2025 American Academy of Neurology Abstract Website

Objective:

evaluate the possibility of using implanted FES to improve the gait function in this population.

Background:

Recent studies indicate that functional electrical stimulation (FES) applied to lower limb nerves is effective for foot drop due to stroke. While implanted FES systems may enhance gait function, there are currently no systematic reviews evaluating their potential in this context.

Design/Methods:

A comprehensive search was conducted across PubMed, Cochrane Library, EMBASE, Web of Science, and Scopus from inception until August 2024. Included studies were randomized controlled trials and crossover studies comparing FES as a single treatment or in combination with other therapies for stroke-related foot drop. Study characteristics, demographics, interventions, and results were analyzed, with inter-study variability assessed using the I² statistic. This systematic review included 18 studies.

Results:

Eighteen RCTs involving 1,472 patients (mean age 56.66 ± 7.39 years) were analyzed. The primary outcome, the mean difference (MD) in the 10-Meter Walk Test (10MWT), favoured FES (SMD = -0.1, 95% CI [-0.01 to -0.01], P = 0.00001). However, this significance diminished after excluding certain studies. Additionally, the Berg Balance Scale showed a mean difference favouring the comparator (SMD = 1.29, P = 0.00001), and FES was less effective than conventional therapies in enhancing balance and gait velocity as measured by the 6-Minute Walk Test (SMD = 10.63, P = 0.00001) and dorsiflexion range of motion (SMD = 1.59, P = 0.0003).

Conclusions:

FES targeting the peroneal nerve may improve gait velocity in stroke patients with foot drop. However, further research is necessary to compare FES with other rehabilitation strategies and to establish guidelines for its use in stroke therapy.