Experiences of individuals with multiple sclerosis and stroke using transcutaneous foot drop electrical stimulators: a systematic review and meta-synthesis of qualitative studies

Abstract

Purpose

To explore the end users’ experiences of foot drop electrical stimulator use for people with neurological conditions.

Materials and methods

Electronic databases MEDLINE, EMBASE, CINAHL, Scopus, and Google Scholar were searched in March 2022. Included articles were quality assessed using the Critical Appraisal Skills Programme (CASP) checklist. A thematic synthesis approach was used to synthesise the review findings and establish analytical themes. A Confidence in the Evidence from Reviews of Qualitative Research (CERQual) Approach was used to assess the level of confidence of analytical themes.

Results

Seven qualitative studies were included with 67 participants with stroke and multiple sclerosis. The outcomes to foot drop stimulator use were enhanced walking ability, independence, confidence, and social participation. Main barriers to use were device aesthetics, usability challenges, trustworthiness of device in complex environments, and cost of the device. A conceptual model was created illustrating the barriers and outcomes in managing foot drop.

Conclusions

We recommend that the outcomes to continued use of foot drop electrical stimulators are carefully considered against the barriers. Our conceptual model may be useful to guide clinical conversations around the possible use of FES for managing foot drop in people with multiple sclerosis and stroke.

Implications for rehabilitation

• The key outcomes to foot drop electrical stimulator use were enhanced walking ability, improved independence and confidence, and enhanced social participation.

• The main barriers to foot drop electrical stimulator use were device aesthetics, usability challenges, trustworthiness of device in complex environments, and cost of the device.

• We created a conceptual model that may be useful to guide clinical conversations around the possible use of FES for managing foot drop in people with multiple sclerosis and stroke.

Keywords:

• Foot drop electrical stimulator
• users’ experience
• neurological conditions
• barriers
• facilitators

Acknowledgements

Thank you to Thelma Fisher, physiotherapy support librarian from the University of Otago, New Zealand for assistance with referencing support.

Author contributions

The contributions of all authors are outlined in Supplementary Appendix B.

Disclosure statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Funding

This work was supported by School of Physiotherapy Research Fund, University of Otago, New Zealand.