title: Neuroprosthesis peroneal functional electrical stimulation in the acute inpatient rehabilitation setting: a case series.
abstract: OBJECTIVE
  Studies have suggested that peroneal nerve functional electrical stimulation (peroneal FES) during walking improves gait in patients with chronic stroke. The effect of peroneal FES during the acute stages of stroke recovery is not known. The purposes of this case report are: (1) to describe differences between walking with and without a neuroprosthesis during the first few weeks after stroke, (2) to offer a clinical perspective on decision making for the use of peroneal FES during acute rehabilitation, and (3) to determine the feasibility of rehabilitation with peroneal FES neuroprostheses during the acute phases of stroke recovery.
  
  
  METHODS
  This case report describes 2 patients with different clinical presentations but both receiving inpatient rehabilitation less than 2 weeks after stroke. Each patient received peroneal FES via a neuroprothesis as tolerated while gait training in therapy.
  
  
  RESULTS
  One patient immediately increased gait speed (128%) and decreased time to perform the Timed "Up & Go" Test (40%) using the neuroprothesis. Both patients immediately increased the 6-Minute Walk Test distance using the neuroprothesis (121% and 101%). The patient who underwent testing with the instrumented walking system also demonstrated improved gait symmetry. After 1 to 3 weeks of using the neuroprothesis, the difference between outcomes with and without the neuroprothesis decreased.
  
  
  CONCLUSIONS
  It is possible that peroneal FES delivered through a neuroprosthesis during acute stroke recovery may improve gait outcomes. Research is needed to determine proper duration and timing.
authors.affiliation: Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati Academic Medical Center, OH 45220-0394, USA. kari.dunning@uc.edu
authors.forename: Kari
authors.initials: K
authors.lastname: Dunning
authors.forename: Kristy
authors.initials: K
authors.lastname: Black
authors.forename: Andrea
authors.initials: A
authors.lastname: Harrison
authors.forename: Keith
authors.initials: K
authors.lastname: McBride
authors.forename: Susan
authors.initials: S
authors.lastname: Israel
mesh_terms: D000369:Aged, 80 and over; D004599:Electric Stimulation Therapy / Q000379:methods*; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation*; D004856:Postural Balance; D020127:Recovery of Function; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking