title: Randomized controlled trial of surface peroneal nerve stimulation for motor relearning in lower limb hemiparesis.
abstract: OBJECTIVE
  To compare the motor relearning effect of a surface peroneal nerve stimulator (PNS) versus usual care on lower limb motor impairment, activity limitation, and quality of life among chronic stroke survivors.
  
  
  METHODS
  Single-blinded randomized controlled trial.
  
  
  METHODS
  Teaching hospital of academic medical center.
  
  
  METHODS
  Chronic stroke survivors (N=110; >12wk poststroke) with unilateral hemiparesis and dorsiflexion strength of ≤4/5 on the Medical Research Council scale.
  
  
  METHODS
  Subjects were stratified by motor impairment level and then randomly assigned to ambulation training with either a surface PNS device or usual care (ankle-foot orthosis or no device) intervention. Subjects were treated for 12 weeks and followed up for 6 months posttreatment.
  
  
  METHODS
  Lower limb portion of the Fugl-Meyer (FM) Assessment (motor impairment), the modified Emory Functional Ambulation Profile (mEFAP) performed without a device (functional ambulation), and the Stroke Specific Quality of Life (SSQOL) scale.
  
  
  RESULTS
  There was no significant treatment group main effect or treatment group by time interaction effect on FM, mEFAP, or SSQOL raw scores (P>.05). The time effect was significant for the 3 raw scores (P<.05). However, when comparing average change scores from baseline (t1) to end of treatment (t2, 12wk), and at 12 weeks (t3) and 24 weeks (t4) after end of treatment, significant differences were noted only for the mEFAP and SSQOL scores. The change in the average scores for both mEFAP and SSQOL occurred between t1 and t2, followed by relative stability thereafter.
  
  
  CONCLUSIONS
  There was no evidence of a motor relearning effect on lower limb motor impairment in either the PNS or usual-care groups. However, both the PNS and usual-care groups demonstrated significant improvements in functional mobility and quality of life during the treatment period, which were maintained at 6-month follow-up.
authors: Department of Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, OH 44109, USA. lsheffler@metrohealth.org
authors: Lynne R
authors: LR
authors: Sheffler
authors: Paul N
authors: PN
authors: Taylor
authors: Douglas D
authors: DD
authors: Gunzler
authors: Jaap H
authors: JH
authors: Buurke
authors: Maarten J
authors: MJ
authors: Ijzerman
authors: John
authors: J
authors: Chae
mesh_terms: D000328:Adult; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000503:physiopathology* / Q000534:rehabilitation*; D006801:Humans; D007866:Leg / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000503:physiopathology* / Q000534:rehabilitation*; D010543:Peroneal Nerve / Q000503:physiopathology*; D011788:Quality of Life; D018709:Statistics, Nonparametric; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
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