STROKE-FUNCTIONAL ELECTRICAL STIMULATION (FES) & GAIT
SUMMARY
LOWER LIMBS
1. FES of the common peroneal nerve has been used to enhance ankle dorsiflexion during the swing phase of gait.
2. Although weak ankle dorsiflexion with plantar flexion hypertonicity is typically corrected by an AFO, FES may be a suitable alternative for highly motivated patients who are able to walk independently or with minimal assistance.
3. Two systematic reviews of RCTs found that FES was superior to training alone for improving functional mobility in both acute and chronic phases & there is strong evidence FES and gait retraining results in improvements in hemiplegic gait[1]
2. Teasell, R., Hussein, N., Mirkowski, M., Vanderlaan, D., Saikaley, M., Longval, M. and Iruthayarajah, J., 2020. Lower Extremity Motor and Mobility Rehabilitation. [online] Ebrsr.com. Available at: Ebrsr.com [Accessed 11 November 2020].
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4. Canadian Best Practice Guidelines: FES should be used to improve strength and function (gait) in selected patients, but the effects may not be sustained (Evidence Level: A)[2]
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5. Summary: FES has been shown to improve ADLs, muscle strength, functional ambulation and gait. It may help motor function and spasticity but does not improve balance and functional mobility more than conventional care.
Reference(s)
- ↑ Howlett, O. A., Lannin, N. A., Ada, L., & McKinstry, C. (2015). Functional electrical stimulation improves activity after stroke: a systematic review with meta-analysis. Arch Phys Med Rehabil, 96(5), 934-943. doi:10.1016/j.apmr.2015.01.013
- ↑ Teasell, R., Hussein, N., Mirkowski, M., Vanderlaan, D., Saikaley, M., Longval, M. and Iruthayarajah, J., 2020. Lower Extremity Motor and Mobility Rehabilitation. [online] Ebrsr.com. Available at: Ebrsr.com [Accessed 11 November 2020].
Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
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O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.
