title: The therapeutic effect of outpatient use of a peroneal nerve functional electrical stimulation neuroprosthesis in people with stroke: a case series.
abstract: OBJECTIVE
  Foot drop is a common problem following a stroke. Although peroneal nerve functional electrical stimulation (pFES) for foot drop has been shown to improve function and gait, the majority of studies have used daily stimulation. There are few studies to show benefit and guide practice for less frequent dosing. Therefore, the purpose of this study was to examine the effect of gait training with pFES on ambulation and lower extremity kinematics when used on a schedule consistent with usual care in an outpatient therapy clinic.
  
  
  METHODS
  A pFES neuroprosthesis was used with overground gait training 3 times per week for 6 weeks in 2 subjects with foot drop due to chronic stroke (more than 6 months poststroke). Outcomes including functional gait (modified Emory Functional Ambulation Profile [mEFAP]), gait speed, and gait kinematics were assessed at baseline and at 6 weeks without the pFES (therapeutic effect).
  
  
  RESULTS
  Both subjects demonstrated decreased ankle plantarflexion at initial heel contact during gait. Both subjects also showed decreased time to complete the mEFAP. Only 1 subject showed increased gait velocity.
  
  
  CONCLUSIONS
  This case series suggests that the use of neuroprothesis pFES combined with overground gait training on a typical outpatient therapy schedule for 6 weeks may increase foot clearance during gait for persons with chronic stroke. Although the evidence is limited, it may be beneficial for clinicians to use pFES in creative ways during different aspects of treatment.
authors.affiliation: College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Israel
authors.forename: Susan
authors.initials: S
authors.lastname: Kotowski
authors.forename: Nancy
authors.initials: N
authors.lastname: Talbott
authors.forename: Keri
authors.initials: K
authors.lastname: Fisher
authors.forename: Kari
authors.initials: K
authors.lastname: Dunning
mesh_terms: D004599:Electric Stimulation Therapy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D010543:Peroneal Nerve / Q000502:physiology*; D020127:Recovery of Function; D020521:Stroke / Q000628:therapy*; D016896:Treatment Outcome