Focus of the Report: This Health Technology Assessment focuses on the use of functional electrical stimulation (FES) for treatment of foot drop in patients who have a history of stroke an average of ≥ 1 year prior to FES treatment. This mean 1-year threshold was implemented to ensure that the majority of enrolled patients within each study were in the chronic phase of poststroke recovery. The goals of this therapy are to improve gait, walking speed, quality of life, and overall functional mobility.
Technology Description: FES uses electrical pulses applied to the common peroneal nerve to try to recreate the muscle contractions and movements of normal voluntary gait (lifting the foot as it swings forward and placing it correctly on the ground). In skin-surface FES, electrodes placed over the nerve are connected to a stimulator unit, which provides control that can be facilitated by a foot switch or remote programming. In patients with foot drop due to stroke, FES may be used as an assistive device worn daily to facilitate walking and other activities of daily living or as a short-term rehabilitative intervention aimed at enabling users to regain the ability to move voluntarily.
Controversy: Compared with an AFO for treatment of foot drop due to stroke, FES devices may not provide greater improvements in walking, despite their greater complexity and expense.
Does functional electrical stimulation (FES) used for assistive or rehabilitative purposes during the chronic phase of stroke recovery improve gait and quality of life in adult patients who have foot drop related to stroke?
How does FES compare with clinical standards for treatment of foot drop due to stroke during the chronic phase of stroke recovery?
Is FES treatment associated with any safety issues in patients who have a history of stroke?
Have definitive patient selection criteria been established for FES treatment of foot drop in patients in the chronic phase of stroke recovery?
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