The long-term effects of an implantable drop foot stimulator on gait in hemiparetic patients.

Authors:
Agnes Sturma
Agnes Sturma
Christian Doppler Laboratory for Restoration of Extremity Function
Othmar Schuhfried
Othmar Schuhfried
Medical University of Vienna
Austria
Timothy Hasenoehrl
Timothy Hasenoehrl
University of Vienna
Newport Beach | United States
Clemens Ambrozy
Clemens Ambrozy
Medical University of Vienna
Wien | Austria
Stefan Salminger
Stefan Salminger
Christian Doppler Laboratory for Restoration of Extremity Function
Laura A Hruby
Laura A Hruby
Christian Doppler Laboratory for Restoration of Extremity Function
Johannes A Mayer
Johannes A Mayer
Medical University Vienna
Wien | Austria

PLoS One 2019 17;14(4):e0214991. Epub 2019 Apr 17.

Christian Doppler Laboratory for Restoration of Extremity Function, Medical University of Vienna, Vienna, Austria.

Drop foot is a frequent abnormality in gait after central nervous system lesions. Different treatment strategies are available to functionally restore dorsal extension during swing phase in gait. Orthoses as well as surface and implantable devices for electrical stimulation of the peroneal nerve may be used in patients who do not regain good dorsal extension. While several studies investigated the effects of implanted systems on walking speed and gait endurance, only a few studies have focussed on the system's impact on kinematics and long-term outcomes. Therefore, our aim was to further investigate the effects of the implanted system ActiGait on gait kinematics and spatiotemporal parameters for the first time with a 1-year follow-up period. 10 patients were implanted with an ActiGait stimulator, with 8 patients completing baseline and follow-up assessments. Assessments included a 10-m walking test, video-based gait analysis and a Visual Analogue Scale (VAS) for health status. At baseline, gait analysis was performed without any assistive device as well as with surface electrical stimulation. At follow-up patients walked with the ActiGait system switched off and on. The maximum dorsal extension of the ankle at initial contact increased significantly between baseline without stimulation and follow-up with ActiGait (p = 0.018). While the spatio-temporal parameters did not seem to change much with the use of ActiGait in convenient walking speed, patients did walk faster when using surface stimulation or ActiGait compared to no stimulation at the 10-m walking test at their fastest possible walking speed. Patients rated their health better at the 1-year follow-up. In summary, a global improvement in gait kinematics compared to no stimulation was observed and the long-term safety of the device could be confirmed.

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214991PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469760PMC
April 2019
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