Electrical Stimuation vs. AFO for People with Stroke Related Foot Drop

Van Swigchem, Roos. Effect of Peroneal Electrical Stimulation Versus an Ankle-Foot Orthosis on Obstacle Avoidance Ability in People With Stroke-Related Foot Drop. http://ptjournal.apta.org/search? author1=Roos+van+Swigchem&sortspec=date&submit=Submit. Phys Ther.; 2012 vol. 92 no. 3: 398-406. : doi: 10.2522/ ptj.20100405. 1) Within-subject comparison. Impact factor: 2.78 2) Population: community dwelling post stroke at least 6 months prior to study 3) Mode: Functional Electrical Stimulation 4) Parameters: amplitude: pulse width: 1-150 nanosec., frequency/pulse rate: 30 Hz, phase duration: 230 microseconds 5) Protocol: electrodes placed over the common peroneal nerve and anterior tibialis. Treadmill was set at 20-30 km/hr. depending on patient ability 6) Outcome: Use of FES proved to improve obstacle clearance ability in those who have had a stroke, specifically if there is decreased muscular strength involved in the anterior tibialis area. The use of the FES was superior, but not significantly superior, to the use of an AFO. Based on this article, I would use functional electrical stimulation to aide in decreasing foot drop related fall risk due to decreased obstacle clearance ability. I would not, however, base my decision between FES and an orthotic strictly on this study because the difference in outcome was not significant enough to influence my opinion. I would focus more on specific patient situation and preference when selecting method of control for foot clearance of object.