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Ankle-foot orthoses and continuous functional electrical stimulation improve walking speed after stroke: a systematic review and meta-analyses of randomized controlled trials
Foot-drop is a common impairment after stroke, which reduces walking ability. To examine the efficacy of interventions aimed at reducing foot-drop, i.e., ankle-foot orthoses and functional electrical stimulation, on walking speed and balance after stroke. MEDLINE, EMBASE, Cochrane, PsycINFO, and PED...
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| Published in: | Physiotherapy 2020-12, Vol.109, p.43-53 |
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| container_title | Physiotherapy |
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| creator | Nascimento, Lucas Rodrigues da Silva, Layla Alvarenga Araújo Barcellos, João Victor Matos Teixeira-Salmela, Luci Fuscaldi |
| description | Foot-drop is a common impairment after stroke, which reduces walking ability.
To examine the efficacy of interventions aimed at reducing foot-drop, i.e., ankle-foot orthoses and functional electrical stimulation, on walking speed and balance after stroke.
MEDLINE, EMBASE, Cochrane, PsycINFO, and PEDro databases.
The review included only parallel, randomized trials. Participants were ambulatory adults after stroke. The experimental interventions were the use of an ankle-foot orthosis or functional electrical stimulation.
Outcome data related to walking speed and balance were extracted from the eligible trials and combined in random-effects meta-analyses. The quality of trials was assessed by the PEDro scores and the quality of evidence was determined according the Grading of Recommendations Assessment, Development, and Evaluation system.
Eleven trials involving 1135 participants were included. The mean PEDro score of the trials was 5.8 (ranging from 4 to 7). Ankle-foot orthoses (MD 0.24m/s; 95% CI 0.06 to 0.41) and functional electrical stimulation (MD 0.09m/s; 95% CI 0.03 to 0.14) significantly increased walking speed, compared with no intervention/placebo. Results regarding balance were inconclusive. Ankle-foot orthoses were not superior to functional electrical stimulation for improving walking speed (MD 0.00m/s; 95% CI -0.06 to 0.05) or balance (MD 0.27 points on the Berg Balance Scale; 95% CI -0.85 to 1.39) after stroke.
This systematic review provided moderate-quality evidence that both ankle-foot orthoses and functional electrical stimulation improve walking speed after stroke, but the effects on balance remain unclear.
PROSPERO CRD42019130988 |
| doi_str_mv | 10.1016/j.physio.2020.08.002 |
| format | article |
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To examine the efficacy of interventions aimed at reducing foot-drop, i.e., ankle-foot orthoses and functional electrical stimulation, on walking speed and balance after stroke.
MEDLINE, EMBASE, Cochrane, PsycINFO, and PEDro databases.
The review included only parallel, randomized trials. Participants were ambulatory adults after stroke. The experimental interventions were the use of an ankle-foot orthosis or functional electrical stimulation.
Outcome data related to walking speed and balance were extracted from the eligible trials and combined in random-effects meta-analyses. The quality of trials was assessed by the PEDro scores and the quality of evidence was determined according the Grading of Recommendations Assessment, Development, and Evaluation system.
Eleven trials involving 1135 participants were included. The mean PEDro score of the trials was 5.8 (ranging from 4 to 7). Ankle-foot orthoses (MD 0.24m/s; 95% CI 0.06 to 0.41) and functional electrical stimulation (MD 0.09m/s; 95% CI 0.03 to 0.14) significantly increased walking speed, compared with no intervention/placebo. Results regarding balance were inconclusive. Ankle-foot orthoses were not superior to functional electrical stimulation for improving walking speed (MD 0.00m/s; 95% CI -0.06 to 0.05) or balance (MD 0.27 points on the Berg Balance Scale; 95% CI -0.85 to 1.39) after stroke.
This systematic review provided moderate-quality evidence that both ankle-foot orthoses and functional electrical stimulation improve walking speed after stroke, but the effects on balance remain unclear.
