Spatiotemporal and kinematic effect of peroneal nerve stimulation versus an ankle-foot orthosis in patients with multiple sclerosis: a case series.
OBJECTIVE
To compare the effect of a surface peroneal nerve stimulator (PNS) versus an ankle-foot orthosis (AFO) on spatiotemporal and kinematic parameters of gait in patients with multiple sclerosis.


METHODS
This was a case series design.


METHODS
Four subjects with multiple sclerosis and dorsiflexion weakness.


METHODS
Quantitative gait analysis with the use of (1) no device, (2) AFO, and (3) PNS as a single point-in-time assessment.


METHODS
Included walking speed, stride length, cadence, and double support time; kinematic parameters included peak pelvic obliquity during swing, peak contralateral hip abduction during stance, peak knee flexion and hip flexion during swing, ankle dorsiflexion at initial contact, and peak ankle internal rotation during swing.


RESULTS
One-way analysis of variance was used to compare intrasubject performance under the 3 device conditions. The PNS significantly increased ankle dorsiflexion angle at initial contact, as compared with both no device and the AFO, in 3 of the 4 subjects. However, other spatiotemporal and kinematic gait parameters were more variably affected by the device conditions.


CONCLUSIONS
With the exception of ankle dorsiflexion angle at initial contact, PNS and AFO have a variable effect on spatiotemporal and kinematic gait parameters in individual subjects with multiple sclerosis. Further studies are indicated to determine the clinical significance of intrasubject differences between device conditions.
Sheffler
Lynne R
LR
Department of Physical Medicine, Cleveland Functional Electrical Stimulation Center, MetroHealth Medical Center, 2500 MetroHealth Drive S1-107A, Cleveland, OH 44109, USA. lsheffler@metrohealth.org
Bailey
Stephanie Nogan
SN
Chae
John
J
D000328:Adult; D000704:Analysis of Variance; D000843:Ankle Joint / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D005528:Foot; D020233:Gait Disorders, Neurologic / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000534:rehabilitation*; D009989:Orthotic Devices; D010543:Peroneal Nerve / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome