Peroneal nerve stimulation versus an ankle foot orthosis for correction of footdrop in stroke: impact on functional ambulation

Abstract

Objective: To compare the efficacy of the Odstock Dropped-Foot Stimulator (ODFS), a transcutaneous peroneal nerve stimulation device, versus an ankle foot orthosis (AFO) in improving functional ambulation of chronic stroke survivors.

Intervention: Fourteen chronic stroke survivors with foot-drop participated in the study. Participants received ambulation training under 3 test conditions: 1) ODFS, 2) customized AFO, and 3) no device. Each participant was evaluated using the modified Emory Functional Ambulation Profile under the 3 test conditions. All participants were evaluated with a post-evaluation survey to solicit device feedback and preferences.

Results: Functional ambulation with the AFO was significantly improved, relative to no device, on the floor (P = 0.000), carpet (P = 0.013), and "up and go" test (P = 0.042). There was a trend toward significance on the obstacle (P = 0.092) and stair (P = 0.067) trials. Functional ambulation with the ODFS was significantly improved, relative to no device, on the carpet(P = 0.004). A trend toward significance on floor (P = 0.081), obstacle (P = 0.092), and stair (P = 0.079) trials was observed. The difference in functional ambulation between the AFO and ODFS showed a trend toward statistical significance on floor (P = 0.065) and up and go (P = 0.082) trials only. Given a choice between the ODFS and AFO for long-term correction of footdrop, participants indicated a preference for the ODFS.

Conclusion: The AFO and the ODFS may be comparable in their effect on improving functional ambulation as compared to no device. Specific characteristics of the ODFS may make it a preferred intervention by stroke survivors. More rigorously controlled trials are needed to confirm these findings.