MS foot drop treatments tested

06 September 2013

Linda Miller

Linda Miller

A GCU researcher is leading a study which aims to discover the best way to treat foot drop – a common condition amongst those living with multiple sclerosis (MS) which affects patients’ ability to walk.

A joint bid led by Linda Miller who is also employed by NHS Ayrshire & Arran, has been awarded more than £139,000 from the MS Society UK for the three year project.

The study will look at two treatments for the condition. The most common involves the use of plastic splints or shoe inserts called ankle-foot-orthoses (AFO). The second, called Functional Electrical Stimulation (FES), uses electricity to stimulate upward movement of the foot at the ankle joint as a patient walks.

Miller said: “Some evidence around the orthotic effects of Functional Electrical Stimulation and ankle-foot-orthoses on walking speed and effort of walking is emerging. Prescription decisions, however, are not currently based on evidence but on clinician preference, clinical judgement and cost.

“Conventionally foot drop has been treated using ankle-foot-orthoses; however there are a number of disadvantages including muscle wasting and poor compliance. Our study will gather evidence on the impact of FES and AFO on gait, activity and participation amongst MS patients.”

The full title of the study is ‘A quantitative, qualitative and cost utility comparison of Functional Electrical Stimulation and Ankle Foot Orthoses for the management of foot drop in Multiple Sclerosis.’ It will also involve Paul Mattison, NHS Ayrshire and Arran, Danny Rafferty, GCU, Dr Lorna Paul, Glasgow University, and Dr Roy Bowers, Strathclyde University.

Eighty four people with MS presenting with foot drop will be recruited from the NHS Ayrshire and Arran and NHS Greater Glasgow and Clyde MS services over a two year period. Participants will be randomly assigned into one of 2 groups receiving one of the two treatments.

All participants will be assessed at three, six and 12 month intervals using a range of outcome measures which will measure walking speed, endurance and energy cost, fatigue, the physical and psychological impact of MS, quality of life, fall frequency and free living activity.

At the end of 12 months all participants will be invited to participate in a focus group which will explore their experiences of using the two treatments. In addition a comparison of the cost effectiveness of both treatments will be undertaken.

Miller added: “The results from this study will help to inform future decisions regarding the prescription of these treatments in people with MS and other neurological conditions.”