rehabilitation therapy 5 days a week for 4 weeks. The evaluation parameters were repeated in weeks 2 and 4, and these parameters were compared. Results: From the baseline values to the end of week 4, a significant improvement was determined in respect of functional disability, balance, upper and lower extremity functions, walking speed and rhythm. Conclusion: FES and balance-weighted rehabilitation therapy in addition to conventional rehabilitation is an effective treatment method for hemiplegic foot rehabilitation as it improves functional ambulation and increases the level of independence in daily living activities.

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Ankle-foot orthoses and continuous functional electrical stimulation improve walking speed after stroke: a systematic review and meta-analyses of randomized controlled trials

Cited by 11 publications

References 35 publications

The quality of systematic reviews/meta‐analyses assessing the effects of ankle–foot orthosis on clinical outcomes in stroke patients: A methodological systematic review

The quality of systematic reviews/meta‐analyses assessing the effects of ankle–foot orthosis on clinical outcomes in stroke patients: A methodological systematic review

Brazilian practice guidelines for stroke rehabilitation: Part II

The Efficiency of Functional Electrical Stimulation and Balance-Weighted Rehabilitation Therapy in Stroke Patients with Foot-Drop: A Pilot Study

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