A decision support system for electrode shaping in multi-pad FES foot drop correction.
Jovana Malešević, Suzana Dedijer Dujović, Andrej M Savić and 5 others
PMID 28673311WHAT IT FOUND
Top-ranked pads suggested by an electrical stimulation system for foot drop were used in over 95% of patterns, and voluntary ankle movement increased over 20 sessions in 10 stroke patients, but there was no control group.
Key findings
01Clinicians included the top-ranked pad suggested by the system in more than 95% of dorsiflexion and plantar flexion patterns.
02Clinicians used only system-suggested pads in 82% of dorsiflexion sessions and 89% of plantar flexion sessions, and chose non-suggested pads in 1.5% of sessions.
03During FES-assisted walking therapy, voluntary ankle range of motion rose from a median 19° at baseline to 28.5° after one week and 40.5° at the end.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 10 stroke patients were studied, and there was no control group, randomisation or blinding, so changes over time cannot be separated from usual recovery, practice or other therapy effects. The authors said the outcomes of FES-assisted gait therapy were not discussed except for ankle range of motion, so gait, balance, falls or walking speed were not reported. Patients had different stroke severity, time since stroke, and walking aids, so it is unclear which patients might benefit. Pad choices varied from session to session, possibly because of garment placement, skin contact, swelling or tissue hydration. The clinicians were trained on the device and could overrule the system, so the result reflects a supported clinical process rather than a fully automated system. The study was done at one rehabilitation clinic.
The easy way to misread this
Do not read the increased ankle range of motion as proof that the decision support system, multi-pad stimulation, or walking therapy improves gait. The study had 10 patients, no control group, and the authors did not report gait outcomes beyond range of motion. The contribution of any single component cannot be separated.