PROSPERO CRD42019130988</description><identifier>ISSN: 0031-9406</identifier><identifier>EISSN: 1873-1465</identifier><identifier>DOI: 10.1016/j.physio.2020.08.002</identifier><identifier>PMID: 33120054</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Balance ; Cerebrovascular accident ; Combined Modality Therapy ; Electric Stimulation Therapy ; Foot Orthoses ; Gait ; Gait Disorders, Neurologic - therapy ; Humans ; Orthosis ; Postural Balance ; Randomized Controlled Trials as Topic ; Rehabilitation ; Stroke Rehabilitation - methods ; Walking Speed</subject><ispartof>Physiotherapy, 2020-12, Vol.109, p.43-53</ispartof><rights>2020 Chartered Society of Physiotherapy</rights><rights>Copyright © 2020 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-5a4aaae12780e623faa020249fc54cabf429848c8381a08392cd69776b7bfa7e3</citedby><cites>FETCH-LOGICAL-c362t-5a4aaae12780e623faa020249fc54cabf429848c8381a08392cd69776b7bfa7e3</cites><orcidid>0000-0002-6792-0819 ; 0000-0001-8358-8636</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33120054$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nascimento, Lucas Rodrigues</creatorcontrib><creatorcontrib>da Silva, Layla Alvarenga</creatorcontrib><creatorcontrib>Araújo Barcellos, João Victor Matos</creatorcontrib><creatorcontrib>Teixeira-Salmela, Luci Fuscaldi</creatorcontrib><title>Ankle-foot orthoses and continuous functional electrical stimulation improve walking speed after stroke: a systematic review and meta-analyses of randomized controlled trials</title><title>Physiotherapy</title><addtitle>Physiotherapy</addtitle><description>Foot-drop is a common impairment after stroke, which reduces walking ability.
To examine the efficacy of interventions aimed at reducing foot-drop, i.e., ankle-foot orthoses and functional electrical stimulation, on walking speed and balance after stroke.
MEDLINE, EMBASE, Cochrane, PsycINFO, and PEDro databases.
The review included only parallel, randomized trials. Participants were ambulatory adults after stroke. The experimental interventions were the use of an ankle-foot orthosis or functional electrical stimulation.
Outcome data related to walking speed and balance were extracted from the eligible trials and combined in random-effects meta-analyses. The quality of trials was assessed by the PEDro scores and the quality of evidence was determined according the Grading of Recommendations Assessment, Development, and Evaluation system.
Eleven trials involving 1135 participants were included. The mean PEDro score of the trials was 5.8 (ranging from 4 to 7). Ankle-foot orthoses (MD 0.24m/s; 95% CI 0.06 to 0.41) and functional electrical stimulation (MD 0.09m/s; 95% CI 0.03 to 0.14) significantly increased walking speed, compared with no intervention/placebo. Results regarding balance were inconclusive. Ankle-foot orthoses were not superior to functional electrical stimulation for improving walking speed (MD 0.00m/s; 95% CI -0.06 to 0.05) or balance (MD 0.27 points on the Berg Balance Scale; 95% CI -0.85 to 1.39) after stroke.
This systematic review provided moderate-quality evidence that both ankle-foot orthoses and functional electrical stimulation improve walking speed after stroke, but the effects on balance remain unclear.
PROSPERO CRD42019130988</description><subject>Balance</subject><subject>Cerebrovascular accident</subject><subject>Combined Modality Therapy</subject><subject>Electric Stimulation Therapy</subject><subject>Foot Orthoses</subject><subject>Gait</subject><subject>Gait Disorders, Neurologic - therapy</subject><subject>Humans</subject><subject>Orthosis</subject><subject>Postural Balance</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Rehabilitation</subject><subject>Stroke Rehabilitation - methods</subject><subject>Walking Speed</subject><issn>0031-9406</issn><issn>1873-1465</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9UctuFDEQtBCILIE_QMhHLjPYHs-LA1IU8ZIicYGz1etpE-96xovtSbR8FN9ILxs4cuqWXdXVXcXYSylqKWT3Zlcfbo_Zx1oJJWox1EKoR2wjh76ppO7ax2wjRCOrUYvugj3LeUeAVvbyKbtoGqmEaPWG_bpa9gErF2PhMZXbmDFzWCZu41L8ssY1c7cutvi4QOAY0JbkLbW5-HkNcPrgfj6keIf8HsLeL995PiBOHFzBRLgU9_iWA8_HXHAmhuUJ7zze_xGasUAFNPx4ko6OJ3qNs_-J5yVSDIFaUoWQn7Mnjgq-eKiX7NuH91-vP1U3Xz5-vr66qWzTqVK1oAEApeoHgZ1qHACZpPTobKstbJ1W46AHOzSDBDE0o7JTN_Z9t-23DnpsLtnr81y668eKuZjZZ4shwIJkiVG67bQSrRgJqs9Qm2LOCZ05JD9DOhopzCkpszPnpMwpKSMGQ0EQ7dWDwrqdcfpH-hsNAd6dAUh3klvJZOtxsTj5RCGYKfr_K_wGq2msTg</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Nascimento, Lucas Rodrigues</creator><creator>da Silva, Layla Alvarenga</creator><creator>Araújo Barcellos, João Victor Matos</creator><creator>Teixeira-Salmela, Luci Fuscaldi</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6792-0819</orcidid><orcidid>https://orcid.org/0000-0001-8358-8636</orcidid></search><sort><creationdate>202012</creationdate><title>Ankle-foot