Poster 52 Randomized Controlled Trial of Peroneal Nerve Functional Electrical Stimulation Versus Ankle-Foot Orthosis in Chronic Stroke

Béthoux, François; Rogers, Helen; Nolan, Karen J.; Abrams, Gary; Annaswamy, Thiru M.; Brandstater, Murray E.; Browne, Barbara; Burnfield, Judith M.; Feng, Wuwei; Freed, Mitchell; Geis, Carolyn; Greenberg, Jason; Gudesblatt, Mark; Ikramuddin, Farha; Jayaraman, Arun; Kautz, Steven A.; Lutsep, Helmi L.; Madhavan, Sangeetha; Meilahn, Jill; Pease, William S.; Rao, Noel; Sethi, Pramod; Turk, Margaret A.

doi:10.1016/j.apmr.2013.08.098

Cited by 9 publications

(25 citation statements)

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“…Kluding et al 32 showed a moderate and significant difference in favor of ankle-foot orthosis arm compared with functional electrical stimulation arm (SMD = −0.56, 95% CI = −0.99 to −0.12). The SMD value was found by Bethoux et al, 27 which indicates no clinical and no statistical improvement in balance for WalkAide arm (SMD = 0.02, 95% CI = −0.17 to 0.22). In another study, Nikamp et al 35 compared early ankle-foot orthosis-provision with late ankle-foot orthosisprovision.…”

Section: Results Of Secondary Outcomesmentioning

confidence: 85%

“…Three studies 27,32,35 measured the static and dynamic balance abilities by the Berg Balance Scale. Kluding et al 32 showed a moderate and significant difference in favor of ankle-foot orthosis arm compared with functional electrical stimulation arm (SMD = −0.56, 95% CI = −0.99 to −0.12).…”

Section: Results Of Secondary Outcomesmentioning

confidence: 99%

“…A summary of the results of the search strategy as well as the inclusion and exclusion process is represented in the PRISMA flowchart ( Figure 1). The systematic search strategy resulted in 14 randomized controlled trials [27][28][29][30][31][32][33][34][35][36][37][38][39][40] to the final synthesis.…”

Section: Study Selectionmentioning

confidence: 99%

“…The papers that related to the results of same trial 27,33,35,37,[41][42][43][44][45] were synthesized together and referenced to the publication date from which the maximum data were extracted. 27,33,35,37 A list of excluded studies alongside the reason for exclusion based on the full text has also been provided in Supplemental Appendix 2.…”

Section: Study Selectionmentioning

confidence: 99%

“…A total of 1186 participants with stroke (57% male, 43% female) were included in 14 selected studies. Among all selected studies, 10 studies were randomized controlled trials, 27,29,[31][32][33][35][36][37][38][39] 3 studies 28,34,40 were randomized pilot study, and 1 study 30 was crossover randomized controlled trial (for detailed information, see Table 1).…”

Section: Study Characteristicsmentioning

confidence: 99%

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The effects of ankle-foot orthoses on walking speed in patients with stroke: a systematic review and meta-analysis of randomized controlled trials

et al. 2019

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Objective: The aim of this study was to evaluate the effects of ankle-foot orthoses on speed walking in patients with stroke. Data sources: PubMed, Embase, Web of Science, Scopus, CENTRAL, PEDro, RehabData, RECAL, and ProQuest were searched from inception until 30 September 2019. Review methods: This study was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline statement. Risk of bias assessment was performed using the Cochrane Risk of Bias Tool. Begg’s test and Egger’s regression method were used to assess the publication bias. Trim and fill analysis was also used to adjust any potential publication bias. Sensitivity analysis was performed to evaluate the effect of individual studies. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Results: Overall, 14 studies were included with a total of 1186 participants. A small-to-moderate and non-significant improvement in favor of the ankle-foot orthosis versus without ankle-foot orthosis (standardized mean difference (SMD) = 0.41, 95% confidence interval = −0.15 to 0.96), similar effects of ankle-foot orthosis and functional electrical stimulation (SMD = 0.00, 95% confidence interval = −0.16 to 0.16), and a small and non-significant improvement in favor of ankle-foot orthosis versus another type of ankle-foot orthosis (SMD = 0.22, 95% confidence interval = −0.05 to 0.49) in walking speed were found. However, the quality of evidence for all comparisons was low or very low. Conclusion: Despite reported positive effects in some studies, there is no firm evidence of any benefit of ankle-foot orthoses on walking speed.

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Section: Results Of Secondary Outcomesmentioning

confidence: 85%

Section: Results Of Secondary Outcomesmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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The effects of ankle-foot orthoses on walking speed in patients with stroke: a systematic review and meta-analysis of randomized controlled trials

et al. 2019

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Identifying Instruments to Assess Care Quality for Individuals With Custom Ankle Foot Orthoses: A Scoping Review

Fatone

Jerousek

Slater

et al. 2021

Archives of Physical Medicine and Rehabilitation

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Architectural Changes in Superficial and Deep Compartments of the Tibialis Anterior During Electrical Stimulation Over Different Sites

Carbonaro

Seynnes

Maffiuletti

et al. 2020

IEEE Trans. Neural Syst. Rehabil. Eng.

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Electrical stimulation is widely used in rehabilitation to prevent muscle weakness and to assist the functional recovery of neural deficits. Its application is however limited by the rapid development of muscle fatigue due to the non-physiological motor unit (MU) recruitment. This issue can be mitigated by interleaving muscle belly (mStim) and nerve stimulation (nStim) to distribute the temporal recruitment among different MU groups. To be effective, this approach requires the two stimulation modalities to activate minimally-overlapped groups of MUs. In this manuscript, we investigated spatial differences between mStim and nStim MU recruitment through the study of architectural changes of superficial and deep compartments of tibialis anterior (TA). We used ultrasound imaging to measure variations in muscle thickness, pennation angle, and fiber length during mStim, nStim, and voluntary (Vol) contractions at 15% and 25% of the maximal force. For both contraction levels, architectural changes induced by nStim in the deep and superficial compartments were similar to those observed during Vol. Instead, during mStim superficial fascicles underwent a greater change compared to those observed during nStim and Vol, both in absolute magnitude and in their relative differences between compartments. These observations suggest that nStim results in a distributed MU recruitment over the entire muscle volume, similarly to Vol, whereas mStim preferentially activates the superficial muscle layer. The diversity between spatial recruitment of nStim and mStim suggests the involvement of different MU populations, which justifies strategies based on interleaved nerve/muscle stimulation to reduce muscle fatigue during electrically-induced contractions of TA.

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Poster 52 Randomized Controlled Trial of Peroneal Nerve Functional Electrical Stimulation Versus Ankle-Foot Orthosis in Chronic Stroke

Cited by 9 publications

References 0 publications

The effects of ankle-foot orthoses on walking speed in patients with stroke: a systematic review and meta-analysis of randomized controlled trials

The effects of ankle-foot orthoses on walking speed in patients with stroke: a systematic review and meta-analysis of randomized controlled trials

Identifying Instruments to Assess Care Quality for Individuals With Custom Ankle Foot Orthoses: A Scoping Review

Architectural Changes in Superficial and Deep Compartments of the Tibialis Anterior During Electrical Stimulation Over Different Sites

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