The weakness of the lower leg muscles due to nerve damage or muscle weakness can result in foot drop, a change in gait that manifests as an inability to lift the toes of the foot when walking. Foot drop results in a decreased quality of life, with unassisted movement becoming difficult or impossible. The increased risk of falls is particularly problematic as foot drop often affects the elderly or infirm for whom falling already presents a great danger. Current treatment options include fixed ankle–foot orthosis (AFO) aiming to provide rigid support to the foot if the impairment is mild or surgical intervention and functional electrical stimulation (FES) devices if the weakness is more severe. FES intervention is effective for providing a non-invasive treatment in even severe cases of foot drop. Limitations of current models relate to the non-naturalistic recreation of gait in the affected leg and its unsuitability for patients with extensive peripheral nerve damage. Although there are attempts to enhance integration of sensory information and mimic natural stimulation patterns, the focus on restoring a natural feedback loop is still amiss. Without such a closed loop feedback, restoration of a natural gait pattern is unlikely to occur. We here recommend, integration of motor output from multiple muscles, information about the inputs from higher-order controllers, recorded from the intact leg with a closed loop system to improve the effectiveness of FES.

中文翻译：

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脚下垂和功能性电刺激的调查

由神经损伤或肌肉无力引起的小腿肌肉无力可导致脚下垂，步态变化表现为步行时无法抬起脚趾。脚掉落会导致生活质量下降，无助运动变得困难或不可能。跌倒的风险增加尤其成问题，因为脚下垂经常影响老年人或身体虚弱的人，跌倒已经给他们带来了极大的危险。当前的治疗方法包括固定的踝足矫形器（AFO），旨在在轻度损伤或手术干预时为足部提供坚硬的支撑，如果虚弱程度更严重，则可以使用功能性电刺激（FES）装置。FES干预即使在严重的跌脚情况下也可有效提供无创治疗。当前模型的局限性涉及受累腿部步态的非自然再现及其不适用于周围神经广泛损伤的患者。尽管尝试增强感官信息的整合并模仿自然刺激模式，但仍然缺乏恢复自然反馈回路的关注。没有这种闭环反馈，自然步态不会恢复。我们在这里建议整合来自多条肌肉的运动输出，有关来自高阶控制器的输入的信息，从完整腿部记录的闭环系统信息，以提高FES的有效性。尽管尝试增强感官信息的整合并模仿自然刺激模式，但仍然缺乏恢复自然反馈回路的关注。没有这种闭环反馈，自然步态不会恢复。我们在这里建议整合来自多条肌肉的运动输出，有关来自高阶控制器的输入的信息，从完整腿部记录的闭环系统信息，以提高FES的有效性。尽管尝试增强感官信息的整合并模仿自然刺激模式，但仍然缺乏恢复自然反馈回路的关注。没有这种闭环反馈，自然步态不会恢复。我们在这里建议整合来自多条肌肉的运动输出，有关来自高阶控制器的输入的信息，从完整腿部记录的闭环系统信息，以提高FES的有效性。