The long-term effects of an implantable drop foot stimulator on gait in hemiparetic patients
Author(s)
Type
Journal Article
Abstract
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.
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.
Date Issued
2019-04-17
Date Acceptance
2019-03-26
Citation
PLoS One, 2019, 14 (4)
ISSN
1932-6203
Publisher
Public Library of Science (PLoS)
Journal / Book Title
PLoS One
Volume
14
Issue
4
Copyright Statement
© 2019 Sturma et al. This is an open
access article distributed under the terms of the
Creative Commons Attribution License, which
permits unrestricted use, distribution, and
reproduction in any medium, provided the original
author and source are credited.
access article distributed under the terms of the
Creative Commons Attribution License, which
permits unrestricted use, distribution, and
reproduction in any medium, provided the original
author and source are credited.
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000465010000038&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
FUNCTIONAL ELECTRICAL-STIMULATION
RANDOMIZED CONTROLLED-TRIAL
PERONEAL NERVE-STIMULATION
WALKING SPEED
STROKE
PEOPLE
SATISFACTION
ORTHOSIS
PHASE
HIP
Publication Status
Published
Article Number
e0214991
Date Publish Online
2019-04-17