orthoses and continuous functional electrical stimulation improve walking speed after stroke: a systematic review and meta-analyses of randomized controlled trials</title><author>Nascimento, Lucas Rodrigues ; da Silva, Layla Alvarenga ; Araújo Barcellos, João Victor Matos ; Teixeira-Salmela, Luci Fuscaldi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-5a4aaae12780e623faa020249fc54cabf429848c8381a08392cd69776b7bfa7e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Balance</topic><topic>Cerebrovascular accident</topic><topic>Combined Modality Therapy</topic><topic>Electric Stimulation Therapy</topic><topic>Foot Orthoses</topic><topic>Gait</topic><topic>Gait Disorders, Neurologic - therapy</topic><topic>Humans</topic><topic>Orthosis</topic><topic>Postural Balance</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Rehabilitation</topic><topic>Stroke Rehabilitation - methods</topic><topic>Walking Speed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nascimento, Lucas Rodrigues</creatorcontrib><creatorcontrib>da Silva, Layla Alvarenga</creatorcontrib><creatorcontrib>Araújo Barcellos, João Victor Matos</creatorcontrib><creatorcontrib>Teixeira-Salmela, Luci Fuscaldi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Physiotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nascimento, Lucas Rodrigues</au><au>da Silva, Layla Alvarenga</au><au>Araújo Barcellos, João Victor Matos</au><au>Teixeira-Salmela, Luci Fuscaldi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ankle-foot orthoses and continuous functional electrical stimulation improve walking speed after stroke: a systematic review and meta-analyses of randomized controlled trials</atitle><jtitle>Physiotherapy</jtitle><addtitle>Physiotherapy</addtitle><date>2020-12</date><risdate>2020</risdate><volume>109</volume><spage>43</spage><epage>53</epage><pages>43-53</pages><issn>0031-9406</issn><eissn>1873-1465</eissn><notes>ObjectType-Article-2</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-1</notes><notes>content type line 23</notes><notes>ObjectType-Undefined-3</notes><abstract>Foot-drop is a common impairment after stroke, which reduces walking ability.
To examine the efficacy of interventions aimed at reducing foot-drop, i.e., ankle-foot orthoses and functional electrical stimulation, on walking speed and balance after stroke.
MEDLINE, EMBASE, Cochrane, PsycINFO, and PEDro databases.
The review included only parallel, randomized trials. Participants were ambulatory adults after stroke. The experimental interventions were the use of an ankle-foot orthosis or functional electrical stimulation.
Outcome data related to walking speed and balance were extracted from the eligible trials and combined in random-effects meta-analyses. The quality of trials was assessed by the PEDro scores and the quality of evidence was determined according the Grading of Recommendations Assessment, Development, and Evaluation system.
Eleven trials involving 1135 participants were included. The mean PEDro score of the trials was 5.8 (ranging from 4 to 7). Ankle-foot orthoses (MD 0.24m/s; 95% CI 0.06 to 0.41) and functional electrical stimulation (MD 0.09m/s; 95% CI 0.03 to 0.14) significantly increased walking speed, compared with no intervention/placebo. Results regarding balance were inconclusive. Ankle-foot orthoses were not superior to functional electrical stimulation for improving walking speed (MD 0.00m/s; 95% CI -0.06 to 0.05) or balance (MD 0.27 points on the Berg Balance Scale; 95% CI -0.85 to 1.39) after stroke.
This systematic review provided moderate-quality evidence that both ankle-foot orthoses and functional electrical stimulation improve walking speed after stroke, but the effects on balance remain unclear.
PROSPERO CRD42019130988</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>33120054</pmid><doi>10.1016/j.physio.2020.08.002</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-6792-0819</orcidid><orcidid>https://orcid.org/0000-0001-8358-8636</orcidid></addata></record> |
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| source | ScienceDirect Freedom Collection |
| subjects | Balance Cerebrovascular accident Combined Modality Therapy Electric Stimulation Therapy Foot Orthoses Gait Gait Disorders, Neurologic - therapy Humans Orthosis Postural Balance Randomized Controlled Trials as Topic Rehabilitation Stroke Rehabilitation - methods Walking Speed |
| title | Ankle-foot orthoses and continuous functional electrical stimulation improve walking speed after stroke: a systematic review and meta-analyses of randomized controlled trials |
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