The use of functional electrical stimulation (FES) in adults with dropped foot. This evidence note updates evidence note 25 published in October 2008
Thompson L
Record ID 32013000469
English
Authors' recommendations:
Dropped foot is the inability to lift the foot from the ground during the swing phase of gait. This condition is present in around 20% of patients surviving a stroke. It is also associated with multiple sclerosis (MS) and other neurological conditions.
A body of evidence, based largely on uncontrolled observational studies in patients with stroke with dropped foot and patients with multiple sclerosis with dropped foot, using heterogeneous outcome measures, indicates that functional electrical stimulation (FES) (mainly using surface electrodes) is associated with improved walking speed and reduced walking effort.
There are preliminary findings of a therapeutic effect of FES use in patients in the chronic phase of stroke rehabilitation. Three large randomised controlled trials are underway in chronic stroke patients which may provide data on comparison with the ankle foot orthosis.
There are few safety concerns around the use of surface-applied FES and patient acceptability appears to be high, however the use of implanted electrodes may be associated with more serious adverse events.
A recent UK economic model showed FES in addition to usual physiotherapy care to be cost effective compared with usual physiotherapy care alone in patients who have suffered a stroke (conservative base case cost per QALY of approximately £19,239). No cost effectiveness evidence was identified for other patient groups.
Details
Project Status:
Completed
Year Published:
2012
URL for published report:
http://www.healthcareimprovementscotland.org/our_work/technologies_and_medicines/shtg_-_evidence_notes/evidence_note_46.aspx
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Scotland, United Kingdom
MeSH Terms
- Electric Stimulation Therapy
- Foot
Contact
Organisation Name:
Scottish Health Technologies Group
Contact Address:
Scottish Health Technologies Group, Delta House, 50 West Nile Street, Glasgow, G1 2NP Tel: 0141 225 6998
Contact Name:
his.shtg@nhs.scot
Contact Email:
his.shtg@nhs.scot
Copyright:
Healthcare Improvement Scotland
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.