Advances in neuroprosthetic management of foot drop: A review

Javier Gil-Castillo, Fady Alnajjar, Aikaterini Koutsou, Diego Torricelli, Juan C. Moreno

Research output: Contribution to journalReview articlepeer-review

17 Citations (Scopus)

Abstract

This paper reviews the technological advances and clinical results obtained in the neuroprosthetic management of foot drop. Functional electrical stimulation has been widely applied owing to its corrective abilities in patients suffering from a stroke, multiple sclerosis, or spinal cord injury among other pathologies. This review aims at identifying the progress made in this area over the last two decades, addressing two main questions: What is the status of neuroprosthetic technology in terms of architecture, sensorization, and control algorithms?. What is the current evidence on its functional and clinical efficacy? The results reveal the importance of systems capable of self-adjustment and the need for closed-loop control systems to adequately modulate assistance in individual conditions. Other advanced strategies, such as combining variable and constant frequency pulses, could also play an important role in reducing fatigue and obtaining better therapeutic results. The field not only would benefit from a deeper understanding of the kinematic, kinetic and neuromuscular implications and effects of more promising assistance strategies, but also there is a clear lack of long-term clinical studies addressing the therapeutic potential of these systems. This review paper provides an overview of current system design and control architectures choices with regard to their clinical effectiveness. Shortcomings and recommendations for future directions are identified.

Original languageEnglish
Article number46
JournalJournal of NeuroEngineering and Rehabilitation
Volume17
Issue number1
DOIs
Publication statusPublished - Mar 25 2020

Keywords

  • Foot drop syndrome
  • Functional electrical stimulation
  • Gait
  • Neuroprosthetics

ASJC Scopus subject areas

  • Rehabilitation
  • Health Informatics

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