A Randomized Controlled Trial of an Implantable 2-Channel Peroneal Nerve Stimulator on Walking Speed and Activity in Poststroke Hemiplegia

• Published in: Archives of physical medicine and rehabilitation Vol. 88; no. 8; pp. 971 - 978
• Main Authors: Kottink, Anke I., Hermens, Hermie J., Nene, Anand V., Tenniglo, Martin J., van der Aa, Hans E., Buschman, Hendrik P., IJzerman, Maarten J.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.2007; Elsevier
• Subjects: Biological and medical sciences; Electric stimulation; Electric Stimulation Therapy - instrumentation; Electrodes, Implanted; Equipment Design; Exercise Test; Female; Follow-Up Studies; Foot; Foot - innervation; Hemiplegia - etiology; Hemiplegia - physiopathology; Hemiplegia - rehabilitation; Humans; Male; Medical sciences; Middle Aged; Miscellaneous; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Peroneal Nerve; Physical Medicine and Rehabilitation; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation; Stroke; Stroke - complications; Treatment Outcome; Vascular diseases and vascular malformations of the nervous system; Walking; Walking - physiology; Peroneal nerve; Walking; Stroke; Rehabilitation; Electric stimulation; Foot; Orthopedic shoe; Prognosis; Motor system disorder; Cardiovascular disease; Vascular disease; Ankle joint; Reeducation; Hemiplegia; Neurological disorder; Cerebrovascular disease; Human; Speed; Nervous system diseases; Survivor; Device; Orthosis; Orthopedic treatment; Electric; Stimulator; Cerebral disorder; Ankle; Chronic; Functional recovery; Central nervous system disease; Comparative study
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2007.05.002

Kottink AI, Hermens HJ, Nene AV, Tenniglo MJ, van der Aa HE, Buschman HP, IJzerman MJ. A randomized controlled trial of an implantable 2-channel peroneal nerve stimulator on walking speed and activity in poststroke hemiplegia. To determine the effect of a new implantable 2-channel peroneal nerve stimulator on walking speed and daily activities, in comparison with the usual treatment in chronic stroke survivors with a drop foot. Randomized controlled trial. All subjects were measured 5 times in the gait laboratory. Twenty-nine stroke survivors with chronic hemiplegia with drop foot who fulfill the predefined inclusion and exclusion criteria were included in the study. The intervention group received an implantable 2-channel peroneal nerve stimulator for correction of their drop foot. The control group continued using their conventional walking device, consisting of an ankle-foot orthosis, orthopedic shoes, or no device. Walking speed, assessed both by a six-minute walk test (6MWT) and by using a 10-m walkway, was selected as primary outcome measure and activity monitoring data, consisting of percentage time spent on stepping, standing, and sitting/lying were selected as secondary outcome measure. Functional electric stimulation (FES) resulted in a 23% improvement of walking speed measured with the 6MWT, whereas the improvement in the control group was only 3% ( P=.010). Comfortable walking speed measured on a 10-m walkway was also significantly improved in favor of FES ( P=.038). The percentage time spent on stepping deteriorated with 3% in the intervention and 0.8% in control group, which was not statistically significant between both groups ( P=.13). The present study shows a clinically relevant effect of the implantable 2-channel peroneal nerve stimulator on walking speed in the sample of stroke survivors included in our study.