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Therapeutic effect of an implantable peroneal nerve stimulator in subjects with chronic stroke and footdrop: a randomized controlled trial.

BACKGROUND AND PURPOSE: Footdrop, characterized by a person's inability to raise the foot at the ankle, is a common problem in patients with stroke. A randomized controlled trial was performed to determine the therapeutic effect of using a new implantable, 2-channel peroneal nerve stimulator for 6 m...

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Published in:Physical Therapy Vol. 88; no. 4; pp. 437 - 449
Main Authors: Kottink AIR, Hermens HJ, Nene AV, Tenniglo MJ, Groothuis-Oudshoorn CG, Ijzerman MJ
Format: research tables/charts tracings randomized controlled trial Journal Article
Published: Oxford University Press / USA Apr2008
Online Access:View this record in EBSCOhost
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      dt: Apr2008
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      pub: Oxford University Press / USA
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        atl: Therapeutic effect of an implantable peroneal nerve stimulator in subjects with chronic stroke and footdrop: a randomized controlled trial.
      aug:
        au:
          Kottink AIR
          Hermens HJ
          Nene AV
          Tenniglo MJ
          Groothuis-Oudshoorn CG
          Ijzerman MJ
        affil: Roessingh Research and Development, PO Box 310, 7500 AH, Enschede, the Netherlands.
      sug:
        subj:
          Electrical Stimulation, Functional
          Peripheral Nervous System Diseases Rehabilitation
          Stroke Rehabilitation
          Chronic Disease
          Randomized Controlled Trials
          Data Analysis Software
          Electrodes, Implanted
          Electromyography
          Extension
          Flexion
          Gait Analysis
          Intraclass Correlation Coefficient
          Motion Analysis Systems
          Paired T-Tests
          Pearson's Correlation Coefficient
          Power Analysis
          Human
      ab: BACKGROUND AND PURPOSE: Footdrop, characterized by a person's inability to raise the foot at the ankle, is a common problem in patients with stroke. A randomized controlled trial was performed to determine the therapeutic effect of using a new implantable, 2-channel peroneal nerve stimulator for 6 months versus an ankle-foot orthosis (AFO). SUBJECTS: Twenty-nine patients with chronic stroke and footdrop participated in the study. The mean time from stroke was 7.3 years (SD=7.3), and all subjects were community ambulators. METHODS: The study used a randomized controlled trial design. The functional electrical stimulation (FES) group received the implantable stimulation system for correction of their footdrop. The control group continued using their conventional walking device (ie, AFO, orthopedic shoes, or no walking device). All subjects were measured at baseline and at weeks 4, 8, 12, and 26 in the gait laboratory. The therapeutic effect of FES on the maximum value of the root mean square (RMSmax) of the tibialis anterior (TA) muscle with both flexed and extended knees and walking speed were selected as the primary outcome measures. The RMSmax of the peroneus longus (PL), gastrocnemius (GS), and soleus (SL) muscles with both flexed and extended knees and muscle activity of the TA muscle of the affected leg during the swing phase of gait were selected as secondary outcome measures. RESULTS: A significantly higher RMSmax of the TA muscle with extended knee was found after using FES. No change in walking speed was found when the stimulator was not switched on. A significantly increased RMSmax of the GS muscle with both flexed and extended knees was found after using FES. DISCUSSION AND CONCLUSION: Functionally, no therapeutic effect of implantable peroneal nerve stimulation was found. However, the significantly increased voluntary muscle output of the TA and GS muscles after the use of FES suggests that there was a certain extent of plasticity in the subjects in this study.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        tracings
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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