Peroneal Nerve Stimulation versus an Ankle Foot Orthosis for Correction of Footdrop in Stroke: Impact on Functional Ambulation

Abstract

Objective. To compare the efficacy of the Odstock Dropped-Foot Stimulator (ODFS), a transcutaneous peroneal nerve stimulation device, versus an ankle foot orthosis (AFO) in improving functional ambulation of chronic stroke survivors. Intervention. Fourteen chronic stroke survivors with foot-drop participated in the study. Participants received ambulation training under 3 test conditions: 1) ODFS, 2) customized AFO, and 3) no device. Each participant was evaluated using the modified Emory Functional Ambulation Profile under the 3 test conditions. All participants were evaluated with a post-evaluation survey to solicit device feedback and preferences. Results. Functional ambulation with the AFO was significantly improved, relative to no device, on the floor (P = 0.000), carpet (P = 0.013), and “up and go” test (P = 0.042). There was a trend toward significance on the obstacle (P = 0.092) and stair (P = 0.067) trials. Functional ambulation with the ODFS was significantly improved, relative to no device, on the carpet(P = 0.004). A trend toward significance on floor (P = 0.081), obstaclxze (P = 0.092), and stair (P = 0.079) trials was observed. The difference in functional ambulation between the AFO and ODFS showed a trend toward statistical significance on floor (P = 0.065) and up and go (P = 0.082) trials only. Given a choice between the ODFS and AFO for long-term correction of footdrop, participants indicated a preference for the ODFS. Conclusion. The AFO and the ODFS may be comparable in their effect on improving functional ambulation as compared to no device. Specific characteristics of the ODFS may make it a preferred intervention by stroke survivors. More rigorously controlled trials are needed to confirm these findings.