Functional Electrical Stimulation for Foot Drop in Multiple Sclerosis: A Systematic Review and Meta-Analysis of the Effect on Gait Speed

Miller, Linda A.; McFadyen, Angus; Lord, Anna C; Hunter, Rebecca; Paul, Lorna; Rafferty, Danny; Bowers, Roy; Mattison, Paul

doi:10.1016/j.apmr.2016.12.007

Cited by 52 publications

(63 citation statements)

References 42 publications

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“…19 Such effects are similar to those identified in previous FES studies. 15,16,29 Similar changes in the COPM scores were reported after a 4-week interdisciplinary inpatient rehabilitation program with people with MS, 40 suggesting that an FES intervention may produce comparable effects.…”

Section: Discussionmentioning

confidence: 67%

“…To our knowledge, this is the first systematic review to specifically evaluate the effect of FES for foot drop on aspects of HRQOL in MS. None of the studies selected for review had a HRQOL measure as its primary outcome. Nevertheless, a better understanding of the impact of FES on HRQOL is critical in providing insight into how previously identified improvements in gait parameters 16 might affect an individual's QOL, thus improving compliance with and acceptance of such an intervention over the long-term. Improvements in aspects of HRQOL with FES, such as fatigue, fitness, confidence in walking, and increased engagement in physical activity and participation in daily activities, have been identified in an interpretative phenomenological analysis focus group study 15 and a clinical audit.…”

Section: Discussionmentioning

confidence: 99%

“…15 Most studies investigating FES in people with MS have evaluated the effect on gait parameters such as speed, energy expenditure, walking distance, and gait kinematics. A recent systematic review and meta-analysis found clinically meaningful orthotic effects of FES on walking speed in people with MS. 16 Although it is important to evaluate the effect of FES on these aspects of walking, understanding the effect of FES on HRQOL will provide clinicians with greater insight into the potential effect on an individual's daily life. This review aimed to systematically review evidence of the effect of FES on aspects of HRQOL in people with MS who present with foot drop.…”

Section: Data Extractionmentioning

confidence: 99%

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Evaluating the Effect of Functional Electrical Stimulation Used for Foot Drop on Aspects of Health-Related Quality of Life in People with Multiple Sclerosis

Renfrew¹,

Lord²,

Warren³

et al. 2019

International Journal of MS Care

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Background: Multiple sclerosis (MS) is a common degenerative neurologic condition resulting in walking difficulties. Foot drop is a common walking impairment in MS that can affect health-related quality of life (HRQOL). Functional electrical stimulation (FES) can improve walking in people with MS, but its effect on HRQOL is not well established. This review investigated the effect of FES used for foot drop on HRQOL in adults with MS. Methods: A systematic search was performed using CINAHL, MEDLINE, Cochrane Library, PubMed, and PEDro online databases. Inclusion and exclusion criteria were applied to select eligible studies. Data were extracted, and two reviewers independently rated the quality of the studies using the Effective Public Health Practice Project assessment tool. Results: Eight studies were eligible for review; seven were of moderate-to-strong methodological quality and one was weak. Seven studies demonstrated significant positive effects of FES on different aspects of HRQOL as measured by the 29-item Multiple Sclerosis Impact Scale, 36-item Short Form Health Status Survey, Canadian Occupational Performance Measure, and Psychosocial Impact of Assistive Devices Scale. Conclusions: This review provides preliminary evidence that FES has a positive effect on aspects of HRQOL in people with MS; however, the variety of HRQOL outcomes used makes it difficult to determine definitive conclusions. Future larger-scale randomized studies with long-term follow-up are recommended to better understand the effect of FES on HRQOL. This will inform prescribing decisions and support compliance with FES over the longer-term.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Data Extractionmentioning

confidence: 99%

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Evaluating the Effect of Functional Electrical Stimulation Used for Foot Drop on Aspects of Health-Related Quality of Life in People with Multiple Sclerosis

Renfrew¹,

Lord²,

Warren³

et al. 2019

International Journal of MS Care

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“…One article with PEDro score of <4 was excluded from further analysis. 14 The outcome measures used in these studies were speed of walking, 9,10,13,[15][16][17][18][19][21][22][23] activities of daily living, 11 energy expenditure for walking, 9,22 qualitative interviews, 8 gait analysis-4, 12,15,17,19 and patient reported outcome measure-1. 18…”

