TY - JOUR
T1 - Surface peroneal nerve stimulation in lower limb hemiparesis
T2 - Effect on quantitative gait parameters
AU - Sheffler, Lynne R.
AU - Taylor, Paul N.
AU - Bailey, Stephanie Nogan
AU - Gunzler, Douglas
AU - Buurke, Jaap H.
AU - Ijzerman, Maarten J.
AU - Chae, John
PY - 2015/5/21
Y1 - 2015/5/21
N2 - Objective: The objective of this study was to evaluate possible mechanisms for functional improvement and compare ambulation training with surface peroneal nerve stimulation vs. usual care via quantitative gait analysis. Design: This study is a randomized controlled clinical trial. Setting: The setting of this study is a teaching hospital of an academic medical center. Participants: One hundred ten chronic stroke survivors (912 wks poststroke) with unilateral hemiparesis participated in this study. Interventions: The subjects were randomized to a surface peroneal nerve stimulation device or usual care intervention. The subjects were treated for 12 wks and followed up for 6-mo posttreatment. Main Outcome Measures: Spatiotemporal, kinematic, and kinetic parameters of gait were the main outcome measures. Results: Cadence (F3,153 = 5.81, P = 0.012), stride length (F3,179 = 20.01, P G 0.001), walking speed (F3,167 = 18.2, P G 0.001), anterior-posterior ground reaction force (F3,164 = 6.61, P = 0.004), peak hip power in preswing (F3,156 = 8.76, P G 0.001), and peak ankle power at push-off (F3,149=6.38, P=0.005) all improved with respect to time. However, peak ankle ankle dorsiflexion in swing (F3,184 = 4.99, P = 0.031) worsened. In general, the greatest change for all parameters occurred during the treatment period. There were no significant treatment group timeinteraction effects for any of the spatiotemporal, kinematic, or kinetic parameters. Conclusions: Gait training with peroneal nerve stimulation and usual care was associated with improvements in peak hip power in preswing and peak ankle power at push-off, which may have resulted in improved cadence, stride length, and walking speed; however, there were no differences between treatment groups. Both treatment groups also experienced a decrease in peak ankle ankle dorsiflexion in swing, although the clinical implications of this finding are unclear.
AB - Objective: The objective of this study was to evaluate possible mechanisms for functional improvement and compare ambulation training with surface peroneal nerve stimulation vs. usual care via quantitative gait analysis. Design: This study is a randomized controlled clinical trial. Setting: The setting of this study is a teaching hospital of an academic medical center. Participants: One hundred ten chronic stroke survivors (912 wks poststroke) with unilateral hemiparesis participated in this study. Interventions: The subjects were randomized to a surface peroneal nerve stimulation device or usual care intervention. The subjects were treated for 12 wks and followed up for 6-mo posttreatment. Main Outcome Measures: Spatiotemporal, kinematic, and kinetic parameters of gait were the main outcome measures. Results: Cadence (F3,153 = 5.81, P = 0.012), stride length (F3,179 = 20.01, P G 0.001), walking speed (F3,167 = 18.2, P G 0.001), anterior-posterior ground reaction force (F3,164 = 6.61, P = 0.004), peak hip power in preswing (F3,156 = 8.76, P G 0.001), and peak ankle power at push-off (F3,149=6.38, P=0.005) all improved with respect to time. However, peak ankle ankle dorsiflexion in swing (F3,184 = 4.99, P = 0.031) worsened. In general, the greatest change for all parameters occurred during the treatment period. There were no significant treatment group timeinteraction effects for any of the spatiotemporal, kinematic, or kinetic parameters. Conclusions: Gait training with peroneal nerve stimulation and usual care was associated with improvements in peak hip power in preswing and peak ankle power at push-off, which may have resulted in improved cadence, stride length, and walking speed; however, there were no differences between treatment groups. Both treatment groups also experienced a decrease in peak ankle ankle dorsiflexion in swing, although the clinical implications of this finding are unclear.
KW - Gait
KW - Hemiparesis
KW - Peroneal Nerve
UR - http://www.scopus.com/inward/record.url?scp=84928114106&partnerID=8YFLogxK
U2 - 10.1097/PHM.0000000000000269
DO - 10.1097/PHM.0000000000000269
M3 - Article
C2 - 25802966
AN - SCOPUS:84928114106
VL - 94
SP - 341
EP - 357
JO - American journal of physical medicine & rehabilitation
JF - American journal of physical medicine & rehabilitation
SN - 0894-9115
IS - 5
ER -