FES showed no benefits in patients with isolated foot drop

Patients with hemiplegia who used a functional electrical stimulation device for isolated foot drop showed no significant functional differences during gait, according to results presented at the Association of Children’s Prosthetic-Orthotic Clinics Annual Meeting, here.

By Amanda Alexander, Healio April 15, 2016

Broomfiled, Colorado – David E. Westberry MD and colleagues at Shriners Hospital for Children in Greenville SC, conducted a retrospective review of four patients who underwent motion analysis studies during ambulation with and without the WalkAide, an active functional electrical system (FES) device. Patients ranged in age from 12 years to 18 years.

All of the patients completed motion lab assessments while wearing the device. Two patients had spastic hemiplegia, one patient had asymmetric diplegia and one patient had hemiparesis secondary to hemispherectomy. Prior interventions included a posterior leaf spring orthosis for one patient, plantar flexor Botox injection for one patient and plantar flexor lengthening in two patients. Patients used the FES device for an average of 19.3 months prior to gait lab assessment.

Results of the study showed no significant functional benefits for any of the patients. One patient showed improvement in peak ankle dorsiflexion during the swing phase when the FES was in place and active, but showed no improvement during the stance phase.

“[Among] functional results, there were no differences in walking speed, stride length or cadence,” Westberry said.

Despite these results, all four patients preferred the FES device compared with traditional ankle foot orthoses (AFOs).

“In subjective results, there was a preference for the WalkAide over the traditional AFOs and the kids did appreciate the benefit of utilizing the device,” Westberry said. “The outcomes were variable and may not be sufficient to justify the clinical use, but the overall, patient experience was favorable.”

Source Healio

References

Westberry D, et al. Paper #1. Presented at the Association of Children’s Prosthetic-Orthotic Clinics Annual Meeting, April 13, 2016. Broomfield CO.

Further reading

Relationship between ankle function and walking ability for children and young adults with cerebral palsy: A systematic review of deficits and targeted interventions, Conner BC, Remec NM, Michaels CM, Wallace CW, Andrisevic E, Lerner ZF. Gait Posture. 2022 Jan;91:165-178. doi: 10.1016/j.gaitpost.2021.10.024. Epub 2021 Oct 25. Full text

Functional Electrical Stimulation for Foot Drop in Multiple Sclerosis: A Systematic Review and Meta-Analysis of the Effect on Gait Speed, Miller L, McFadyen A, Lord AC, Hunter R, Paul L, Rafferty D, Bowers R, Mattison P. Arch Phys Med Rehabil. 2017 Jul;98(7):1435-1452. doi: 10.1016/j.apmr.2016.12.007. Epub 2017 Jan 11.

WalkAide Efficacy on Gait and Energy Expenditure in Children with Hemiplegic Cerebral Palsy: A Randomized Controlled Trial, El-Shamy SM, Abdelaal AA. Am J Phys Med Rehabil. 2016 Sep;95(9):629-38. doi: 10.1097/PHM.0000000000000514.

Muscle plasticity and ankle control after repetitive use of a functional electrical stimulation device for foot drop in cerebral palsy, Damiano DL, Prosser LA, Curatalo LA, Alter KE. Neurorehabil Neural Repair. 2013 Mar-Apr;27(3):200-7. doi: 10.1177/1545968312461716. Epub 2012 Oct 4. Full text

BIONic WalkAide for correcting foot drop, Weber DJ, Stein RB, Chan KM, Loeb GE, Richmond FJ, Rolf R, James K, Chong SL. Conf Proc IEEE Eng Med Biol Soc. 2004;2004:4189-92. doi: 10.1109/IEMBS.2004.1404169.

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