Section: Resultsmentioning

confidence: 99%

“…A meta-analysis of 20 studies (RCTs, non-RCTs, and case series) involving 490 patients noted that use of FES improved speed of walking by 0.05 to 0.08 m/s through an orthotic effect. 23 There is level-1 evidence on effectiveness of FES as an orthotic device in improving speed of walking.…”

Section: Speed Of Walkingmentioning

confidence: 99%

Is Functional Electrical Stimulation Effective in improving Gait in People with Multiple Sclerosis? A Systematic Review

Nair¹,

Hariharan²

2017

Indian Journal of Physical Medicine and Rehabilitation

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Introduction: One of the reasons for difficulty with walking in people with multiple sclerosis (PwMS) is foot drop; the inability to dorsiflex the ankle during the swing phase of the gait. One approach to correct foot drop is to passively support the ankle joint with an ankle foot orthosis (AFO) or a foot up splint. Another approach is to use functional electrical stimulation (FES). Objective: Is FES effective in improving gait in people with foot drop due to multiple sclerosis (MS)? Materials and methods: AMED, EMBASE, BNI, MEDLINE, and CINAHL were searched. Meta-analysis, randomized control trials (RCTs) and non-RCTs, and case series involving investigating FES for foot drop in PwMS were reviewed. Conference abstracts, non-English articles, expert opinions, and FES for other indications were excluded. Full texts of the articles were reviewed by two authors independently using the Physiotherapy Evidence Database (PEDro) scale. The strength of evidence was graded from 1 to 5. Results: Among the 172 results, we excluded 130 after reading the titles (duplicates, articles not in English, and articles on use of FES for indications other than foot drop). After reviewing the abstracts, we excluded further 27 (conference presentations, opinions, and reviews). The PEDro scores of the articles varied between 3 and 7. None of the studies blinded the participants and only one study used blinded assessors. Two RCTs and one meta-analysis found an orthotic effect of FES causing improvement in speed of walking by 0.05 to 0.08 m/s. Two RCTs reported 73 to 83% reduction in number of falls. There were no RCTs comparing effect of FES with AFO in this cohort. Conclusion: There is level-1 evidence that the FES increases speed of walking through an orthotic effect. There is level-2 evidence that it reduces number of falls in PwMS. Further appropriately powered multicenter studies are required to assess the comparison of FES with AFO in this cohort.

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Triboelectric Nanogenerators for Therapeutic Electrical Stimulation

et al. 2021

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Current solutions developed for the purpose of in and on body (IOB) electrical stimulation (ES) lack autonomous qualities necessary for comfortable, practical, and self‐dependent use. Consequently, recent focus has been placed on developing self‐powered IOB therapeutic devices capable of generating therapeutic ES for human use. With the recent invention of the triboelectric nanogenerator (TENG), harnessing passive human biomechanical energy to develop self‐powered systems has allowed for the introduction of novel therapeutic ES solutions. TENGs are especially effective at providing ES for IOB therapeutic systems given their bioconformability, low cost, simple manufacturability, and self‐powering capabilities. Due to the key role of naturally induced electrical signals in many physiological functions, TENG‐induced ES holds promise to provide a novel paradigm in therapeutic interventions. The aim here is to detail research on IOB TENG devices applied for ES‐based therapy in the fields of regenerative medicine, neurology, rehabilitation, and pharmaceutical engineering. Furthermore, considering TENG‐produced ES can be measured for sensing applications, this technology is paving the way to provide a fully autonomous personalized healthcare system, capable of IOB energy generation, sensing, and therapeutic intervention. Considering these grounds, it seems highly relevant to review TENG‐ES research and applications, as they could constitute the foundation and future of personalized healthcare.

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Functional Electrical Stimulation for Foot Drop in Multiple Sclerosis: A Systematic Review and Meta-Analysis of the Effect on Gait Speed

Cited by 52 publications

References 42 publications

Evaluating the Effect of Functional Electrical Stimulation Used for Foot Drop on Aspects of Health-Related Quality of Life in People with Multiple Sclerosis

Evaluating the Effect of Functional Electrical Stimulation Used for Foot Drop on Aspects of Health-Related Quality of Life in People with Multiple Sclerosis

Is Functional Electrical Stimulation Effective in improving Gait in People with Multiple Sclerosis? A Systematic Review

Triboelectric Nanogenerators for Therapeutic Electrical Stimulation

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