Thu 24th Nov, 2011

ABSTRACT

INTRODUCTION: Functional Electrical Stimulation (FES) is an evidence based treatment for dropped foot correction. The feasibility of combining physiotherapy and FES to improve gait in people less than 6 months post stroke has not been established.

METHOD: Adults less than 6 months post first stroke were randomised to Group A (physiotherapy, n=10) or Group B (physiotherapy+FES, n=10). Physiotherapy consisted of 12 sessions of individualised goal orientated, task specific, gait rehabilitation. Group B used FES for dropped foot correction, integrated into the physiotherapy sessions and at home. Assessments were conducted before randomisation (Week 1), after treatment (Week 8) and after follow-up in ‘usual care’ (Week 20).

RESULTS: Mean (range) time post-stoke was 10.4 weeks (3.6-20.1). During treatment (Week 1-8) both groups demonstrated statistically significant improvements in 10m walking speed, 6-minute walking distance, Rivermead Mobility Index and Canadian Occupational Performance Measure. During the follow-up period (Week 8-20) this was maintained but not increased i.e. most of the improvement occurred in the initial treatment phase. No evidence of between group differences was found. There was significant orthotic improvement in 10m walking speed (Group B: stimulation on versus off) at Week 8 p=0.03 (median 0.04m/s (8%)) and Week 20 p=0.04 (median 0.07m/s (22%). There was evidence that Group B participants who wanted to continue FES after the trial had greater walking difficulties at Week 1.

CONCLUSION: This study demonstrated the feasibility of integrating FES into physiotherapy. FES produced an orthotic benefit however there was no evidence of a training effect relative to physiotherapy alone.

Presentation available below.