Effects of flexor reflex stimulation on gait aspects in stroke patients: randomized clinical trial.
Aida Sehle, Christian Salzmann, Joachim Liepert
PMID 38802939WHAT IT FOUND
During a single session, stroke patients walked faster and farther with sole-of-foot reflex stimulation than without, but most gait parameters did not change and the speed gain was below reported clinically meaningful values.
Key findings
01On the 10-m walk test, walking with Incedo was faster than without (15.0 ± 8.5 s versus 17.0 ± 11.4 s), and the paper reported 7.4% faster speed.
02On the 2-min walk test, distance with Incedo was greater than without (90.0 ± 36.4 m versus 86.3 ± 36.8 m), and the paper reported 6.3% longer distance.
03Gait analysis showed only one significant change: step length was shorter with Incedo (0.77 ± 0.21 m versus 0.79 ± 0.21 m), while cadence, stance and swing timing, single and double support, stride length, heel strike angle, toe off angle, maximum foot height and maximum circumduction were unchanged.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study tested only one session, so it cannot show lasting gait improvement or training benefit. There was no sham stimulation and no blinding of participants or assessors; patients could feel the stimulation and visible responses were often present. The sample was small: 25 patients were analysed, and 20 patients were withdrawn before inclusion. The 10-m walk speed gain was below the clinically meaningful values cited in the paper (0.08 m/s versus 0.13, 0.16, or 0.175 m/s). Not all patients improved: five walked slower on the 10-m test and three had worse performance on the 2-min test. Gait response was judged visually and subjectively, and the instrumented gait analysis did not capture visually observed changes such as increased dorsiflexion and hip flexion.
Declared interests
The supplied text does not report a funding source or conflicts-of-interest declaration. The publication types indicate non-U.S. government research support. Incedo was developed by Nordic NeuroSTIM ApS.
The easy way to misread this
Do not conclude that Incedo is an established treatment for long-term post-stroke gait recovery. This was a single-session, unblinded comparison, and the walking-speed gain was below the clinically meaningful values cited by the authors.