Objective To systematically evaluate the orthotic effect of functional electrical stimulation (FES) on the improvement of walking in stroke patients with foot drop. Methods The randomized controlled trials (RCTs) that investigated the orthotic effect of FES on walking in stroke patients with foot drop were electronically searched in the databases such as PubMed, Web of Science, The Cochrane Library (Issue 1, 2013), EMbase, CBM, CNKI, VIP and WanFang Data from January 2000 to January 2013, and the relevant references of included papers were also manually searched. Two reviewers independently screened the trials according to the inclusion and exclusion criteria, extracted the data, and assessed the methodology quality. The meta-analyses were performed using RevMan 5.1 software. Results A total of 8 RCTs involving 255 patients were included. The results of meta-analyses on 4 RCTs showed that, compared with the conventional rehabilitation intervention, the functional electrical stimulation could significantly improve the walking speed, with significant difference (MD=0.09, 95%CI 0.00 to 0.18, P=0.04). The other indicators were only descriptively analyzed due to the incomplete data. Conclusions Functional electrical stimulation is effective in improving walking speed, but it is uncertain of other therapeutic indicators. So it should be further proved by conducting more high quality, large sample and multi-center RCTs.
ObjectiveTo investigate the effectiveness of tibialis posterior tendon transfer for foot drop secondary to peroneal nerve palsy.MethodsThe clinical data of 21 patients with unilateral foot drop secondary to peroneal nerve palsy between October 2009 and September 2016 was retrospectively analyzed. There were 12 males and 9 females with an average age of 32.1 years (range, 23-47 years). The causes of peroneal nerve injury were iatrogenic injury in 7 cases, tibiofibular fractures combined with compartment syndrome in 5 cases, nerve exploration surgery after stab or cut injury in 3 cases, direct violence in 4 cases, and the fibular head fracture in 2 cases. The average time from injury to operation was 5.6 years (range, 2-8 years). There was 1 case of hallux valgus and 5 cases of toe flexion contracture. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot scores, Foot and Ankle Ability Measure (FAAM) scores, range of motion (ROM), and dorsiflexion strength of ankle joint were used to evaluated the ankle function. Radiographic evaluation for the changes of postoperative foot alignment included Meary angle, calcaneal pitch angle, and hindfoot alignment angle.ResultsAll incisions healed by first intention. All patients were followed up 18-42 months (mean, 30.2 months). The dorsiflexion strength of ankle joint recovered from grade 0 to grade 3-4 after operation. There was no patient with a postoperative flat foot deformity and claw toe during follow-up. There was no significant difference in Meary angle, calcaneal pitch angle, and hindfoot alignment angle between pre- and post-operation (P>0.05). The AOFAS score, FAAM score, and ROM of dorsiflexion significantly improved at last follow-up when compared with preoperative values (P<0.05); while there was no significant difference in ROM of plantar-flexion between pre- and post-operation (t=4.239, P=0.158). There were significant differences in AOFAS score, FAAM score, and ROM of dorsiflexion between affected and healthy sides (P<0.05); but no significant difference in ROM of plantar-flexion was found (t=2.319, P=0.538).ConclusionTibialis posterior tendon transfer is an effective surgical option for foot drop secondary to peroneal nerve palsy. And no postoperative flat foot deformity occurred at short-term follow-up.
Stroke has the characteristics of high incidence rate, high mortality rate and high disability rate. Most patients may have some motor dysfunction after stroke, which greatly affects the normal life of patients. As a common sequela after stroke, foot drop seriously affects the walking gait of patients, limits the activities of patients, and reduces their quality of life. In recent years, repetitive peripheral magnetic stimulation (rPMS) has been used more and more in the rehabilitation of various diseases. Because rPMS is noninvasive, affordable and effective, it is accepted by many patients. This article reviews the research progress of rPMS for foot drop after stroke.