Functional Electrical Stimulation for foot drop in Multiple Sclerosis: A Systematic Review and Meta-Analysis of the impact on gait speed

Publication date: Available online 11 January 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Linda Miller, Angus McFadyen, Anna C. Lord, Rebecca Hunter, Lorna Paul, Danny Rafferty, Roy Bowers, Paul Mattison
ObjectiveTo 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.Data sourcesFive databases (Cochrane Library, CINAHL, Embase, MEDLINE, Pubmed) and reference lists were searched.Study selectionStudies of both observational and experimental design where gait speed data in pwMS could be extracted were included.Data extractionData were independently extracted and recorded. Methodological quality was assessed using the Effective Public Health Practice Project (EPHPP) tool.Data synthesisNineteen studies (described in 20 articles) recruiting 490 pwMS were identified and rated moderate or weak, with none gaining a strong rating. All studies rated weak for blinding. Initial and ongoing orthotic and therapeutic effects were assessed with regards to the impact 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 = 0.016) with a mean increase in gait speed of 0.05 meters per second (m/s) and ongoing orthotic effect (t = 2.81, p = 0.003) with a mean increase of 0.08m/s. There were no initial or ongoing effect on gait speed in long walk tests and no therapeutic effect on gait speed in either short or long walk tests.ConclusionsFES 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.



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