title: Functional Electrical Stimulation for Foot Drop in Multiple Sclerosis: A Systematic Review and Meta-Analysis of the Effect on Gait Speed.
abstract: To review the efficacy of functional electrical stimulation (FES) used for foot drop in people with multiple sclerosis (pwMS) on gait speed in short and long walking performance tests.
  
  
  
  Five databases (Cochrane Library, CINAHL, Embase, MEDLINE, and PubMed) and reference lists were searched.
  
  
  
  Studies of both observational and experimental design where gait speed data in pwMS could be extracted were included.
  
  
  
  Data were independently extracted and recorded. Methodologic quality was assessed using the Effective Public Health Practice Project tool.
  
  
  
  Nineteen studies (described in 20 articles) recruiting 490 pwMS were identified and rated as moderate or weak, with none gaining a strong rating. All studies rated weak for blinding. Initial and ongoing orthotic and therapeutic effects were assessed regarding the effect of FES on gait speed in short and long walking tests. Meta-analyses of the short walk tests revealed a significant initial orthotic effect (t=2.14, P=.016), with a mean increase in gait speed of .05m/s, and ongoing orthotic effect (t=2.81, P=.003), with a mean increase of .08m/s. There were no initial or ongoing effects on gait speed in long walk tests and no therapeutic effect on gait speed in either short or long walk tests.
  
  
  
  FES used for foot drop has a positive initial and ongoing effect on gait speed in short walking tests. Further fully powered randomized controlled trials comparing FES with alternative treatments are required.
authors.affiliation: Multiple Sclerosis Service, NHS Ayrshire and Arran, Irvine, UK; School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK. Electronic address: linda.renfrew@aapct.scot.nhs.uk.
authors.forename: Linda
authors.initials: L
authors.lastname: Miller
authors.affiliation: AKM-STATS Statistics, Glasgow, UK.
authors.forename: Angus
authors.initials: A
authors.lastname: McFadyen
authors.affiliation: Multiple Sclerosis Service, NHS Ayrshire and Arran, Irvine, UK.
authors.forename: Anna C
authors.initials: AC
authors.lastname: Lord
authors.affiliation: Multiple Sclerosis Service, NHS Ayrshire and Arran, Irvine, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hunter
authors.affiliation: School of Medicine, Glasgow University, Glasgow, UK.
authors.forename: Lorna
authors.initials: L
authors.lastname: Paul
authors.affiliation: School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Danny
authors.initials: D
authors.lastname: Rafferty
authors.affiliation: Department of Biomedical Engineering, Strathclyde University, Glasgow, UK.
authors.forename: Roy
authors.initials: R
authors.lastname: Bowers
authors.affiliation: Multiple Sclerosis Service, NHS Ayrshire and Arran, Irvine, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Mattison
mesh_terms: D000328:Adult; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000628:therapy*; D016138:Walking / Q000502:physiology*
keywords: Electric stimulation; Gait disorders, neurologic; Multiple sclerosis; Rehabilitation; Review [publication type]; Walking