title: Functional electrical stimulation versus ankle foot orthoses for foot-drop: A meta-analysis of orthotic effects.
abstract: OBJECTIVE
  To compare the effects on walking of functional electrical stimulation (FES) and ankle foot orthoses for foot-drop of central neurological origin, assessed in terms of unassisted walking behaviours compared with assisted walking following a period of use (combined-orthotic effects).
  
  
  METHODS
  MEDLINE, AMED, CINAHL, Cochrane Central Register of Controlled Trials, Scopus, REHABDATA, PEDro, NIHR Centre for Reviews and Dissemination and clinicaltrials.gov, plus reference list, journal, author and citation searches.
  
  
  METHODS
  English language comparative randomized controlled trials (RCTs).
  
  
  RESULTS
  Seven RCTs were eligible for inclusion. Two of these reported different results from the same trial and another 2 reported results from different follow-up periods and were therefore combined, resulting in 5 synthesized trials with 815 stroke participants. Meta-analyses of data from the final assessment in each study and 3 overlapping time-points showed comparable improvements in walking speed over 10 m (p = 0.04-0.79), functional exercise capacity (p = 0.10-0.31), timed up-and-go (p = 0.812 and p = 0.539) and perceived mobility (p = 0.80) for both interventions.
  
  
  CONCLUSIONS
  Data suggest that, in contrast to assumptions that predict FES superiority, ankle foot orthoses have equally positive combined-orthotic effects as FES on key walking measures for foot-drop caused by stroke. However, further long-term, high-quality RCTs are required. These should focus on measuring the mechanisms-of-action; whether there is translation of improvements in impairment to function, plus detailed reporting of the devices used across diagnoses. Only then can robust clinical recommendations be made.
authors: , Room RG/23, Ramsden Building University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, HD1 3DH, United Kingdom. s.prenton@hud.ac.uk.
authors: Sarah
authors: S
authors: Prenton
authors: Kristen L
authors: KL
authors: Hollands
authors: Laurence P J
authors: LP
authors: Kenney
mesh_terms: D000368:Aged; D000842:Ankle / Q000503:physiopathology; D004558:Electric Stimulation; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005528:Foot / Q000503:physiopathology; D061826:Foot Orthoses / Q000706:statistics & numerical data*; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D016138:Walking / Q000502:physiology