Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 1150-1162 |
| Number of pages | 13 |
| Journal | Clinical Rehabilitation |
| Volume | 33 |
| Issue number | 7 |
| Early online date | 11 Apr 2019 |
| DOIs | |
| Publication status | Published - 1 Jul 2019 |
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Keywords
- multiple sclerosis
- patient-centred outcome measure
- functional electrical stimulation
- walking
- orthoses
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The clinical- and cost-effectiveness of functional electrical stimulation and ankle-foot orthoses for foot drop in Multiple Sclerosis: a multicentre randomized trial. / Renfrew, Linda; Paul, Lorna; McFadyen, Angus; Rafferty, Danny; Mosley, Owen; Lord, Anna C.; Bowers, Roy; Mattison, Paul.
In: Clinical Rehabilitation, Vol. 33, No. 7, 01.07.2019, p. 1150-1162.Research output: Contribution to journal › Article
TY - JOUR
T1 - The clinical- and cost-effectiveness of functional electrical stimulation and ankle-foot orthoses for foot drop in Multiple Sclerosis: a multicentre randomized trial
AU - Renfrew, Linda
AU - Paul, Lorna
AU - McFadyen, Angus
AU - Rafferty, Danny
AU - Mosley, Owen
AU - Lord, Anna C.
AU - Bowers, Roy
AU - Mattison, Paul
N1 - Acceptance in SAN
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Objective: Compare the clinical and cost effectiveness of ankle-foot orthoses (AFO) and functional electrical stimulation (FES) over 12 months in people with Multiple Sclerosis with foot drop. Design: Multi-centre, powered, non-blinded, randomised trial. Setting: Seven multiple sclerosis out-patient centres across Scotland. Subjects: 85 treatment-naïve people with Multiple Sclerosis with persistent (> 3 months) foot drop. Interventions: Participants randomised to receive a custom-made, ankle-foot orthosis (n=43) or functional electrical stimulation device (n=42). Outcome measures: Assessed at 0,3,6 and 12 months; 5-minute self-selected walk test (primary), Timed 25 Foot walk, oxygen cost of walking, Multiple Sclerosis Impact Scale-29, Multiple Sclerosis Walking Scale-12, Modified Fatigue Impact Scale, EQ–5D-5L, Activities-specific Balance and Confidence Scale, Psychological Impact of Assistive Devices Score, equipment and NHS staff time costs of interventions. Results: Groups were similar for age (AFO, 51.4(11.2); FES, 50.4(10.4) years) and baseline walking speed (AFO, 0.62 (0.21); FES 0.73 (0.27) m/s). 38 % dropped out by 12 months (AFO, n=21; FES, n=11). Both groups walked faster at 12 months with device (p<0.001; AFO, 0.73 (0.24); FES, 0.79 (0.24) m/s) but no difference between groups. Significantly higher Psychological Impact of Assistive Devices Scores for FES for Competence (p=0.016; AFO, 0.85(1.05); FES, 1.53(1.05)), Adaptability (p=0.001; AFO,0.38(0.97); FES 1.53(0.98)) and Self-Esteem (p=0.006; AFO, 0.45(0.67); FES 1(0.68)). Effects were comparable for other measures. Functional electrical stimulation may offer value for money alternative to usual care. Conclusion: Ankle-foot orthoses and functional electrical stimulation have comparable effects on walking performance and patient reported outcomes, however high drop outs introduces uncertainty.
AB - Objective: Compare the clinical and cost effectiveness of ankle-foot orthoses (AFO) and functional electrical stimulation (FES) over 12 months in people with Multiple Sclerosis with foot drop. Design: Multi-centre, powered, non-blinded, randomised trial. Setting: Seven multiple sclerosis out-patient centres across Scotland. Subjects: 85 treatment-naïve people with Multiple Sclerosis with persistent (> 3 months) foot drop. Interventions: Participants randomised to receive a custom-made, ankle-foot orthosis (n=43) or functional electrical stimulation device (n=42). Outcome measures: Assessed at 0,3,6 and 12 months; 5-minute self-selected walk test (primary), Timed 25 Foot walk, oxygen cost of walking, Multiple Sclerosis Impact Scale-29, Multiple Sclerosis Walking Scale-12, Modified Fatigue Impact Scale, EQ–5D-5L, Activities-specific Balance and Confidence Scale, Psychological Impact of Assistive Devices Score, equipment and NHS staff time costs of interventions. Results: Groups were similar for age (AFO, 51.4(11.2); FES, 50.4(10.4) years) and baseline walking speed (AFO, 0.62 (0.21); FES 0.73 (0.27) m/s). 38 % dropped out by 12 months (AFO, n=21; FES, n=11). Both groups walked faster at 12 months with device (p<0.001; AFO, 0.73 (0.24); FES, 0.79 (0.24) m/s) but no difference between groups. Significantly higher Psychological Impact of Assistive Devices Scores for FES for Competence (p=0.016; AFO, 0.85(1.05); FES, 1.53(1.05)), Adaptability (p=0.001; AFO,0.38(0.97); FES 1.53(0.98)) and Self-Esteem (p=0.006; AFO, 0.45(0.67); FES 1(0.68)). Effects were comparable for other measures. Functional electrical stimulation may offer value for money alternative to usual care. Conclusion: Ankle-foot orthoses and functional electrical stimulation have comparable effects on walking performance and patient reported outcomes, however high drop outs introduces uncertainty.
KW - multiple sclerosis
KW - patient-centred outcome measure
KW - functional electrical stimulation
KW - walking
KW - orthoses
U2 - 10.1177/0269215519842254
DO - 10.1177/0269215519842254
M3 - Article
VL - 33
SP - 1150
EP - 1162
JO - Clinical Rehabilitation
JF - Clinical Rehabilitation
SN - 0269-2155
IS - 7
ER -