Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Feb 2:5:2055668318755071.
doi: 10.1177/2055668318755071. eCollection 2018 Jan-Dec.

A comparison of the initial orthotic effects of functional electrical stimulation and ankle-foot orthoses on the speed and oxygen cost of gait in multiple sclerosis

Linda Miller Renfrew  1   2 , Anna C Lord  1 , Angus K McFadyen  3 , Danny Rafferty  2 , Rebecca Hunter  1 , Roy Bowers  4 , Paul Mattison  1 , Owen Moseley  5 , Lorna Paul  2
Affiliations

A comparison of the initial orthotic effects of functional electrical stimulation and ankle-foot orthoses on the speed and oxygen cost of gait in multiple sclerosis

Linda Miller Renfrew et al. J Rehabil Assist Technol Eng. .

Abstract

Background: Foot drop affects walking in people with multiple sclerosis (pwMS). This study compares the initial orthotic effects of two treatments for foot drop: ankle-foot orthoses (AFO) and functional electrical stimulation (FES), on the speed and oxygen cost of walking in MS.

Method and materials: Seventy-eight pwMS were randomised to receive AFO or FES (ODFS PACE (OML, Salisbury, UK)). Participants completed the 25-ft walk test (25ftWT) and 5-min self-selected walk test (5minSSWT), from which oxygen cost was determined, with and without their device. Between-, within- and sub-group analyses (based on baseline walking speed of <0.8 m/s (slow) or ≥0.8 m/s (fast)) were undertaken.

Results: No significant differences between baseline measures were observed. The AFO group walked significantly slower than the FES group (5minSSWT, p = 0.037, 0.11 m/s). The AFO group walked significantly slower with than without AFO (25ftWT, p = 0.037), particularly in the fast-walking group ( p = 0.011). The slow-walking FES group walked significantly faster with FES than without (25ftWT; p = 0.029, 5minSSWT; p = 0.037). There were no differences in the fast-walking FES group or in the oxygen cost for either device.

Conclusion: AFO reduced walking speed, particularly in fast walkers. FES increased walking speed in slow, but not fast walkers.

Keywords: Ankle-foot orthosis; electrical stimulation; neurorehabilitation; orthotics; walking velocity.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Consort diagram. AFO: ankle foot orthoses; FES: functional electrical stimulation.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. National Institute of Health and Clinical Excellence (NICE). Multiple sclerosis in adults: management, Manchester: NICE, 2014, pp. 1–37.
    1. Pittock SJ, McClelland RL, Mayr WT, et al. Clinical implications of benign multiple sclerosis: a 20-year population-based follow-up study. Annals Neurol 2004; 56: 303–306. - PubMed
    1. Crenshaw SJ, Roger TD, Richards JG, et al. Gait variability in people with multiple sclerosis. Mult Scler 2006; 12: 613–619. - PubMed
    1. Martin CL, Phillips BA, Kilpatrick TJ, et al. Gait and balance impairment in early multiple sclerosis in the absence of clinical disability. Mult Scler 2006; 12: 620–628. - PubMed
    1. Morris M, Cantell C, Vowels, et al. Changes in gait and fatigue from morning to afternoon in people with multiple sclerosis. J Neurol Neurosurg Psychiatry 2002; 72: 361–365. - PMC - PubMed

LinkOut - more resources