title: Tolerability and effectiveness of a neuroprosthesis for the treatment of footdrop in pediatric patients with hemiparetic cerebral palsy.
abstract: OBJECTIVE
  To assess the tolerability and efficacy of a commercially available footdrop neuroprosthesis for treatment of footdrop in children with hemiparetic cerebral palsy.
  
  
  METHODS
  A prospective, observational pilot study.
  
  
  METHODS
  Marshfield Clinic, Department of Physical Medicine.
  
  
  METHODS
  Ten children, ages 7-12 years, with hemiparetic cerebral palsy, who use an ankle foot orthosis (AFO) for correction of footdrop.
  
  
  METHODS
  Children replaced their AFO with a transcutaneous peroneal (fibular) nerve stimulation neuroprosthesis for 3 months.
  
  
  METHODS
  The ability to tolerate fitting and programming of the device, device-recorded wear time, a daily-use diary, satisfaction survey, and secondary measures, including passive range of motion and gait laboratory measurement of gait velocity and ankle kinematics.
  
  
  RESULTS
  All 10 participants (100%) tolerated fitting and programming of the neuroprosthesis and wore the device for 6 weeks. Seven of 10 (70%) wore the device for the entire 3-month study period; 6 of 10 (60%) continued to use the device after study completion. Wear time varied from 2 to 11 hours per day. Tolerability and satisfaction were high; although 6 participants complained of "size" and "bulkiness" of the device, and 2 reported skin irritation. Gait velocity increased in 5 subjects (50%). Seven participants (70%) preferred the neuroprosthesis to their AFO.
  
  
  CONCLUSIONS
  Analysis of the preliminary evidence suggests that electrical stimulation by a footdrop neuroprosthesis is tolerated well by children and is effective for the treatment of footdrop in children with hemiparetic cerebral palsy. Commercially available neuroprostheses may offer a promising alternative treatment option for children with footdrop.
authors: Department of Physical Medical, Marshfield Clinic, 1000 North Oak Ave, Marshfield, WI 54449, USA. meilahn.jill@marshfieldclinic.org
authors: Jill R
authors: JR
authors: Meilahn
mesh_terms: D000367:Age Factors; D002547:Cerebral Palsy / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D002648:Child; D005260:Female; D005684:Gait / Q000502:physiology; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009989:Orthotic Devices; D010291:Paresis / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D010349:Patient Compliance; D017060:Patient Satisfaction; D010543:Peroneal Nerve; D010865:Pilot Projects; D011446:Prospective Studies; D017755:Prosthesis Fitting; D057566:Self Report; D004561:Transcutaneous Electric Nerve Stimulation / Q000295:instrumentation*