Long-Term Follow-up to a Randomized Controlled Trial Comparing Peroneal Nerve Functional Electrical Stimulation to an Ankle Foot Orthosis for Patients with Chronic Stroke

Francois Bethoux*, Helen L. Rogers, Karen J. Nolan, Gary M. Abrams, Thiru Annaswamy, Murray Brandstater, Barbara Browne, Judith M. Burnfield, Wuwei Feng, Mitchell J. Freed, Carolyn Geis, Jason Greenberg, Mark Gudesblatt, Farha Ikramuddin, Arun Jayaraman, Steven A. Kautz, Helmi L. Lutsep, Sangeetha Madhavan, Jill Meilahn, William S. PeaseNoel Rao, Subramani Seetharama, Pramod Sethi, Margaret A. Turk, Roi Ann Wallis, Conrad Kufta

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


Background. Evidence supports peroneal nerve functional electrical stimulation (FES) as an effective alternative to ankle foot orthoses (AFO) for treatment of foot drop poststroke, but few long-term, randomized controlled comparisons exist. Objective. Compare changes in gait quality and function between FES and AFOs in individuals with foot drop poststroke over a 12-month period. Methods. Follow-up analysis of an unblinded randomized controlled trial (ClinicalTrials.gov #NCT01087957) conducted at 30 rehabilitation centers comparing FES to AFOs over 6 months. Subjects continued to wear their randomized device for another 6 months to final 12-month assessments. Subjects used study devices for all home and community ambulation. Multiply imputed intention-to-treat analyses were utilized; primary endpoints were tested for noninferiority and secondary endpoints for superiority. Primary endpoints: 10 Meter Walk Test (10MWT) and device-related serious adverse event rate. Secondary endpoints: 6-Minute Walk Test (6MWT), GaitRite Functional Ambulation Profile, and Modified Emory Functional Ambulation Profile (mEFAP). Results. A total of 495 subjects were randomized, and 384 completed the 12-month follow-up. FES proved noninferior to AFOs for all primary endpoints. Both FES and AFO groups showed statistically and clinically significant improvement for 10MWT compared with initial measurement. No statistically significant between-group differences were found for primary or secondary endpoints. The FES group demonstrated statistically significant improvements for 6MWT and mEFAP Stair-time subscore. Conclusions. At 12 months, both FES and AFOs continue to demonstrate equivalent gains in gait speed. Results suggest that long-term FES use may lead to additional improvements in walking endurance and functional ambulation; further research is needed to confirm these findings.

Original languageEnglish (US)
Pages (from-to)911-922
Number of pages12
JournalNeurorehabilitation and Neural Repair
Issue number10
StatePublished - Nov 1 2015


  • ankle foot orthosis
  • foot drop
  • functional electrical stimulation
  • gait speed
  • quality of life
  • stroke rehabilitation

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Rehabilitation


Dive into the research topics of 'Long-Term Follow-up to a Randomized Controlled Trial Comparing Peroneal Nerve Functional Electrical Stimulation to an Ankle Foot Orthosis for Patients with Chronic Stroke'. Together they form a unique fingerprint.

Cite this